Original Article
Effect of Inhaled Triamcinolone on the Decline in Pulmonary Function in Chronic Obstructive Pulmonary Disease
N Engl J Med 2000; 343:1902-1909December 28, 2000
- Abstract
Background
Chronic obstructive pulmonary disease (COPD) results from a progressive decline in lung function, which is thought to be the consequence of airway inflammation. We hypothesized that antiinflammatory therapy with inhaled corticosteroids would slow this decline.
Methods
We enrolled 1116 persons with COPD whose forced expiratory volume in one second (FEV1) was 30 to 90 percent of the predicted value in a 10-center, placebo-controlled, randomized trial of inhaled triamcinolone acetonide administered at a dose of 600 μg twice daily. The primary outcome measure was the rate of decline in FEV1 after the administration of a bronchodilator. The secondary outcome measures included respiratory symptoms, use of health care services, and airway reactivity. In a substudy of 412 participants, we measured bone density in the lumbar spine and femur at base line and one and three years after the beginning of treatment.
Results
The mean duration of follow-up was 40 months. The rate of decline in the FEV1 after bronchodilator use was similar in the 559 participants in the triamcinolone group and the 557 participants in the placebo group (mean [±SE], 44.2±2.9 vs. 47.0±3.0 ml per year, P=0.50). Members of the triamcinolone group had fewer respiratory symptoms during the course of the study (21.1 per 100 person-years vs. 28.2 per 100 person-years, P=0.005) and had fewer visits to a physician because of a respiratory illness (1.2 per 100 person-years vs. 2.1 per 100 person-years, P=0.03). Those taking triamcinolone also had lower airway reactivity in response to methacholine challenge at 9 months and 33 months (P=0.02 for both comparisons). After three years, the bone density of the lumbar spine (P=0.007) and the femur (P<0.001) was significantly lower in the triamcinolone group.
Conclusions
Inhaled triamcinolone does not slow the rate of decline in lung function in people with COPD, but it improves airway reactivity and respiratory symptoms and decreases the use of health care services for respiratory problems. These benefits should be weighed against the potential long-term adverse effects of triamcinolone on bone mineral density.
Media in This Article
Figure 1
Decline in the Forced Expiratory Volume in One Second (FEV1) before (Panel A) and after (Panel B) the Use of a Bronchodilator.Table 1
Base-Line Characteristics of the 1116 Study Participants.Article Activity
- Article
Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States.1 COPD results mainly from cigarette smoking by susceptible persons and develops over years, with a progressive decline in lung function. Smoking cessation is the only intervention that effectively slows the decline in pulmonary function, but only 20 to 40 percent of patients succeed in quitting smoking.2 Because airway inflammation is thought to cause COPD, it has been hypothesized that antiinflammatory agents might slow progression of the disease.3-6
In persons with asthma, inhaled corticosteroids reduce airway inflammation, improve lung function, and reduce airway reactivity.7 In persons with COPD, there is some evidence that inhaled corticosteroids reduce airway inflammation,8,9 but the evidence is not consistent.10 Inhaled corticosteroids are recommended for symptomatic patients whose disease has responded to oral corticosteroids11 and are widely prescribed for patients with COPD.12,13 Three large European clinical trials of inhaled corticosteroids, given for three years to patients with COPD, have had inconsistent results; the first showed no benefit, the second showed an initial improvement in lung function with inhaled corticosteroids, and the third showed a nonsignificant trend toward benefit.14-16
We conducted a randomized, placebo-controlled clinical trial of inhaled corticosteroids in patients with COPD. The primary hypothesis was that inhaled corticosteroids would decrease the rate of decline of pulmonary function. The secondary hypothesis was that inhaled corticosteroids would reduce symptoms, morbidity, and airway reactivity without systemic adverse effects.
Methods
Enrollment of Participants
Participants were recruited from among those who had previously participated in or been screened for the Lung Health Study. The Lung Health Study was a trial of smoking cessation and the use of inhaled bronchodilators in 5887 smokers with airflow obstruction, conducted at 10 centers between November 1986 and May 1994.2,17 The enrollment period for the current study was from November 1994 to November 1995. The participants were 40 to 69 years of age and had airflow obstruction, with a ratio of forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) of less than 0.70 and a value for FEV1 that was 30 to 90 percent of the predicted value.18 All were current smokers or had quit within the previous two years. Candidates were excluded if they had medical conditions such as cancer, recent myocardial infarction, alcoholism, heart failure, insulin-dependent diabetes mellitus, and neuropsychiatric disorders, or if they had used bronchodilators or oral or inhaled corticosteroids in the previous year. The participants provided written informed consent, and the protocol was approved by the institutional review board at each of the 10 clinical centers. A data and safety monitoring board approved the protocol and reviewed trial data every six months to monitor performance, safety, and treatment effects.
Treatment Groups
Randomization occurred during the second base-line visit, after eligibility was established and consent had been given. The participants were randomly assigned to one of two treatment groups with stratification according to clinical center and smoking status (participants were current smokers or had recently quit). Those assigned to receive an inhaled corticosteroid were given metered-dose inhalers containing triamcinolone acetonide (Azmacort, Rhône–Poulenc Rorer) and delivering a dose of 100 μg per inhalation. Those in the placebo group were given identical inhalers containing only vehicle. For each group, six inhalations twice daily were prescribed, resulting in a dose of 1200 μg per day for the triamcinolone group. The participants and clinical center staff were unaware of the study-drug assignments.
Outcome Measures
The primary outcome measure was the rate of decline in the FEV1 after the administration of a bronchodilator, an indicator of the progression of COPD. Secondary outcome measures included respiratory symptoms, cause-specific morbidity and mortality, airway reactivity in response to methacholine, and health-related quality of life.
We performed spirometric measurements before and after two inhalations of isoproterenol.19 The participants underwent methacholine bronchial provocation with use of a dosimeter technique, beginning with the inhalation of five breaths of diluent and then breaths at increasing methacholine concentrations (1, 5, 10, and 25 mg per milliliter).20 The procedure ended when the FEV1 reached a value 20 percent below the FEV1 after the inhalation of diluent or when the maximal concentration had been reached. For safety, we performed the methacholine challenge only if the base-line FEV1 was at least 50 percent of the participant's predicted value.
We assessed respiratory symptoms with the American Thoracic Society–Division of Lung Diseases questionnaire.21 This questionnaire asks about smoking status and the presence and severity of cough, phlegm, wheezing, and breathlessness — symptoms associated with a higher risk of a rapid decline in lung function.22 Every three months, clinic staff asked the participants about new or worsening respiratory symptoms and potential side effects of corticosteroids, which were graded as mild, moderate, or severe.
Use of medical care during the previous interval was recorded every six months. Records of hospitalizations, emergency department visits, and nonroutine visits to a physician were obtained so that the reason for the care could be coded by a medical-records expert who was unaware of the participants' treatment assignments. Most records were subsequently classified by a morbidity and mortality review board, a panel of three physicians who were also unaware of treatment assignments. The board reviewed the medical records of participants who died to determine the causes of death. Eight aspects of health-related quality of life (physical function, social function, pain, physical and emotional role limitation, vitality, personal perceptions of health, and emotional well-being) were measured every year with use of the 36-item Medical Outcomes Study Short-Form General Health Survey (SF-36).23 The scale for each aspect ranges from 0 to 100, with a higher score indicating better health.
Screening Visits and Randomization
During the initial screening visit, we ascertained the patients' eligibility, administered questionnaires about health status and medication use, and conducted spirometry and bronchial provocation testing with methacholine. The second base-line visit included spirometry, the administration of questionnaires, and randomization. Clinic staff distributed an initial supply of inhalers with instructions on their use.
