Symposium 9 — Debate

Inhaled Coticosteroids in COPD – Friend or Foe?
For the Motion
Dr Irfhan Ali Bin Hyder Ali

Inhaled Corticosteroids have long been used in the treatment for COPD, and is rightfully mentioned and acknowledged in most international guidelines, including the latest GOLD guidelines 2024.

It is recognized that COPD does have an element of inflammation although not as pronounced as asthma, and anti-inflammatory drugs such as inhaled steroids have a major part to play in treating this disease. There are numerous clinical trials that support the role of steroids in COPD thus their prominent mention in guidelines.

There are certain groups of patients for whom ICS may not have any benefit, and it is imperative for the treating clinician to be wary of these groups. These include those with recurrent pneumonias, history of previous tuberculosis infection and patients with low eosinophil counts. On the contrary, patients with recurrent exacerbations, high eosinophil counts and those with possibility of asthma will likely benefit from the addition of ICS.

Thus, ICS does have an important role in COPD and is definitely considered a friend in our armamentarium of medications against COPD.