TY - JOUR T1 - Inhaled steroids and COPD JF - European Respiratory Journal JO - Eur Respir J SP - 523 LP - 524 DO - 10.1183/09031936.00030508 VL - 32 IS - 2 AU - C. B. Cooper AU - M. Decramer Y1 - 2008/08/01 UR - http://erj.ersjournals.com/content/32/2/523.abstract N2 - To the Editors: We read with interest the paper by Suissa et al. 1, in which he and his co-authors state that “the effectiveness of inhaled corticosteroids in treating chronic obstructive pulmonary disease remains doubtful.” They review the reported efficacy of inhaled corticosteroids (ICS), noting a lack of pulmonary function improvement but reduction in exacerbation frequency, and a meta-analysis showing reduced mortality 2. However, they conclude that these findings could be biased by methodological problems. One form of bias that they highlight is failure to follow patients after premature withdrawal from randomised clinical trials. Suissa et al. 1 opine that the TORCH (Towards a Revolution in COPD Health) 3 and OPTIMAL 4 studies have provided important evolution in understanding these issues. While both studies used intent-to-treat analysis, … ER -