Counseling of Participants and Monitoring of Adherence
We measured adherence to treatment at each three-month visit by questioning the participants and by weighing returned canisters. We observed how the participants used their inhalers at each six-month visit and provided counseling to improve their technique or adherence as necessary. The participants were informed that they had abnormal pulmonary function resulting from cigarette smoking and were advised to quit. Those who requested assistance were referred to smoking-cessation programs. We provided transdermal nicotine patches for those who had a prescription from their physician. No other medications were provided as part of the study.
Data-Collection Schedule
The participants returned every three months to obtain new inhalers and to report respiratory symptoms or potential side effects. Every six months, the participants underwent spirometry and were interviewed about medical care during the preceding interval. At the first six-month visit, and annually thereafter, participants completed questionnaires on respiratory symptoms. Methacholine testing was repeated at the 9-month and 33-month visits. The participants were followed from randomization until a common ending date (April 30, 1999) 4 1/2 years after the initiation of the trial.
An ancillary study of bone mineral density was performed in a convenience sample of 412 participants at seven clinical centers. Bone scans were obtained with Hologic dual-energy x-ray absorptiometry scanners (model QDR 1000, 1000w, or 2000, Hologic, Bedford, Mass.). Scans of the lumbar spine and the femoral neck were obtained at base line and at the one-year and three-year visits. The scanners were cross-calibrated against a standard bone model that was circulated among the centers. The technical quality of digitized images was evaluated and bone density was determined at a central reading facility at the Mayo Clinic. No instructions were given to participants regarding the use of calcium or vitamin D supplements.
Statistical Analysis
The target enrollment of 1100 participants was designed to enable the study to detect a mean difference of 12.5 ml per year between the treatment groups in the degree of change in the FEV1, with a two-sided P value of 0.05 and a power of 85 percent, on the assumption that follow-up would be 90 percent complete and that the rate of adherence to the treatment protocol would be 50 percent. We defined satisfactory adherence as the use of six or more puffs per day, averaged over all study visits.
The primary study outcome was analyzed according to the intention-to-treat principle. Preliminary examination of the data indicated that the decline in FEV1 was approximately linear. The data were fitted to a linear longitudinal random-effects model24 to determine whether the treatment assignment altered the rate of decline in FEV1. Secondary analyses with adjustment for base-line covariates, including sex, age, smoking status, base-line lung function, and base-line bronchodilator response, were performed with use of a similar model with additional terms. The statistical analysis was performed with the SAS Proc Mixed procedure (SAS Institute).25 Similar analyses were conducted for the FEV1 before the use of a bronchodilator and the FVC before and after the use of a bronchodilator. Prespecified subgroup analyses performed with use of similar methods explored treatment effects according to sex and according to initial lung function, bronchodilator response, presence or absence of asthma diagnosed by a physician, airway reactivity, and presence or absence of wheezing at base line. We also examined the effect of treatment on the decline in FEV1 within subgroups of participants with similar rates of adherence to the use of inhalers.
Interim analyses of outcome measures were presented to the monitoring board six times during the final three years of the trial.26 No formal rules for stopping were adopted by the monitoring board, although the board did suggest consideration of halting the trial if the power of the study, conditional on the results of the interim analysis, fell below 15 percent, an event that did not occur.
The rates of health care use and of new or worsening respiratory symptoms were compared according to treatment group with use of the Wilcoxon rank-sum test. The dyspnea and wheezing scales and airway reactivity in response to methacholine were treated as ordered categorical variables. These variables were also compared by means of the Wilcoxon rank-sum test. Comparisons of overall and cause-specific mortality were performed with use of life-table methods and the log-rank test. Other quantitative variables were compared with use of the t-test.
We report quantitative base-line characteristics as means ±SD and outcome measures as means ±SE or as percentages within groups. The reported P values are two-sided, and the P values for comparisons of treatment groups have not been adjusted for multiple comparisons or interim analyses.
Results
Base-Line Characteristics
A total of 1116 participants were enrolled, out of 1347 candidates who completed initial in-clinic screening. The most common reason for exclusion was failure to meet the pulmonary-function criteria. The mean age of the participants was 56 years at entry. In general, the two treatment groups were well matched with respect to base-line characteristics (Table 1Table 1
Base-Line Characteristics of the 1116 Study Participants.). They had mild-to-moderate abnormalities of pulmonary function, with an FEV1 before bronchodilator use of 64.1±13.3 percent of the predicted value. The triamcinolone group had slightly better base-line lung function. About 35 percent of the participants reported having daily cough and phlegm for three or more months during the previous year, and 41 percent reported some breathlessness. Ninety percent of the participants were smokers, with an average daily consumption of 23.5±12.7 cigarettes. Ten percent were former smokers.Follow-up and Adherence
During follow-up, 90.7 percent of the pulmonary-function tests and 95.0 percent of the questionnaires were completed. The mean duration of follow-up was 40.0 months. At the final visit, we obtained questionnaire data from 96 percent of the participants and performed pulmonary-function tests in 92 percent. The rate of satisfactory adherence to the treatment protocol was 68.9 percent for the placebo group and 69.4 percent for the triamcinolone group, according to the participants' reports; the rates were 58.5 percent for placebo and 53.7 percent for triamcinolone, according to canister weights. Sixty-six participants (38 in the placebo group and 28 in the triamcinolone group) permanently discontinued the study drug. Twelve of these (4 in the placebo group and 8 in the triamcinolone group) stopped because of side effects, and 17 (12 and 5, respectively) stopped because their physicians prescribed an inhaled corticosteroid other than triamcinolone for treatment of their respiratory disease. Other reasons for discontinuation included difficulty in adhering to the regimen, perceived lack of efficacy, and the advice of their personal physician. During the trial, the smoking rates declined to 75.3 percent among those who were current smokers at the beginning of the trial and increased to 23.8 percent among those who were former smokers at the beginning of the trial. At the end of the study, 71.4 percent of all participants were smoking, and the percentage of smokers did not differ significantly between the treatment groups.
Pulmonary Function
There were no significant effects of treatment assignment on the decline in the FEV1 or the FVC either before or after bronchodilator use (Table 2Table 2
Outcome Measures. and Figure 1Figure 1Decline in the Forced Expiratory Volume in One Second (FEV1) before (Panel A) and after (Panel B) the Use of a Bronchodilator.). The mean decline in the FEV1 after bronchodilator use in the triamcinolone group was 44.2±2.9 ml per year, as compared with 47.0±3.0 ml per year in the placebo group (95 percent confidence interval for the difference, –11.0 to 5.4 ml per year) (Table 2 and Figure 1). At base line the triamcinolone and placebo groups had similar airway reactivity in response to methacholine (Table 1). However, at 9 and 33 months, the triamcinolone group had less reactivity in response to methacholine than the placebo group (P=0.02 for both comparisons) (Table 2).Symptoms and Respiratory Illness and Death
The incidence of respiratory symptoms over the preceding 12 months, as reported on the American Thoracic Society–Division of Lung Diseases questionnaire at the 36-month visit, did not differ significantly between the treatment groups, with the exception of dyspnea, which was more frequent in the placebo group (P=0.02) (Table 2). Unscheduled physicians' visits and hospitalization for respiratory conditions were less frequent in the triamcinolone group. There were no significant differences between the groups in the rate of visits to an emergency department (not resulting in hospitalization) for either respiratory or nonrespiratory conditions, or in the rate of all health care visits (visits to a physician, visits to an emergency department, and hospitalizations) for nonrespiratory conditions. Thirty-four participants (15 taking triamcinolone and 19 taking placebo) died during the trial. Cancer was the most common cause of death. There was no significant difference between the treatment groups in overall mortality, but there were more deaths from cancers other than lung cancer in the placebo group (P=0.02). None of the eight quality-of-life aspects showed changes associated with treatment assignment except the score on the mental health subscale, which was slightly worse at 36 months in the triamcinolone group (decrease from base line, 2.3±0.6 vs. 0.1±0.7 on a scale of 100; P=0.03, without adjustment for multiple comparisons).
