To the Editor: The systematic review and meta-analysis by Dr Drummond and colleagues1 drew on 11 randomized controlled trials involving inhaled corticosteroids of 6 months or longer duration in COPD to suggest that inhaled corticosteroid therapy was not associated with a survival benefit in these patients. However, a pooled analysis by Sin et al2 drew on 6 of the 11 trials (references 10, 11, 14, 34, 36, and 37 in Drummond et al). It came to the conclusion that inhaled corticosteroids were associated with a 27% reduction in all-cause mortality in stable COPD, although none of the 6 studies (whose follow-up ranged from 9 to 42 months) were designed to evaluate mortality as an end point in either review.
Wall J, Aziz I. Inhaled Corticosteroids in Patients With Chronic Obstructive Pulmonary Disease. JAMA. 2009;301(14):1432-1434. doi:10.1001/jama.2009.436