FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 340:1948-1953 June 24, 1999 Number 25 Next

	Full Text PDF Editorial by Boushey, H. A. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background and Methods Although patients with chronic obstructive pulmonary disease (COPD) should stop smoking, some do not. In a double-blind, placebo-controlled study, we evaluated the effect of the inhaled glucocorticoid budesonide in subjects with mild COPD who continued smoking. After a six-month run-in period, we randomly assigned 1277 subjects (mean age, 52 years; mean forced expiratory volume in one second [FEV₁], 77 percent of the predicted value; 73 percent men) to twice-daily treatment with 400 µg of budesonide or placebo, inhaled from a dry-powder inhaler, for three years.

Results Of the 1277 subjects, 912 (71 percent) completed the study. Among these subjects, the median decline in the FEV₁ after the use of a bronchodilator over the three-year period was 140 ml in the budesonide group and 180 ml in the placebo group (P=0.05), or 4.3 percent and 5.3 percent of the predicted value, respectively. During the first six months of the study, the FEV₁ improved at the rate of 17 ml per year in the budesonide group, as compared with a decline of 81 ml per year in the placebo group (P<0.001). From nine months to the end of treatment, the FEV₁ declined at similar rates in the two groups (P=0.39). Ten percent of the subjects in the budesonide group and 4 percent of those in the placebo group had skin bruising (P<0.001). Newly diagnosed hypertension, bone fractures, postcapsular cataracts, myopathy, and diabetes occurred in less than 5 percent of the subjects, and the diagnoses were equally distributed between the groups.

Conclusions In persons with mild COPD who continue smoking, the use of inhaled budesonide is associated with a small one-time improvement in lung function but does not appreciably affect the long-term progressive decline.

Source Information

From the Department of Respiratory Diseases, University Hospital, Ghent, Belgium (R.A.P.); the Department of Respiratory Medicine, University Hospital, Lund, Sweden (C.-G.L.); the Department of Medicine, University Central Hospital, Helsinki, Finland (L.A.L.); the Department of Epidemiology and Statistics, University of Groningen, Groningen, the Netherlands (J.P.S.); the Division of Respiratory Disease, University Hospital, Groningen, the Netherlands (D.S.P.); the Respiratory Division, Imperial College School of Medicine, Hammersmith Hospital, London (N.B.P.); and Clinical Research and Development, Astra Draco, Lund, Sweden (S.V.O.).

Address reprint requests to Dr. Pauwels at the Department of Respiratory Diseases, University Hospital, De Pintelaan 185, B9000 Ghent, Belgium, or at romain.pauwels{at}rug.ac.be.

Full Text of this Article

This article has been cited by other articles:

• Reilly, J. J. (2008). COPD and Declining FEV1 -- Time to Divide and Conquer?. NEJM 359: 1616-1618 [Full Text]  
• Tashkin, D. P., Celli, B., Senn, S., Burkhart, D., Kesten, S., Menjoge, S., Decramer, M., the UPLIFT Study Investigators, (2008). A 4-Year Trial of Tiotropium in Chronic Obstructive Pulmonary Disease. NEJM 359: 1543-1554 [Abstract] [Full Text]  
