Cardioprotective effects of inhaled corticosteroid-containing combination therapy in COPD

The pooled post hoc analysis of three randomised controlled trials by Vestbo et al. [1] found that combinations containing inhaled corticosteroid (ICS) significantly reduced non-respiratory-related mortality in chronic obstructive pulmonary disease (COPD) compared to long-acting bronchodilator therapies alone, the difference amounting to −35% (95% CI −57% to −3%). These studies did not adjudicate on cause of death and only followed patients for up to 1 year. In the IMPACT trial, all-cause mortality was 42% lower and cardiovascular attributed deaths were 52% lower when comparing triple therapy to combined long-acting bronchodilators over 1 year [2].