Does Tripling the Dose of Inhaled-Steroid and Long-Acting β-Agonist Therapy During Colds Prevent COPD Exacerbations?

Upper respiratory infections (URIs) are associated with more than half of acute exacerbations in patients with chronic obstructive pulmonary disease (COPD). To examine whether increasing doses of inhaled corticosteroids (ICS) and long-acting β-agonists (LABA) might lower this risk, researchers enrolled 450 patients with COPD and one or more exacerbations during the previous year in a 1-year trial. All patients received combination budesonide (200 μg) and formoterol (6 μg) twice daily for the entire year; two thirds of patients also took long-acting antimuscarinics during the study. At the first sign of cold symptoms, patients were randomized either to additional budesonide (400 μg) plus formoterol (12 μg) or to placebo, taken twice daily fo…