• Celli, B. R., Thomas, N. E., Anderson, J. A., Ferguson, G. T., Jenkins, C. R., Jones, P. W., Vestbo, J., Knobil, K., Yates, J. C., Calverley, P. M. A. (2008). Effect of Pharmacotherapy on Rate of Decline of Lung Function in Chronic Obstructive Pulmonary Disease: Results from the TORCH Study. Am. J. Respir. Crit. Care Med. 178: 332-338 [Abstract] [Full Text]  
• Celli, B. R. (2008). Update on the Management of COPD. Chest 133: 1451-1462 [Abstract] [Full Text]  
• Albert, P., Calverley, P. M. A. (2008). Drugs (including oxygen) in severe COPD. Eur Respir J 31: 1114-1124 [Abstract] [Full Text]  
• Falk, J. A., Minai, O. A., Mosenifar, Z. (2008). Inhaled and Systemic Corticosteroids in Chronic Obstructive Pulmonary Disease. Proc Am Thorac Soc 5: 506-512 [Abstract] [Full Text]  
• Chatila, W. M., Thomashow, B. M., Minai, O. A., Criner, G. J., Make, B. J. (2008). Comorbidities in Chronic Obstructive Pulmonary Disease. Proc Am Thorac Soc 5: 549-555 [Abstract] [Full Text]  
• Sears, M. R. (2008). Long-Acting Bronchodilators in COPD. Chest 133: 1057-1058 [Full Text]  
• Eisner, M. D., Iribarren, C., Yelin, E. H., Sidney, S., Katz, P. P., Ackerson, L., Lathon, P., Tolstykh, I., Omachi, T., Byl, N., Blanc, P. D. (2008). Pulmonary Function and the Risk of Functional Limitation in Chronic Obstructive Pulmonary Disease. Am J Epidemiol 167: 1090-1101 [Abstract] [Full Text]  
• Kunisaki, K. M., Rice, K. L., Janoff, E. N., Rector, T. S., Niewoehner, D. E. (2008). Exhaled nitric oxide, systemic inflammation, and the spirometric response to inhaled fluticasone propionate in severe chronic obstructive pulmonary disease: A prospective study. Therapeutic Advances in Respiratory Disease 2: 55-64 [Abstract]  
• Jarad, N. A., Giles, K. (2008). Risk factors for increased need for intravenous antibiotics for pulmonary exacerbations in adult patients with cystic fibrosis. Chronic Respiratory Disease 5: 29-33 [Abstract]  
• Imaoka, H., Hoshino, T., Takei, S., Kinoshita, T., Okamoto, M., Kawayama, T., Kato, S., Iwasaki, H., Watanabe, K., Aizawa, H. (2008). Interleukin-18 production and pulmonary function in COPD. Eur Respir J 31: 287-297 [Abstract] [Full Text]  
• Camp, P. G., Goring, S. M. (2007). Gender and the Diagnosis, Management, and Surveillance of Chronic Obstructive Pulmonary Disease. Proc Am Thorac Soc 4: 686-691 [Abstract] [Full Text]  
• Qaseem, A., Snow, V., Shekelle, P., Sherif, K., Wilt, T. J., Weinberger, S., Owens, D. K., for the Clinical Efficacy Assessment Subcommittee, (2007). Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease: A Clinical Practice Guideline from the American College of Physicians. ANN INTERN MED 147: 633-638 [Abstract] [Full Text]  
• Wilt, T. J., Niewoehner, D., MacDonald, R., Kane, R. L. (2007). Management of Stable Chronic Obstructive Pulmonary Disease: A Systematic Review for a Clinical Practice Guideline. ANN INTERN MED 147: 639-653 [Abstract] [Full Text]  
• Mahler, D. A., Criner, G. J. (2007). Assessment Tools for Chronic Obstructive Pulmonary Disease: Do Newer Metrics Allow For Disease Modification?. Proc Am Thorac Soc 4: 507-511 [Abstract] [Full Text]  
• Suissa, S., McGhan, R., Niewoehner, D., Make, B. (2007). Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease. Proc Am Thorac Soc 4: 535-542 [Abstract] [Full Text]  
