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Inhaled corticosteroids (ICS) have had an interesting and evolving course in regard to their use in chronic obstructive pulmonary disease (COPD). They have moved from not being on the menu at all in the 1970s, trialled with great hope in the 1980s, widespread adoption in the 1990s, before falling under a shadow in the 2000s because of concerns over increased risk of pneumonia. However, the place of ICS in the management of COPD is now the subject of renewed interest. Although the initial ICS COPD trials that assessed rate of decline in lung function by measuring forced expiratory volume in 1 second as the primary outcome measure were negative, manufacturers persisted in looking for a role for ICS in COPD. Their efforts paid off with trials of ICS in …
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