From the authors

From the authors: M.A. Puhan raises several issues that are frequently used to argue against the use of inhaled corticosteroids (ICS) in chronic obstructive pulmonary disease (COPD). First, he implicitly equates hormone replacement (HRT) and celecoxib therapies with the use of ICS in COPD. This is neither fair nor justified based on the existing literature. Unlike these drugs, ICS have been vigorously evaluated through many large randomised controlled trials (RCTs). Over the past 20 yrs, clinical trials involving >7,000 patients (and 17,000 person-yrs of observation) have unequivocally demonstrated the benefits of ICS therapy in ameliorating symptoms, reducing exacerbations and improving health status in COPD 1, 2. In combination with long-acting …