Side Effects
Thrush developed in five participants taking triamcinolone and in two taking placebo (P=0.26). Those taking placebo were more likely to report moderate or severe mouth irritation than those taking triamcinolone (2.3 percent vs. 1.1 percent per year, P=0.02). Those taking triamcinolone were more likely to report moderate or severe degrees of easy bruising than those taking placebo (0.8 percent vs. 0.4 percent per year, P=0.16). There were no significant differences between the groups in the number of participants reporting cataracts (122 taking triamcinolone and 114 taking placebo), diabetes, or myopathy. Technically satisfactory bone scans of the lumbar spine were obtained at base line, one year, and three years in 328 participants, and satisfactory scans of the femoral neck in 359 participants. After three years, those taking triamcinolone had a higher percentage decrease from base line in the bone density at the lumbar spine and the femoral neck than those taking placebo (Table 3Table 3
Bone Mineral Density of Participants for Whom All Three Measurements Were Available.). Increased bone demineralization was evident in both men and women (data not shown).Discussion
Our main finding is that the inhaled corticosteroid triamcinolone acetonide, given at a dose of 1200 μg per day, has no significant effect on the rate of decline in the FEV1 in persons with mild-to-moderate COPD. Although we did not exclude those with asthma, we did exclude those who regularly used bronchodilators or corticosteroids. Thus, we effectively excluded people with symptomatic asthma. Other studies of the use of inhaled corticosteroids in patients with COPD have tended to show greater benefit in those whose disease has more asthma-like characteristics.27 Our analyses of subgroups defined according to the degree of airway reactivity, severity of wheezing, and presence or absence of a diagnosis of asthma did not identify any group that benefited in terms of the decline in the FEV1. Despite counseling to promote adherence to the use of inhalers, only slightly more than half the participants used the inhalers at a satisfactory level — a rate similar to that for patients with asthma for whom inhaled corticosteroids are prescribed.28,29 Although nonadherence may have obscured an effect of treatment, there was no clear benefit associated with triamcinolone among the participants with better adherence.
Although we found no significant association between triamcinolone use and chronic cough, production of phlegm, or wheezing, there was less dyspnea and fewer new or worsening respiratory symptoms in those who used triamcinolone (Table 2). Furthermore, there were fewer visits to physicians and hospitalizations for respiratory illnesses in the triamcinolone group.
It is unclear whether our findings can be extrapolated to other doses or formulations of inhaled corticosteroids. Although inhaled corticosteroids differ in absorption, metabolism, and potency, all have similar effects on airway inflammation and reactivity in patients with asthma. Triamcinolone treatment did reduce airway reactivity, suggesting that airway inflammation decreased. Reduced airway reactivity may have been responsible for the reduced incidence of respiratory symptoms and the lower rate of health care visits for respiratory conditions in this group. The reason that inhaled corticosteroids provide less benefit to patients with COPD than to patients with asthma is not clear; inflammation in COPD may not respond as well to corticosteroids or may not be as tightly linked to the clinical course of the disease.30
Both men and women taking triamcinolone had more bone demineralization than those taking placebo. Whereas systemic corticosteroids have the greatest effect on bone in the first year of treatment, we found no effect until year 3, which suggests that prolonged monitoring for osteoporosis is necessary. We also found a trend toward more skin bruising in the triamcinolone group, which suggests a systemic effect on the fragility of capillaries. Although the decrease in the score on the mental-health subscale of the quality-of-life questionnaire could be a result of the use of corticosteroids, this association is probably spurious, because the effect was small and inconsistent with the results for other subscales.
Several clinical trials have examined the long-term use of inhaled corticosteroids for COPD, with conflicting outcomes.14-16,31-37 Some have found short-term increases in lung function or improvement in symptoms, whereas others have not. A meta-analysis38 of studies published from 1983 to 1996 found three acceptable studies enrolling a total of 183 patients with COPD and without asthma who were followed for two years or more. The meta-analysis concluded that inhaled corticosteroids slowed the decline in the FEV1 but did not prevent exacerbations.
Four trials of corticosteroids in COPD have been published recently. An international study of the use of fluticasone in 281 people found an improvement in the FEV1 and in symptoms over a period of six months.37 A Danish trial of budesonide in 290 people with mild COPD did not find a reduction in the decline in the FEV1 or a reduction in exacerbations over a period of three years.14 A three-year European study of 1277 smokers with mild-to-moderate COPD who were treated with budesonide found an initial improvement in the FEV1 but no change in the subsequent decline in the FEV1.15 A three-year British study of 751 patients with moderate-to-severe COPD who were treated with fluticasone showed initial improvement in the FEV1, with a trend toward a slower decline in the FEV1 and a reduction in exacerbations.16 Although smaller, short-term trials of inhaled corticosteroids have not shown improvement in airway reactivity,8,39 we found declines in airway reactivity in response to methacholine challenge at both 9 and 33 months.
In summary, we found that inhaled triamcinolone does not reduce the decline in the FEV1 in patients with COPD but is associated with less severe airway reactivity and reduced respiratory symptoms. Triamcinolone use is also associated with loss of bone mineral density and increased skin bruising. In patients with COPD, therefore, the symptomatic benefits of inhaled corticosteroids must be weighed against the potential long-term adverse effects. We observed no effect on the long-term progression of the disease.
Supported under a cooperative agreement with the National Institutes of Health (NHLBI-5U01-HL50267-05). Triamcinolone and placebo, as well as support for ancillary safety studies, were provided by Rhône–Poulenc Rorer (now Aventis).
The writing group (Robert Wise, M.D., John Connett, Ph.D., Gail Weinmann, M.D., Paul Scanlon, M.D., and Melissa Skeans, M.S.) assumes responsibility for the overall content and integrity of the manuscript.
Source Information
Address reprint requests to Dr. Connett at the Lung Health Study Coordinating Center, 2221 University Ave. SE, Suite 200, Minneapolis, MN 55414, or at john-c@biostat.umn.edu.
The members of the Lung Health Study Research Group are listed in the Appendix.
