Systemic corticosteroids for chronic obstructive pulmonary disease: benefits and risks.

Systemic corticosteroids have become an increasingly common therapy for patients with stable and unstable chronic obstructive pulmonary disease (COPD), despite uncertain clinical efficacy and known adverse effects. A recently completed, large clinical trial has confirmed that systemic corticosteroids hasten recovery from exacerbations of COPD. Maximum benefits occur with only 2 weeks of therapy. The appropriate role of systemic corticosteroids in stable COPD has not been adequately defined. Prolonged therapy with systemic corticosteroids confers a large risk for developing osteoporotic fractures. Measures for reducing this risk are described.