• Rabe, K. F., Hurd, S., Anzueto, A., Barnes, P. J., Buist, S. A., Calverley, P., Fukuchi, Y., Jenkins, C., Rodriguez-Roisin, R., van Weel, C., Zielinski, J. (2007). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease: GOLD Executive Summary. Am. J. Respir. Crit. Care Med. 176: 532-555 [Abstract] [Full Text]  
• Pujades-Rodriguez, M., Smith, C.J.P., Hubbard, R.B. (2007). Inhaled corticosteroids and the risk of fracture in chronic obstructive pulmonary disease. QJM 100: 509-517 [Abstract] [Full Text]  
• Ernst, P., Gonzalez, A. V., Brassard, P., Suissa, S. (2007). Inhaled Corticosteroid Use in Chronic Obstructive Pulmonary Disease and the Risk of Hospitalization for Pneumonia. Am. J. Respir. Crit. Care Med. 176: 162-166 [Abstract] [Full Text]  
• Celli, B. R., Barnes, P. J. (2007). Exacerbations of chronic obstructive pulmonary disease. Eur Respir J 29: 1224-1238 [Abstract] [Full Text]  
• Lofdahl, C-G., Postma, D. S., Pride, N. B., Boe, J., Thoren, A. (2007). Possible protection by inhaled budesonide against ischaemic cardiac events in mild COPD. Eur Respir J 29: 1115-1119 [Abstract] [Full Text]  
• Fogarty, A. W, Jones, S., Britton, J. R, Lewis, S. A, McKeever, T. M (2007). Systemic inflammation and decline in lung function in a general population: a prospective study. Thorax 62: 515-520 [Abstract] [Full Text]  
• Parimon, T., Chien, J. W., Bryson, C. L., McDonell, M. B., Udris, E. M., Au, D. H. (2007). Inhaled Corticosteroids and Risk of Lung Cancer among Patients with Chronic Obstructive Pulmonary Disease. Am. J. Respir. Crit. Care Med. 175: 712-719 [Abstract] [Full Text]  
• Hylkema, M. N., Sterk, P. J., de Boer, W. I., Postma, D. S. (2007). Tobacco use in relation to COPD and asthma. Eur Respir J 29: 438-445 [Abstract] [Full Text]  
• Sutherland, E. R. (2007). Inhaled Steroids and Outcomes in COPD: Progressing Beyond FEV1. Chest 131: 648-649 [Full Text]  
• Soriano, J. B., Sin, D. D., Zhang, X., Camp, P. G., Anderson, J. A., Anthonisen, N. R., Buist, A. S., Burge, P. S., Calverley, P. M., Connett, J. E., Petersson, S., Postma, D. S., Szafranski, W., Vestbo, J. (2007). A Pooled Analysis of FEV1 Decline in COPD Patients Randomized to Inhaled Corticosteroids or Placebo. Chest 131: 682-689 [Abstract] [Full Text]  
• Bethke, T. D., Bohmer, G. M., Hermann, R., Hauns, B., Fux, R., Morike, K., David, M., Knoerzer, D., Wurst, W., Gleiter, C. H. (2007). Dose-Proportional Intraindividual Single- and Repeated-Dose Pharmacokinetics of Roflumilast, an Oral, Once-Daily Phosphodiesterase 4 Inhibitor. J Clin Pharmacol 47: 26-36 [Abstract] [Full Text]  
• Hubbard, R., Tattersfield, A., Smith, C., West, J., Smeeth, L., Fletcher, A. (2006). Use of inhaled corticosteroids and the risk of fracture.. Chest 130: 1082-1088 [Abstract] [Full Text]  
• Macie, C., Wooldrage, K., Manfreda, J., Anthonisen, N. R. (2006). Inhaled Corticosteroids and Mortality in COPD.. Chest 130: 640-646 [Abstract] [Full Text]  
• Halpin, D. M. G., Miravitlles, M. (2006). Chronic Obstructive Pulmonary Disease: The Disease and Its Burden to Society. Proc Am Thorac Soc 3: 619-623 [Abstract] [Full Text]  
• Watson, L., Schouten, J. P., Lofdahl, C-G., Pride, N. B., Laitinen, L. A., Postma, D. S., on behalf of the European Respiratory Society Stud, (2006). Predictors of COPD symptoms: does the sex of the patient matter?. Eur Respir J 28: 311-318 [Abstract] [Full Text]  
