Inhaled glucocorticosteroids in the treatment of chronic obstructive pulmonary disease: the debate continues


A.V. Emelyanov, E.V. Leshenkova, G.R. Sergeeva

Department of Pulmonology, North-Western State Medical University n.a. I.I. Mechnikov, St. Petersburg, Russia
Chronic obstructive pulmonary disease (COPD) is a common disease characterized by persistent bronchial obstruction. Chronic airway inflammation, which occurs under the influence of tobacco smoke and pollutants, is important in its development and progression. The place of inhaled glucocorticosteroids (IGCS) in the treatment of COPD is one of the most controversial issues in recent years. This article discusses the role of IGCS in the treatment of COPD. The available results of clinical studies allow to recommend these drugs in case of combination of bronchial asthma and COPD. They are also indicated for patients with frequent exacerbations of COPD, despite therapy with long-acting bronchodilators and their combinations. The most likely predictor of IGCS efficacy as a part of dual (IGCS/long-acting β2-agonists [LABA]) and triple therapy (IGCS/LABA/long-acting anticholinergic agents [LAAHA]) is the frequency of exacerbations and the eosinophil blood level. Risk/benefit ratio must be taken into account in case of administration of these drugs.

About the Autors

Corresponding author: Alexander V. Emelyanov, MD, Professor, Head of the Department of Pulmonology NWSMU n.a. I.I. Mechnikov, St. Petersburg, Russia; tel. +7 (812) 970-71-88, e-mail:
Address: Kirochnaya str. 41, St. Petersburg, Russia, 191015

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