Dear Paula Herke! According to GINA (2011), the effect of corticosteroids on pulmonary and systemic inflammation in COPD is ambiguous, so their role in the treatment of COPD is limited. Planned ICS therapy does not affect the reduction in FEV1 and has no effect on overall mortality of patients with COPD.

According to my observations in the pathogenesis of the disease is concomitant fungal and microbial infection. Therefore, the most the best therapeutic effect is observed in the complex treatment, which includes a long-acting bronchodilators, inhaled corticosteroids, antifungals, antibiotics, mucolytics.

As a relapse prevention of COPD is well proven 3-fold courses immunostimulation Broncho - Vaksom7 mg daily for 10 days and pulse therapy antimycotics in spring and autumn periods. In terms of diagnosis of the etiological factors of inflammation in the respiratory system in patients with COPD recommend to carry out a test on Paecilomycosis.

Regards, Alima Akhunova.

Dear Paula and Alima,

GINA guidelines are not going to be the best place to look, the GOLD 2014 update gives good informaiton on treatment of COPD and provides and overview of the evidence base for inhaled and oral corticosteroid therapy.

I think part of the answer to your question Paula is that airway inflammation will have systemic effects, that inhaled steroids will not penetrate mucus layers well and that inhaled therapy is often deposited centrally rather than peripherally. I'd advise reading the GOLD guidelines though.

Tom

www.goldcopd.org

Hm.