Appendix
The principal investigators and senior staff of the clinical and coordinating centers and of the National Heart, Lung, and Blood Institute, and the members of the Data and Safety Monitoring Board, were as follows: Case Western Reserve University, Cleveland — M.D. Altose (principal investigator), S. Redline (co-principal investigator), C.D. Deitz, and K.J. Quinlan; Henry Ford Hospital, Detroit — M.S. Eichenhorn (principal investigator), W.A. Conway (co-principal investigator), R.L. Jentons, K. Braden, and M. Ketchum; Johns Hopkins University School of Medicine, Baltimore — R.A. Wise (principal investigator), S. Permutt (co-principal investigator), C.S. Rand (co-principal investigator), M. Daniel, V. Santopietro, and K.A. Weeks; Mayo Clinic, Rochester, Minn. — P.D. Scanlon (principal investigator), A.M. Patel (co-principal investigator), J.P. Utz (co-principal investigator), D.E. Williams (co-principal investigator), G.M. Caron, and K.S. Mieras; Oregon Health Sciences University, Portland — A.S. Buist (principal investigator), L.R. Johnson (Lung Health Study pulmonary function coordinator), V.J. Bortz, S.L. Persons, and H.A. Schueler; University of Alabama at Birmingham — W.C. Bailey (principal investigator), C.M. Brooks (co-principal investigator), L.B. Gerald, and L. Montiel; University of California, Los Angeles — D.P. Tashkin (principal investigator), A.H. Coulson (co-principal investigator), E.C. Kleerup (co-principal investigator), V.C. Li (co-principal investigator), M.A. Nides, I.P. Zuniga, and Y.E. Lee; University of Manitoba, Winnipeg, Canada — N.R. Anthonisen (principal investigator), J. Manfreda (co-principal investigator), S.C. Rempel-Rossum, and J.M. Stoyko; Coordinating Center, University of Minnesota, Minneapolis — J.E. Connett (principal investigator), M.O. Kjelsberg (co-principal investigator), M.T. Bollenbeck, K.J. Kurnow, T.C. Madhok, M.A. Skeans, and H.T. Voelker; University of Pittsburgh, Pittsburgh — R.M. Rogers (principal investigator), G.R. Owens (principal investigator) (deceased), F.M. Vitale, and M.E. Pusateri; University of Utah, Salt Lake City — R.E. Kanner (principal investigator), G.M. Villegas, C. Esplin, and R.S. Stayner; Data and Safety Monitoring Board — R. Bascom, J.R. Landis, J.R. Maurer, Y. Phillips, S.I. Rennard, J.K. Stoller, I. Tager, and A. Thomas, Jr.; Mortality and Morbidity Review Board — R.E. Hyatt (Mayo Clinic, Rochester, Minn.), C.T. Lambrew (Maine Medical Center, Portland), and B.A. Mason (Oncology Hematology Associates, Philadelphia); National Heart, Lung, and Blood Institute, Bethesda, Md. — S.S. Hurd (director, Division of Lung Diseases), G. Weinmann (project officer), and M.C. Wu (Division of Epidemiology and Clinical Applications).
- References
References
1
Wise RA . Changing smoking patterns and mortality from chronic obstructive pulmonary disease. Prev Med 1997;26:418-421
CrossRef | Web of Science | Medline2
Anthonisen NR ,Connett JE ,Kiley JP , et al. Effects of smoking intervention and the use of an inhaled anticholinergic bronchodilator on the rate of decline of FEV1: the Lung Health Study. JAMA 1994;272:1497-1505
CrossRef | Web of Science | Medline3
Finkelstein R ,Fraser RS ,Ghezzo H ,Cosio MG . Alveolar inflammation and its relation to emphysema in smokers. Am J Respir Crit Care Med 1995;152:1666-1672
Web of Science | Medline4
Stanescu D ,Sanna A ,Veriter C , et al. Airways obstruction, chronic expectoration, and rapid decline of FEV1 in smokers are associated with increased levels of sputum neutrophils. Thorax 1996;51:267-271
CrossRef | Web of Science | Medline5
van Schayck CP ,van Grunsven PM ,Dekhuijzen PN . Do patients with COPD benefit from treatment with inhaled corticosteroids? Eur Respir J 1996;9:1969-1972
CrossRef | Web of Science | Medline6
Kerstjens HA ,Brand PL ,Postma DS . Risk factors for accelerated decline among patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1996;154:S266-S272
Web of Science | Medline7
Juniper EF ,Kline PA ,Vanzieleghem MA ,Ransdale EH ,O'Byrne PM ,Hargreave FE . Effect of long-term treatment with an inhaled corticosteroid (budesonide) on airway hyperresponsiveness and clinical asthma in nonsteroid-dependent asthmatics. Am Rev Respir Dis 1990;142:832-836
Web of Science | Medline8
Rutgers SR ,Koeter GH ,van der Mark TW ,Postma DS . Short-term treatment with budesonide does not improve hyperresponsiveness to adenosine 5'-monophosphate in COPD. Am J Respir Crit Care Med 1998;157:880-886
Web of Science | Medline9
Confalonieri M ,Mainardi E ,Della Porta R , et al. Inhaled corticosteroids reduce neutrophilic bronchial inflammation in patients with chronic obstructive pulmonary disease. Thorax 1998;53:583-585
CrossRef | Web of Science | Medline10
Keatings VM ,Jatakanon A ,Worsdell YM ,Barnes PJ . Effects of inhaled and oral glucocorticoids on inflammatory indices in asthma and COPD. Am J Respir Crit Care Med 1997;155:542-548
Web of Science | Medline11
The COPD Guidelines Group of the Standards of Care Committee of the BTS
CrossRef | Web of Science | Medline12
Jackevicius CA ,Chapman KR . Prevalence of inhaled corticosteroid use among patients with chronic obstructive pulmonary disease: a survey. Ann Pharmacother 1997;31:160-164
Web of Science | Medline13
Jackevicius C ,Joyce DP ,Kesten S ,Chapman KR . Prehospitalization inhaled corticosteroid use in patients with COPD or asthma. Chest 1997;111:296-302
CrossRef | Web of Science | Medline14
Vestbo J ,Sorensen T ,Lange P ,Brix A ,Torre P ,Viskum K . Long-term effect of inhaled budesonide in mild and moderate chronic obstructive pulmonary disease: a randomised controlled trial. Lancet 1999;353:1819-1823
CrossRef | Web of Science | Medline15
Pauwels RA ,Lofdahl C-G ,Laitinen LA , et al. Long-term treatment with inhaled budesonide in persons with mild chronic obstructive pulmonary disease who continue smoking. N Engl J Med 1999;340:1948-1953
Full Text | Web of Science | Medline16
Burge PS ,Calverley PMA ,Jones PW ,Spencer S ,Anderson JA ,Maslen TK . Randomised, double blind, placebo controlled study of fluticasone propionate in patients with moderate to severe chronic obstructive pulmonary disease: the ISOLDE trial. BMJ 2000;320:1297-1303
CrossRef | Web of Science | Medline17
Buist AS ,Connett JE ,Miller RD ,Kanner RE ,Owens GR ,Voelker HT . Chronic Obstructive Pulmonary Disease Early Intervention Trial (Lung Health Study): baseline characteristics of randomized participants. Chest 1993;103:1863-1872
CrossRef | Web of Science | Medline18
Crapo RO ,Morris AH ,Gardner RM . Reference spirometric values using techniques and equipment that meet ATS recommendations. Am Rev Respir Dis 1981;123:659-664
Web of Science | Medline19
Enright PL ,Johnson LR ,Connett JE ,Voelker H ,Buist AS . Spirometry in the Lung Health Study. I. Methods and quality control. Am Rev Respir Dis 1991;143:1215-1223
Web of Science | Medline20
Tashkin DP ,Altose MD ,Bleecker ER , et al. The Lung Health Study: airway responsiveness to inhaled methacholine in smokers with mild to moderate airflow limitation. Am Rev Respir Dis 1992;145:301-310
CrossRef | Web of Science | Medline21
Ferris BG . Epidemiology Standardization Project. Am Rev Respir Dis 1978;118:1-120
Web of Science | Medline22
Sherman CB ,Xu X ,Speizer FE ,Ferris BG Jr ,Weiss ST ,Dockery DW . Longitudinal lung function decline in subjects with respiratory symptoms. Am Rev Respir Dis 1992;146:855-859
Web of Science | Medline23
Harper R ,Brazier JE ,Waterhouse JC ,Walters SJ ,Jones NM ,Howard P . Comparison of outcome measures for patients with chronic obstructive pulmonary disease (COPD) in an outpatient setting. Thorax 1997;52:879-887
CrossRef | Web of Science | Medline24
Laird NM ,Ware JH . Random-effects models for longitudinal data. Biometrics 1982;38:963-974
CrossRef | Web of Science | Medline25
SAS/STAT software: changes and enhancements through release 6.12. Cary N.C.: SAS Institute, 1997.
