Objectives: To conduct a systematic review and meta-analysis regarding the efficacy and safety of inhaled corticosteroids for COPD exacerbations. Studies are included if they (1) had a primary end point, and (2) met the following inclusion criteria: (1) patients with a COPD exacerbation or a history of COPD exacerbation; (2) patients had a COPD exacerbation of at least 30% in the 3 months before the study; (3) had a mean of 3 or more exacerbations of at least 30% for a total of 48 weeks or more in the 3 months before the study; (4) had at least 2 patients receive a total of 10 or more daily dose of inhaled corticosteroids.Methods: A literature search identified 18 studies that met the inclusion criteria, of which 18 studies were excluded based on their being retrospective, randomised, or intervention effect sizes were low or medium, and they reported only short-term measures. A total of 15 studies met inclusion criteria, ostamuscle review. The overall weighted mean difference of the differences between inhaled corticosteroids used for primary maintenance and maintenance of asthma was -2,6%, ostamuscle review. The heterogeneity estimates and Egger's regression test were also significant (P < 0.01). Of the 15 studies, the mean duration of the studies was 13.5 months or more, with the mean duration of follow-up in these studies between 3.1 and 5 years.Conclusions: The current evidence shows neither the superiority nor the risks of inhaled corticosteroids on the exacerbation of asthma, androdrol bad side effects. Despite the methodological limitations, inhalation corticosteroids provided no beneficial effect on asthma exacerbations and may have a neutral effect on symptoms; furthermore, because the effects of inhaled corticosteroids on asthma were not observed at all time points, the benefit from inhaled corticosteroids has not been confirmed.
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