Corticosteroid therapy for chronic obstructive pulmonary disease. Is it worth the risks?

The majority of patients with chronic obstructive pulmonary disease (COPD) do not appear to benefit from long-term corticosteroid therapy. Nevertheless, a small minority demonstrate a response to treatment that is so dramatic that it may be worth the risk of chronic corticosteroid use. A corticosteroid trial is indicated in the patient with COPD who remains symptomatic despite adequate and aggressive routine treatment. If substantial improvement is noted in pulmonary function, chronic corticosteroid treatment should be considered. In patients without an objective response, long-term corticosteroid therapy should not be continued.