26
Lan KKG ,Simon R ,Halperin M . Stochastically curtailed tests in long-term clinical trials. Commun Stat 1982;1:207-21927
Kerstjens HA ,Overbeek SE ,Schouten JP ,Brand PL ,Postma DS . Airways hyperresponsiveness, bronchodilator response, allergy and smoking predict improvement in FEV1 during long-term inhaled corticosteroid treatment. Eur Respir J 1993;6:868-876
Web of Science | Medline28
Coutts JA ,Gibson NA ,Paton JY . Measuring compliance with inhaled medication in asthma. Arch Dis Child 1992;67:332-333
CrossRef | Web of Science | Medline29
Apter AJ ,Reisine ST ,Affleck G ,Barrows E ,ZuWallack RL . Adherence with twice-daily dosing of inhaled steroids: socioeconomic and health-belief differences. Am J Respir Crit Care Med 1998;157:1810-1817
Web of Science | Medline30
Boushey HA . Glucocorticoid therapy for chronic obstructive pulmonary disease. N Engl J Med 1999;340:1990-1991
Full Text | Web of Science | Medline31
Kerstjens HAM ,Brand PLP ,Hughes MD , et al. A comparison of bronchodilator therapy with or without inhaled corticosteroid therapy for obstructive airways disease. N Engl J Med 1992;327:1413-1419
Full Text | Web of Science | Medline32
Dompeling E ,van Schayck CP ,van Grunsven PM , et al. Slowing the deterioration of asthma and chronic obstructive pulmonary disease observed during bronchodilator therapy by adding inhaled corticosteroids: a 4-year prospective study. Ann Intern Med 1993;118:770-778
Web of Science | Medline33
Dompeling E ,van Schayck CP ,Molema J ,Folgering H ,van Grunsven PM ,van Weel C . Inhaled beclomethasone improves the course of asthma and COPD. Eur Respir J 1992;5:945-952
Web of Science | Medline34
Weiner P ,Weiner M ,Azgad Y ,Zamir D . Inhaled budesonide therapy for patients with stable COPD. Chest 1995;108:1568-1571
CrossRef | Web of Science | Medline35
Renkema TE ,Schouten JP ,Koeter GH ,Postma DS . Effects of long-term treatment with corticosteroids in COPD. Chest 1996;109:1156-1162
CrossRef | Web of Science | Medline36
Bourbeau J ,Rouleau MY ,Boucher S . Randomised controlled trial of inhaled corticosteroids in patients with chronic obstructive pulmonary disease. Thorax 1998;53:477-482
CrossRef | Web of Science | Medline37
Paggiaro PL ,Dahle R ,Bakran I ,Frith L ,Hollingworth K ,Efthimiou J . Multicentre randomised placebo-controlled trial of inhaled fluticasone propionate in patients with chronic obstructive pulmonary disease. Lancet 1998;351:773-780[Erratum, Lancet 1998;351:1968.]
CrossRef | Web of Science | Medline38
van Grunsven PM ,van Schayck CP ,Derenne JP , et al. Long term effects of inhaled corticosteroids in chronic obstructive pulmonary disease: a meta-analysis. Thorax 1999;54:7-14
CrossRef | Web of Science | Medline39
Weir DC ,Burge PS . Effects of high dose inhaled beclomethasone dipropionate, 750 micrograms and 1500 micrograms twice daily, and 40 mg per day oral prednisolone on lung function, symptoms, and bronchial hyperresponsiveness in patients with non-asthmatic chronic airflow obstruction. Thorax 1993;48:309-316
CrossRef | Web of Science | Medline
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1
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CrossRef50
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CrossRef51
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CrossRef52
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CrossRef53
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CrossRef54
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CrossRef56
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CrossRef57
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CrossRef58
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CrossRef59
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CrossRef60
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CrossRef61
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CrossRef62
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CrossRef63
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CrossRef64
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CrossRef66
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CrossRef67
Nicola A. Hanania, Amir Sharafkhaneh. (2007) Update on the Pharmacologic Therapy for Chronic Obstructive Pulmonary Disease. Clinics in Chest Medicine 28:3, 589-607
CrossRef68
D. Bellamy, J. Smith. (2007) Role of primary care in early diagnosis and effective management of COPD. International Journal of Clinical Practice 61:8, 1380-1389
CrossRef69
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CrossRef70
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CrossRef71
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CrossRef72
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CrossRef73
Sabina A Antoniu, Traian Mihaescu, & Claudio F Donner. (2007) Inhaled therapy for stable chronic obstructive pulmonary disease. Expert Opinion on Pharmacotherapy 8:6, 777-785
CrossRef74
Basil Varkey. (2007) Weighing the benefits and risks of inhaled corticosteroids. Current Opinion in Pulmonary Medicine 13:2, 89
CrossRef75
Don Hayes, Keith C Meyer. (2007) Acute Exacerbations of Chronic Bronchitis in Elderly Patients. Drugs & Aging 24:7, 555-572
CrossRef76
Jia Liu, Alessandra Sandrini, Michelle C. Thurston, Deborah H. Yates, Paul S. Thomas. (2007) Nitric Oxide and Exhaled Breath Nitrite/Nitrates in Chronic Obstructive Pulmonary Disease Patients. Respiration 74:6, 617-623
CrossRef77
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CrossRef78
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CrossRef79
Maureen P M H Rutten-van M??lken, Floortje E van Nooten, Marion Lindemann, Manfred Caeser, Peter M A Calverley. (2007) A 1-Year Prospective Cost-Effectiveness Analysis of Roflumilast for the Treatment of Patients with Severe Chronic Obstructive Pulmonary Disease. PharmacoEconomics 25:8, 695-711
CrossRef80
Masakazu Ichinose. (2007) 2. Advances in Pharmacotherapy for COPD. Internal Medicine 46:2, 81-84
CrossRef81
Laura Meinke, Rajinder Chitkara, Ganesh Krishna. (2007) Advances in the management of chronic obstructive pulmonary disease. Expert Opinion on Pharmacotherapy 8:1, 23-37
CrossRef82
Paolo Montuschi. (2006) Pharmacological treatment of chronic obstructive pulmonary disease. International Journal of COPD 1:4, 409-423
CrossRef83
TRJ Schermer, NH Chavannes, AJC Hendriks, PNR Dekhuijzen, EFM Wouters, H Hoogen, CP Schayck, C Weel. (2006) Stoppen van onderhoudsbehandeling met inhalatiesteroïden bij COPD. Huisarts en Wetenschap 49:11, 777-784