• O'Byrne, P. M., Pedersen, S., Busse, W. W., Tan, W. C., Chen, Y.-Z., Ohlsson, S. V., Ullman, A., Lamm, C. J., Pauwels, R. A. (2006). Effects of Early Intervention With Inhaled Budesonide on Lung Function in Newly Diagnosed Asthma. Chest 129: 1478-1485 [Abstract] [Full Text]  
• Vestbo, J. (2006). Clinical Assessment, Staging, and Epidemiology of Chronic Obstructive Pulmonary Disease Exacerbations. Proc Am Thorac Soc 3: 252-256 [Abstract] [Full Text]  
• Burge, P. S. (2006). Prevention of Exacerbations: How Are We Doing and Can We Do Better?. Proc Am Thorac Soc 3: 257-261 [Abstract] [Full Text]  
• Gartlehner, G., Hansen, R. A., Carson, S. S., Lohr, K. N. (2006). Efficacy and Safety of Inhaled Corticosteroids in Patients With COPD: A Systematic Review and Meta-Analysis of Health Outcomes. Ann Fam Med 4: 253-262 [Abstract] [Full Text]  
• Zielinski, J., Bednarek, M., Gorecka, D., Viegi, G., Hurd, S. S., Fukuchi, Y., Lai, C. K. W., Ran, P. X., Ko, F. W. S., Liu, S. M., Zheng, J. P., Zhong, N. S., Ip, M. S. M., Vermeire, P. A. (2006). Increasing COPD awareness.. Eur Respir J 27: 833-852 [Full Text]  
• Lange, P, Scharling, H, Ulrik, C S, Vestbo, J (2006). Inhaled corticosteroids and decline of lung function in community residents with asthma. Thorax 61: 100-104 [Abstract] [Full Text]  
• Lapperre, T S, Postma, D S, Gosman, M M E, Snoeck-Stroband, J B, ten Hacken, N H T, Hiemstra, P S, Timens, W, Sterk, P J, Mauad, T, on behalf of the GLUCOLD Study Group, (2006). Relation between duration of smoking cessation and bronchial inflammation in COPD. Thorax 61: 115-121 [Abstract] [Full Text]  
• Rennard, S. I., Schachter, N., Strek, M., Rickard, K., Amit, O. (2006). Cilomilast for COPD: Results of a 6-Month, Placebo-Controlled Study of a Potent, Selective Inhibitor of Phosphodiesterase 4. Chest 129: 56-66 [Abstract] [Full Text]  
• Celli, B. R. (2006). Chronic Obstructive Pulmonary Disease: From Unjustified Nihilism to Evidence-based Optimism.. Proc Am Thorac Soc 3: 58-65 [Abstract] [Full Text]  
• Soler, M. (2005). Modulation of airway inflammation to prevent exacerbations of COPD. ERR 14: 78-82 [Abstract] [Full Text]  
• Sin, D D, Wu, L, Anderson, J A, Anthonisen, N R, Buist, A S, Burge, P S, Calverley, P M, Connett, J E, Lindmark, B, Pauwels, R A, Postma, D S, Soriano, J B, Szafranski, W, Vestbo, J (2005). Inhaled corticosteroids and mortality in chronic obstructive pulmonary disease. Thorax 60: 992-997 [Abstract] [Full Text]  
• Ind, P. W. (2005). COPD disease progression and airway inflammation: uncoupled by smoking cessation. Eur Respir J 26: 764-766 [Full Text]  
• Chung, K. F. (2005). The Role of Airway Smooth Muscle in the Pathogenesis of Airway Wall Remodeling in Chronic Obstructive Pulmonary Disease. Proc Am Thorac Soc 2: 347-354 [Abstract] [Full Text]  
• Petty, T. L. (2005). Are COPD and Lung Cancer Two Manifestations of the Same Disease?. Chest 128: 1895-1897 [Full Text]  
• Anthonisen, N. R., Lindgren, P. G., Tashkin, D. P., Kanner, R. E., Scanlon, P. D., Connett, J. E., for the Lung Health Study Research Group, (2005). Bronchodilator response in the lung health study over 11 yrs. Eur Respir J 26: 45-51 [Abstract] [Full Text]  
