In the first, double-blind, placebo-controlled study to investigate the effect of inhaled corticosteroids (ICS) on the immunopathology of bronchial biopsies in COPD, researchers found that ICS treatment had no effect on major inflammatory cell types, but did significantly improve disease symptoms and seriously reduce patient exacerbations. COPD is a slowly progressive airway disease caused by cigarette smoking that produces a major, non-reversible decline in lung function. In the 14-person placebo group of patients with advanced disease, there were a total of 10 exacerbations, compared with three among the 16 individuals in the treatment group. In addition, those persons who received ICS showed significant reductions in cough symptoms and sputum production, as well as exhibited less use of reliever medication. However, ICS patients did not demonstrate improvement in breathlessness, wheezing, exercise tolerance, or in a general feeling of well being. There was no significant change in lung function in either group. The investigators believe that ICS use does affect selected aspects of airway inflammation in COPD. The research appears in the second issue for June 2002 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine.
Expert points up value of use in advanced COPD
In an editorial, COPD expert Romain Pauwels, M.D., of the Department of Respiratory Disease, Ghent University Hospital, Ghent, Belgium, confirmed that the major benefits from ICS use in
COPD are fewer exacerbations, less progressive decline in health, and an additive effect to long-term 2 agonists on lung function and symptoms. In addition, he noted that there was indirect evidence of improved mortality rates for patients. However, Dr. Pauwels pointed out that the
bronchial biopsies taken in the COPD
Contact: Cathy Carlomagno
American Thoracic Society