CrossRef84
2006. Chronic Obstructive Pulmonary Disease. .
CrossRef85
C. F. McDonald, R. M. D. Zebaze, E. Seeman. (2006) Calcitriol does not prevent bone loss in patients with asthma receiving corticosteroid therapy: a double-blind placebo-controlled trial. Osteoporosis International 17:10, 1546-1551
CrossRef86
Miguel A. Martínez-García, Miguel Perpiñá-Tordera, Pilar Román-Sánchez, Juan Jose Soler-Cataluña. (2006) Inhaled steroids improve quality of life in patients with steady-state bronchiectasis. Respiratory Medicine 100:9, 1623-1632
CrossRef87
E. Q. Wu, H. G. Birnbaum, M. Cifaldi, Y. Kang, D. Mallet, G. Colice. (2006) Development of a COPD severity score. Current Medical Research and Opinion 22:9, 1679-1687
CrossRef88
Yumin ZHOU, Xiaoping WANG, Xiangyi ZENG, Rong QIU, Junfeng XIE, Shengming LIU, Jingping ZHENG, Nanshan ZHONG, Pixin RAN. (2006) Positive benefits of theophylline in a randomized, double-blind, parallel-group, placebo-controlled study of low-dose, slow-release theophylline in the treatment of COPD for 1 year. Respirology 11:5, 603-610
CrossRef89
K F Chung. (2006) Salmeterol/fluticasone combination in the treatment of COPD. International Journal of COPD 1:3, 235-242
CrossRef90
Diahn-Warng Perng, Cheng-Che Wu, Kang-Cheng Su, Yu-Chin Lee, Reury-Perng Perng, Chi-Wei Tao. (2006) Inhaled Fluticasone and Salmeterol Suppress Eosinophilic Airway Inflammation in Chronic Obstructive Pulmonary Disease: Relations with Lung Function and Bronchodilator Reversibility. Lung 184:4, 217-222
CrossRef91
V. Tsagaraki, S. L. Markantonis, A. Amfilochiou. (2006) Pharmacotherapeutic management of COPD patients in Greece – adherence to international guidelines. Journal of Clinical Pharmacy and Therapeutics 31:4, 369-374
CrossRef92
David M Mannino, Victor A Kiri. (2006) Changing the burden of COPD mortality. International Journal of COPD 1:3, 219-233
CrossRef93
Luigi G. Franciosi, Clive P. Page, Bartolome R. Celli, Mario Cazzola, Michael J. Walker, Meindert Danhof, Klaus F. Rabe, Oscar E. Della Pasqua. (2006) Markers of disease severity in chronic obstructive pulmonary disease. Pulmonary Pharmacology & Therapeutics 19:3, 189-199
CrossRef94
Douglas W. Mapel, Judith S. Hurley, Douglas Roblin, Melissa Roberts, Kourtney J. Davis, Robert Schreiner, Floyd J. Frost. (2006) Survival of COPD patients using inhaled corticosteroids and long-acting beta agonists. Respiratory Medicine 100:4, 595-609
CrossRef95
Raffaele Antonelli-Incalzi, Claudio Pedone. (2006) Treatment of chronic obstructive pulmonary disease in older adults. Aging Health 2:2, 277-293
CrossRef96
David A Lipson. (2006) Tiotropium bromide. International Journal of COPD 1:2, 107-114
CrossRef97
Cristóbal Esteban, Javier Moraza, Jose M. Quintana, Mirian Aburto, Alberto Capelastegui. (2006) Use of medication and quality of life among patients with COPD. Respiratory Medicine 100:3, 487-495
CrossRef98
K. M. Beeh, J. Beier. (2006) Handle with care: targeting neutrophils in chronic obstructive pulmonary disease and severe asthma?. Clinical <html_ent glyph="@amp;" ascii="&"/> Experimental Allergy 36:2, 142-157
CrossRef99
M. C. Matheson, C. Abeysena, J. M. Raven, B. Skoric, D. P. Johns, M. J. Abramson, E. H. Walters. (2006) How have we been managing chronic obstructive pulmonary disease in Australia?. Internal Medicine Journal 36:2, 92-99
CrossRef100
Anne L. Fuhlbrigge, Seung Jin Bae, Scott T. Weiss, Karen M. Kuntz, A. David Paltiel. (2006) Cost-effectiveness of inhaled steroids in asthma: Impact of effect on bone mineral density. Journal of Allergy and Clinical Immunology 117:2, 359-366
CrossRef101
2006. Corticosteroids—glucocorticoids, inhaled. , 958-977.
CrossRef102
Shironjit Saha, Christopher E Brightling. (2006) Eosinophilic airway inflammation in COPD. International Journal of COPD 1:1, 39-47
CrossRef103
Joan B. Soriano. (2006) Corticoides inhalados y supervivencia en la EPOC. Archivos de Bronconeumología 42, 38-46
CrossRef104
Nicola Scichilone, Salvatore Battaglia, Alba La Sala, Vincenzo Bellia. (2006) Clinical implications of airway hyper-responsiveness in COPD. International Journal of COPD 1:1, 49-60
CrossRef105
Kiyoshi Takayama. (2006) Folia Pharmacologica Japonica 127:4, 304-307
CrossRef106
Thomas L Petty. (2006) The history of COPD. International Journal of COPD 1:1, 3-14
CrossRef107
M. Lindsay, A. Lee, K. Chan, P. Poon, L. K. Han, W. C. W. Wong, S. Wong. (2005) Does pulmonary rehabilitation give additional benefit over tiotropium therapy in primary care management of chronic obstructive pulmonary disease? Randomized controlled clinical trial in Hong Kong Chinese. Journal of Clinical Pharmacy and Therapeutics 30:6, 567-573
CrossRef108
Ilknur Basyigit, Fusun Yildiz, Sevgiye Kacar Ozkara, Elif Yildirim, Hasim Boyaci, Ahmet Ilgazli. (2005) Addition of inhaled corticosteroid on combined bronchodilator therapy in patients with COPD. Pulmonary Pharmacology & Therapeutics 18:6, 422-426
CrossRef109
N. Roche, G. Huchon. (2005) Reducing airways inflammation to prevent exacerbations in chronic obstructive pulmonary disease. Allergy 60:11, 1350-1356
CrossRef110
Roy A. Pleasants, Douglas Haden. (2005) An Update on Chronic Obstructive Pulmonary Disease. The Consultant Pharmacist 20:11, 965-975
CrossRef111
Matthias John, Susanne Bosse, Ute Oltmanns, Axel Schumacher, Christian Witt. (2005) Effects of inhaled HFA beclomethasone on pulmonary function and symptoms in patients with chronic obstructive pulmonary disease. Respiratory Medicine 99:11, 1418-1424
CrossRef112
Ilana IG Greenstone, Muireann Ni Chroinin, Toby J Lasserson, Francine Ducharme, Ilana IG Greenstone. 2005. Combination of inhaled long-acting beta2-agonists and inhaled steroids versus higher dose of inhaled steroids in children and adults with persistent asthma. .
CrossRef113
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CrossRef114
Kevin J. Mortimer, Anne E. Tattersfield. (2005) Benefit Versus Risk for Oral, Inhaled, and Nasal Glucocorticosteroids. Immunology and Allergy Clinics of North America 25:3, 523-539
CrossRef115
Julia AE Walters, E. Haydn Walters, Richard Wood-Baker, Julia AE Walters. 2005. Oral corticosteroids for stable chronic obstructive pulmonary disease. .