• Wouters, E F M, Postma, D S, Fokkens, B, Hop, W C J, Prins, J, Kuipers, A F, Pasma, H R, Hensing, C A J, Creutzberg, E C, for the COSMIC (COPD and Seretide: a Multi-Center, (2005). Withdrawal of fluticasone propionate from combined salmeterol/fluticasone treatment in patients with COPD causes immediate and sustained disease deterioration: a randomised controlled trial. Thorax 60: 480-487 [Abstract] [Full Text]  
• Rennard, S. I. (2005). Clinical Approach to Patients with Chronic Obstructive Pulmonary Disease and Cardiovascular Disease. Proc Am Thorac Soc 2: 94-100 [Abstract] [Full Text]  
• Vestbo, J, Pauwels, R, Anderson, J A, Jones, P, Calverley, P, on behalf of the TRISTAN study group, (2005). Early onset of effect of salmeterol and fluticasone propionate in chronic obstructive pulmonary disease. Thorax 60: 301-304 [Abstract] [Full Text]  
• Decramer, M, Gosselink, R, Rutten-Van Molken, M, Buffels, J, Van Schayck, O, Gevenois, P-A, Pellegrino, R, Derom, E, De Backer, W (2005). Assessment of progression of COPD: report of a workshop held in Leuven, 11-12 March 2004. Thorax 60: 335-342 [Abstract] [Full Text]  
• Decramer, M, Gosselink, R, Bartsch, P, Lofdahl, C-G, Vincken, W, Dekhuijzen, R, Vestbo, J, Pauwels, R, Naeije, R, Troosters, T (2005). Effect of treatments on the progression of COPD: report of a workshop held in Leuven, 11-12 March 2004. Thorax 60: 343-349 [Abstract] [Full Text]  
• Brightling, C E, McKenna, S, Hargadon, B, Birring, S, Green, R, Siva, R, Berry, M, Parker, D, Monteiro, W, Pavord, I D, Bradding, P (2005). Sputum eosinophilia and the short term response to inhaled mometasone in chronic obstructive pulmonary disease. Thorax 60: 193-198 [Abstract] [Full Text]  
• Tsang, K W, Tan, K C, Ho, P L, Ooi, G C, Ho, J C, Mak, J, Tipoe, G L, Ko, C, Yan, C, Lam, W K, Chan-Yeung, M (2005). Inhaled fluticasone in bronchiectasis: a 12 month study. Thorax 60: 239-243 [Abstract] [Full Text]  
• Malerba, M., Bossoni, S., Radaeli, A., Mori, E., Bonadonna, S., Giustina, A., Tantucci, C. (2005). Growth Hormone Response to Growth Hormone-Releasing Hormone Is Reduced in Adult Asthmatic Patients Receiving Long-term Inhaled Corticosteroid Treatment. Chest 127: 515-521 [Abstract] [Full Text]  
• Ionescu, A A (2005). When should we suspect osteoporosis in patients with chronic airways disease?. Chronic Respiratory Disease 2: 1-2  
• Johannes, C. B., Schneider, G. A., Dube, T. J., Alfredson, T. D., Davis, K. J., Walker, A. M. (2005). The Risk of Nonvertebral Fracture Related to Inhaled Corticosteroid Exposure Among Adults With Chronic Respiratory Disease. Chest 127: 89-97 [Abstract] [Full Text]  
• Scanlon, P. D., Connett, J. E., Wise, R. A., Tashkin, D. P., Madhok, T., Skeans, M., Carpenter, P. C., Bailey, W. C., Buist, A. S., Eichenhorn, M., Kanner, R. E., Weinmann, G., the Lung Health Study Research Group, (2004). Loss of Bone Density with Inhaled Triamcinolone in Lung Health Study II. Am. J. Respir. Crit. Care Med. 170: 1302-1309 [Abstract] [Full Text]  
• Albers, M., Schermer, T., van den Boom, G., Akkermans, R., van Schayck, C., van Herwaarden, C., van Weel, C. (2004). Efficacy of Inhaled Steroids in Undiagnosed Subjects at High Risk for COPD: Results of the Detection, Intervention, and Monitoring of COPD and Asthma Program. Chest 126: 1815-1824 [Abstract] [Full Text]  
• Barnes, P. J. (2004). Mediators of Chronic Obstructive Pulmonary Disease. Pharmacol. Rev. 56: 515-548 [Abstract] [Full Text]  