CrossRef116
A.G.N. Agusti. (2005) COPD, a multicomponent disease: implications for management. Respiratory Medicine 99:6, 670-682
CrossRef117
Donald P Tashkin. (2005) Is a long-acting inhaled bronchodilator the first agent to use in stable chronic obstructive pulmonary disease?. Current Opinion in Internal Medicine 4:3, 303-310
CrossRef118
Allegra Rich. (2005) Corticosteroids and Chronic Obstructive Pulmonary Disease in the Nursing Home. Journal of the American Medical Directors Association 6:3, S68-S74
CrossRef119
Peter Jeffery. (2005) Anti-inflammatory effects of inhaled corticosteroids in chronic obstructive pulmonary disease: similarities and differences to asthma. Expert Opinion on Investigational Drugs 14:5, 619-632
CrossRef120
Michael A. Campos, Adam Wanner. (2005) The Rationale for Pharmacologic Therapy in Stable Chronic Obstructive Pulmonary Disease. The American Journal of the Medical Sciences 329:4, 181-189
CrossRef121
Marc Decramer, Maureen Rutten-van Mölken, PN Richard Dekhuijzen, Thierry Troosters, Cees van Herwaarden, Riccardo Pellegrino, CP Onno van Schayck, Dario Olivieri, Mario Del Donno, Wilfried De Backer, Ida Lankhorst, Alfredo Ardia. (2005) Effects of N-acetylcysteine on outcomes in chronic obstructive pulmonary disease (Bronchitis Randomized on NAC Cost-Utility Study, BRONCUS): a randomised placebo-controlled trial. The Lancet 365:9470, 1552-1560
CrossRef122
M. Decramer, O. Selroos. (2005) Asthma and COPD: differences and similarities. International Journal of Clinical Practice 59:4, 385-398
CrossRef123
Takeshi Shinohara, Takeshi Kaneko, Yoji Nagashima, Atsuhisa Ueda, Akihiro Tagawa, Yoshiaki Ishigatsubo. (2005) Adenovirus-Mediated Transfer and Overexpression of Heme Oxygenase 1 cDNA in Lungs Attenuates Elastase-Induced Pulmonary Emphysema in Mice. Human Gene Therapy 16:3, 318-327
CrossRef124
Marcel Bonay, Catherine Bancal, Bruno Crestani. (2005) The risk/benefit of inhaled corticosteroids in chronic obstructive pulmonary disease. Expert Opinion on Drug Safety 4:2, 251-271
CrossRef125
Karen L. Rascati, Richard H. Stanford, Rohit Borker. (2005) A comparison of the risk of hospitalizations due to chronic obstructive pulmonary disease in medicaid patients with various medication regimens, including ipratropium, inhaled corticosteroids, salmeterol, or their combination. Clinical Therapeutics 27:3, 346-354
CrossRef126
Donald P Tashkin. (2005) Is a long-acting inhaled bronchodilator the first agent to use in stable chronic obstructive pulmonary disease?. Current Opinion in Pulmonary Medicine 11:2, 121-128
CrossRef127
S F Paul Man, Don D Sin. (2005) Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease. Drugs 65:5, 579-591
CrossRef128
Pranoy Barua, M Sinead O???Mahony. (2005) Overcoming Gaps in the Management of Asthma in Older Patients. Drugs & Aging 22:12, 1029-1059
CrossRef129
P. Casan Clarà. (2005) Corticoides inhalados: ¿a quién y cuándo?. Archivos de Bronconeumología 41, 21-23
CrossRef130
B.G. Cosío, A. Agustí. (2005) Empleo de esteroides inhalados en el tratamiento de la EPOC. Revista Clínica Española 205:1, 24-26
CrossRef131
J.M. Marín Trigo, A. Sánchez Barón. (2005) Valoración funcional del paciente con EPOC. Archivos de Bronconeumología 41, 18-23
CrossRef132
Kevin J. Mortimer, T.W. Harrison, A.E. Tattersfield. (2005) Effects of inhaled corticosteroids on bone. Annals of Allergy, Asthma & Immunology 94:1, 15-22
CrossRef133
Brian J Lipworth. (2005) Phosphodiesterase-4 inhibitors for asthma and chronic obstructive pulmonary disease. The Lancet 365:9454, 167-175
CrossRef134
P. de Lucas Ramos, J.M. Rodríguez González-Moro, S. López Martín. (2005) Controversias farmacológicas reflejadas en las guías y normativas nacionales e internacionales. Archivos de Bronconeumología 41, 32-37
CrossRef135
Mark T Dransfield, William C Bailey. (2005) Maintenance pharmacotherapy of chronic obstructive pulmonary disease: an evidence-based approach. Expert Opinion on Pharmacotherapy 6:1, 13-25
CrossRef136
Allegra Rich. (2005) Corticosteroids and Chronic Obstructive Pulmonary Disease in the Nursing Home. Journal of the American Medical Directors Association 6:SUPPLEMENT, S67???S74
CrossRef137
Monali J Bhosle, Rahul A Shenolikar, Amit S Kulkarni, Rajesh Balkrishnan. (2004) Outcomes associated with inhaled corticosteroid use in asthma and COPD: an update. Expert Review of Pharmacoeconomics & Outcomes Research 4:6, 645-656
CrossRef138
M. Romagnoli, F. Luppi, L. Corbetta, A. Papi, L. M. Fabbri. (2004) Management of fixed airflow limitation caused by asthma or chronic obstructive pulmonary disease. Clinical <html_ent glyph="@amp;" ascii="&"/> Experimental Allergy Reviews 4:s2, 205-211
CrossRef139
M. Pfeifer. (2004) Neue Therapiekonzepte bei COPD. Der Internist 45:12, 1395-1401
CrossRef140
Yasuhiro Tamura, Hiroko Okinaga, Hiroshi Takami. (2004) Glucocorticoid-induced osteoporosis. Biomedicine & Pharmacotherapy 58:9, 500-504
CrossRef141
Muireann Ni Chroinin, Ilana IG Greenstone, Francine Ducharme, Muireann Ni Chroinin. 2004. Addition of inhaled long-acting beta2-agonists to inhaled steroids as first line therapy for persistent asthma in steroid-naive adults. .
CrossRef142
Uwe R. Juergens, Tanja Engelen, Kurt Racké, Meinolf Stöber, Adrian Gillissen, Hans Vetter. (2004) Inhibitory activity of 1,8-cineol (eucalyptol) on cytokine production in cultured human lymphocytes and monocytes. Pulmonary Pharmacology & Therapeutics 17:5, 281-287
CrossRef143
Olof Selroos. (2004) The place of inhaled corticosteroids in chronic obstructive pulmonary disease. Current Medical Research and Opinion 20:10, 1579-1593
CrossRef144
Peter J Barnes, Trevor T Hansel. (2004) Prospects for new drugs for chronic obstructive pulmonary disease. The Lancet 364:9438, 985-996
CrossRef145
Stephen I Rennard. (2004) Treatment of stable chronic obstructive pulmonary disease. The Lancet 364:9436, 791-802
CrossRef146
Mark T Dransfield, William C Bailey. (2004) Fluticasone propionate/salmeterol for the treatment of chronic-obstructive pulmonary disease. Expert Opinion on Pharmacotherapy 5:8, 1815-1826
CrossRef147
L Nannini, CJ Cates, TJ Lasserson, P Poole, Luis Javier Nannini. 2004. Combined corticosteroid and longacting beta-agonist in one inhaler for chronic obstructive pulmonary disease. .
CrossRef148
Sutherland, E. Rand, Cherniack, Reuben M., . (2004) Management of Chronic Obstructive Pulmonary Disease. New England Journal of Medicine 350:26, 2689-2697
Full Text149
Neil R. MacIntyre. (2004) Chronic Obstructive Pulmonary Disease. Pharmacotherapy 24:5 Part 2, 33S-43S
CrossRef150
Ganesh Krishna, Viji Sankaranarayanan, Rajinder K Chitkara. (2004) New therapies for chronic obstructive pulmonary disease. Expert Opinion on Investigational Drugs 13:3, 255-267
CrossRef151
Anita B Varkey. (2004) Chronic obstructive pulmonary disease in women. Current Opinion in Pulmonary Medicine 10:2, 98-103
CrossRef152
Kristin B Highland. (2004) Inhaled corticosteroids in chronic obstructive pulmonary disease. Current Opinion in Pulmonary Medicine 10:2, 113-119
CrossRef153
Linus H. Santo Tomas, Basil Varkey. (2004) Improving health-related quality of life in chronic obstructive pulmonary disease. Current Opinion in Pulmonary Medicine 10:2, 120-127
CrossRef154
Michael T. Halpern, Jordana K. Schmier, Maria D. Van Kerkhove, Michael Watkins, Chris J. Kalberg. (2004) Impact of long-term inhaled corticosteroid therapy on bone mineral density: results of a meta-analysis. Annals of Allergy, Asthma & Immunology 92:2, 201-207
CrossRef155
Richard Hubbard, Anne Tattersfield. (2004) Inhaled Corticosteroids, Bone Mineral Density and Fracture in Older People. Drugs & Aging 21:10, 631-638
CrossRef156
Allegra Rich. (2004) Corticosteroids and Chronic Obstructive Pulmonary Disease in the Nursing Home. Journal of the American Medical Directors Association 5:1, 31-37
CrossRef157
David A Lipson. (2004) Redefining Treatment in COPD. Treatments in Respiratory Medicine 3:2, 89-95
CrossRef158
J??rg D Leuppi, Roland M Bingisser. (2004) Pulmonary Rehabilitation Programs. Disease Management & Health Outcomes 12:5, 281-284
CrossRef159
D.C Grootendorst, S.A Gauw, N Benschop, P.J Sterk, P.S Hiemstra, K.F Rabe. (2003) Efficacy of the novel phosphodiesterase-4 inhibitor BAY 19-8004 on lung function and airway inflammation in asthma and chronic obstructive pulmonary disease (COPD). Pulmonary Pharmacology & Therapeutics 16:6, 341-347
CrossRef160
Michele A. Faulkner, Daniel E. Hilleman. (2003) Pharmacologic Treatment of Chronic Obstructive Pulmonary Disease: Past, Present, and Future. Pharmacotherapy 23:10, 1300-1315
CrossRef161
David B. Allen, Leonard Bielory, Hartmut Derendorf, Robert Dluhy, Gene L. Colice, Stanley J. Szefler. (2003) Inhaled Corticosteroids. Journal of Allergy and Clinical Immunology 112:3, S1-S40
CrossRef162
PMA Calverley, Paul Walker. (2003) Chronic obstructive pulmonary disease. The Lancet 362:9389, 1053-1061
CrossRef163
Roberto Walter Dal Negro, Carlo Pomari, Silvia Tognella, Claudio Micheletto. (2003) Salmeterol & Fluticasone 50 μg/250 μg bid in combination provides a better long-term control than salmeterol 50 μg bid alone and placebo in COPD patients already treated with theophylline. Pulmonary Pharmacology & Therapeutics 16:4, 241-246
CrossRef164
O Ethgen, V Tellier, W.B Sedrine, J De Maeseneer, C Gosset, J.-Y Reginster. (2003) Health-related quality of life and cost of ambulatory care in osteoporosis: how may such outcome measures be valuable information to health decision makers and payers?. Bone 32:6, 718-724
CrossRef165
J. Bousquet, M. Ndiaye, N. Ait-Khaled, I. Annesi-Maesano, A.-M. Vignola. (2003) Management of chronic respiratory and allergic diseases in developing countries. Focus on sub-Saharan Africa. Allergy 58:4, 265-283
CrossRef166
Sabina A Antoniu, Irina Mititiuc. (2003) Salmeterol/fluticasone combination in COPD: is together better?. Expert Review of Pharmacoeconomics & Outcomes Research 3:2, 121-124
CrossRef167
D.C Grootendorst, S.A Gauw, R Baan, J Kelly, R.D Murdoch, P.J Sterk, K.F Rabe. (2003) Does a single dose of the phosphodiesterase 4 inhibitor, cilomilast (15mg), induce bronchodilation in patients with chronic obstructive pulmonary disease?. Pulmonary Pharmacology & Therapeutics 16:2, 115-120
CrossRef168
Murray D. Altose. (2003) Approaches to slowing the progression of COPD. Current Opinion in Pulmonary Medicine 9:2, 125-130
CrossRef169
Thomas G. O'Riordan. (2003) Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease: New Trials and Old Practices. Journal of Aerosol Medicine 16:1, 1-8
CrossRef170
Peter J. Barnes. (2003) New Concepts in Chronic Obstructive Pulmonary Disease. Annual Review of Medicine 54:1, 113-129
CrossRef171
Don D Sin, S F Paul Man. (2003) Inhaled Corticosteroids in the Long-Term Management of Patients with Chronic Obstructive Pulmonary Disease. Drugs & Aging 20:12, 867-880
CrossRef172
Peter J Barnes. (2003) Therapy of chronic obstructive pulmonary disease. Pharmacology & Therapeutics 97:1, 87-94
CrossRef173
Abebaw M. Yohannes, Christopher C. Hardy. (2003) Treatment of Chronic Obstructive Pulmonary Disease in Older Patients. Drugs & Aging 20:3, 209-228
CrossRef174
Toru Oga, Koichi Nishimura, Mitsuhiro Tsukino, Takashi Hajiro, Susumu Sato, Akihiko Ikeda, Chikuma Hamada, Michiaki Mishima. (2002) Longitudinal changes in airflow limitation and airway hyperresponsiveness in patients with stable asthma. Annals of Allergy, Asthma & Immunology 89:6, 619-625
CrossRef175
Richard A. Feifer, Ronald Aubert, Robert R. Verbrugge, Mona Khalid. (2002) Disease Management Opportunities for Chronic Obstructive Pulmonary Disease: Gaps Between Guidelines and Current Practice. Disease Management 5:3, 143-156
CrossRef176
L. Fabbri, S. Rennard, A. Leff, B. O'Connor. (2002) Advances in the understanding and future therapy of COPD. Clinical & Experimental Allergy Reviews 2:4, 129-136
CrossRef177
P. Frith, D. McKenzie. (2002) Reply. Internal Medicine Journal 32:7, 362-363
CrossRef178
Hiroyuki Ohbayashi. (2002) Neutrophil elastase inhibitors as treatment for COPD. Expert Opinion on Investigational Drugs 11:7, 965-980
CrossRef179
Federico P. Gómez, Roberto Rodriguez-Roisin. (2002) Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines for chronic obstructive pulmonary disease. Current Opinion in Pulmonary Medicine 8:2, 81-86
CrossRef180
Rajinder K. Chitkara, Priscilla S. A. Sarinas. (2002) Recent advances in diagnosis and management of chronic bronchitis and emphysema. Current Opinion in Pulmonary Medicine 8:2, 126-136
CrossRef181
Diana C. Grootendorst, Klaus F. Rabe. (2002) Selective phosphodiesterase inhibitors for the treatment of asthma and chronic obstructive pulmonary disease. Current Opinion in Allergy and Clinical Immunology 2:1, 61-67
CrossRef182
Alan Jones, Jeanne K Fay, Michael L Burr, Mike Stone, Kerry Hood, Gwyn Roberts, Alan Jones. 2002. Inhaled corticosteroid effects on bone metabolism in asthma and mild chronic obstructive pulmonary disease. .
CrossRef183
Conroy A. Wong, Ganesamoorthy Subakumar, Paul M. Casey. (2002) Effects of asthma and asthma therapies on bone mineral density. Current Opinion in Pulmonary Medicine 8:1, 39-44
CrossRef184
Marcel Bonay, Catherine Bancal, Bruno Crestani. (2002) Benefits and Risks of Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease. Drug Safety 25:1, 57-71
CrossRef185
Sheila A Doggrell. (2001) Triamcinolone: new and old indications. Expert Opinion on Pharmacotherapy 2:7, 1177-1186
CrossRef186
Douglas C Johnson. (2001) A role for phosphodiesterase type-4 inhibitors in COPD?. The Lancet 358:9278, 256-257
CrossRef187
(2001) Inhaled Triamcinolone and Chronic Obstructive Pulmonary Disease. New England Journal of Medicine 344:20, 1553-1556
Full Text188
Sherwood Burge. (2001) Should Inhaled Corticosteroids be Used in the Long Term Treatment of Chronic Obstructive Pulmonary Disease?. Drugs 61:11, 1535-1544
CrossRef189
&NA;. (2001) Triamcinolone doesn't halt progression of COPD. Inpharma Weekly &NA;:1270, 14
CrossRef190
Mapp, Cristina Elisabetta, . (2000) Inhaled Glucocorticoids in Chronic Obstructive Pulmonary Disease. New England Journal of Medicine 343:26, 1960-1961
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