• Donohue, J. F., Ohar, J. A. (2004). Effects of Corticosteroids on Lung Function in Asthma and Chronic Obstructive Pulmonary Disease. Proc Am Thorac Soc 1: 152-160 [Abstract] [Full Text]  
• Calverley, P. M. A. (2004). Effect of Corticosteroids on Exacerbations of Asthma and Chronic Obstructive Pulmonary Disease. Proc Am Thorac Soc 1: 161-166 [Abstract] [Full Text]  
• Tattersfield, A. E., Harrison, T. W., Hubbard, R. B., Mortimer, K. (2004). Safety of Inhaled Corticosteroids. Proc Am Thorac Soc 1: 171-175 [Abstract] [Full Text]  
• Belvisi, M. G. (2004). Regulation of Inflammatory Cell Function by Corticosteroids. Proc Am Thorac Soc 1: 207-214 [Abstract] [Full Text]  
• Kim, H., Liu, X., Kobayashi, T., Conner, H., Kohyama, T., Wen, F.-Q., Fang, Q., Abe, S., Bitterman, P., Rennard, S. I. (2004). Reversible Cigarette Smoke Extract-Induced DNA Damage in Human Lung Fibroblasts. Am. J. Respir. Cell Mol. Bio. 31: 483-490 [Abstract] [Full Text]  
• Tashkin, D. P., Murray, H. E., Skeans, M., Murray, R. P., for the Lung Health Study Research Group, (2004). Skin Manifestations of Inhaled Corticosteroids in COPD Patients: Results From Lung Health Study II. Chest 126: 1123-1133 [Abstract] [Full Text]  
• Lam, S., leRiche, J. C., McWilliams, A., MacAulay, C., Dyachkova, Y., Szabo, E., Mayo, J., Schellenberg, R., Coldman, A., Hawk, E., Gazdar, A. (2004). A Randomized Phase IIb Trial of Pulmicort Turbuhaler (Budesonide) in People with Dysplasia of the Bronchial Epithelium. Clin. Cancer Res. 10: 6502-6511 [Abstract] [Full Text]  
• Perng, D.-W., Huang, H.-Y., Chen, H.-M., Lee, Y.-C., Perng, R.-P. (2004). Characteristics of Airway Inflammation and Bronchodilator Reversibility in COPD: A Potential Guide to Treatment. Chest 126: 375-381 [Abstract] [Full Text]  
• Larj, M. J., Bleecker, E. R. (2004). Therapeutic Responses in Asthma and COPD: Corticosteroids. Chest 126: 138S-149S [Abstract] [Full Text]  
• Mapel, D. W. (2004). Treatment Implications on Morbidity and Mortality in COPD. Chest 126: 150S-158S [Abstract] [Full Text]  
• Cazzola, M., Dahl, R. (2004). Inhaled Combination Therapy With Long-Acting {beta}2-Agonists and Corticosteroids in Stable COPD. Chest 126: 220-237 [Abstract] [Full Text]  
• Sutherland, E. R., Cherniack, R. M. (2004). Management of Chronic Obstructive Pulmonary Disease. NEJM 350: 2689-2697 [Full Text]  
• Celli, B.R., MacNee, W., Agusti, A., Anzueto, A., Berg, B., Buist, A.S., Calverley, P.M.A., Chavannes, N., Dillard, T., Fahy, B., Fein, A., Heffner, J., Lareau, S., Meek, P., Martinez, F., McNicholas, W., Muris, J., Austegard, E., Pauwels, R., Rennard, S., Rossi, A., Siafakas, N., Tiep, B., Vestbo, J., Wouters, E., ZuWallack, R. (2004). Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 23: 932-946 [Full Text]  
• Hahn, D L, Burge, P S, Lewis, S A (2004). Ethics of placebo controlled studies of inhaled steroids for COPD * Authors' reply. Thorax 59: 539-540 [Full Text]  
• de Melo, M.N., Ernst, P., Suissa, S. (2004). Inhaled corticosteroids and the risk of a first exacerbation in COPD patients. Eur Respir J 23: 692-697 [Abstract] [Full Text]  
• Gluck, O., Colice, G. (2004). Recognizing and Treating Glucocorticoid-Induced Osteoporosis in Patients With Pulmonary Diseases. Chest 125: 1859-1876 [Abstract] [Full Text]  
• Dekhuijzen, P.N.R. (2004). Antioxidant properties of N-acetylcysteine: their relevance in relation to chronic obstructive pulmonary disease. Eur Respir J 23: 629-636 [Abstract] [Full Text]  
• Pauwels, R. A. (2004). Similarities and Differences in Asthma and Chronic Obstructive Pulmonary Disease Exacerbations. Proc Am Thorac Soc 1: 73-76 [Abstract] [Full Text]  
• Grootendorst, D. C., Rabe, K. F. (2004). Mechanisms of Bronchial Hyperreactivity in Asthma and Chronic Obstructive Pulmonary Disease. Proc Am Thorac Soc 1: 77-87 [Abstract] [Full Text]  
• Bozinovski, S., Jones, J., Beavitt, S.-J., Cook, A. D., Hamilton, J. A., Anderson, G. P. (2004). Innate immune responses to LPS in mouse lung are suppressed and reversed by neutralization of GM-CSF via repression of TLR-4. Am. J. Physiol. Lung Cell. Mol. Physiol. 286: L877-L885 [Abstract] [Full Text]  
• Suissa, S. (2004). Inhaled steroids and mortality in COPD: bias from unaccounted immortal time. Eur Respir J 23: 391-395 [Abstract] [Full Text]  
• Fan, V. S., Bryson, C. L., Curtis, J. R., Fihn, S. D., Bridevaux, P.-O., McDonell, M. B., Au, D. H. (2003). Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease and Risk of Death and Hospitalization: Time-dependent Analysis. Am. J. Respir. Crit. Care Med. 168: 1488-1494 [Abstract] [Full Text]  
• Rabe, K.F. (2003). Combination therapy for chronic obstructive pulmonary disease: one size fits all?. Eur Respir J 22: 874-875 [Full Text]  
• Calverley, P.M., Boonsawat, W., Cseke, Z., Zhong, N., Peterson, S., Olsson, H. (2003). Maintenance therapy with budesonide and formoterol in chronicobstructive pulmonary disease. Eur Respir J 22: 912-919 [Abstract] [Full Text]  
• Leone, F. T., Fish, J. E., Szefler, S. J., West, S. L. (2003). Systematic Review of the Evidence Regarding Potential Complications of Inhaled Corticosteroid Use in Asthma: Collaboration of American College of Chest Physicians, American Academy of Allergy, Asthma, and Immunology, and American College of Allergy, Asthma, and Immunology. Chest 124: 2329-2340 [Abstract] [Full Text]  
• Celli, B. R. (2003). A 62-Year-Old Woman With Chronic Obstructive Pulmonary Disease. JAMA 290: 2721-2729 [Full Text]  
• Sutherland, E. R. (2003). Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease. ANN INTERN MED 139: 864-864 [Full Text]  
• Highland, K. B. (2003). Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease. ANN INTERN MED 139: 864-865 [Full Text]  
• Decramer, M. (2003). Treatment of chronic respiratory failure: lung volume reduction surgery versus rehabilitation. Eur Respir J 22: 47s-56s [Abstract] [Full Text]  
• Sin, D. D., McAlister, F. A., Man, S. F. P., Anthonisen, N. R. (2003). Contemporary Management of Chronic Obstructive Pulmonary Disease: Scientific Review. JAMA 290: 2301-2312 [Abstract] [Full Text]  
• Ionescu, A.A., Schoon, E. (2003). Osteoporosis in chronic obstructive pulmonary disease. Eur Respir J 22: 64s-75s [Abstract] [Full Text]  
• Burge, P S, Lewis, S A (2003). So inhaled steroids slow the rate of decline of FEV1 in patients with COPD after all?. Thorax 58: 911-913 [Full Text]  
• Sutherland, E R, Allmers, H, Ayas, N T, Venn, A J, Martin, R J (2003). Inhaled corticosteroids reduce the progression of airflow limitation in chronic obstructive pulmonary disease: a meta-analysis. Thorax 58: 937-941 [Abstract] [Full Text]