What does the research show about inhaled corticosteroids?

Inhaled corticosteroids

Meta-analyses found inhaled steroids improved lung function and symptoms in asthma, and adding a long-acting bronchodilator cut exacerbations further without raising serious asthma events. As-needed budesonide-formoterol halved exacerbations against a reliever alone. In COPD they cut flare-ups but raised pneumonia. Children grew about half a centimeter less in the first year, about 1.2 cm by adulthood.

Add to Bio HackChecked 2026-11-13

Status: Prescription drugs in the US. On the labels cited here, fluticasone-salmeterol and budesonide-formoterol are approved for asthma and for COPD maintenance, and the triple inhaler fluticasone furoate-umeclidinium-vilanterol for COPD and for asthma in adults. None is approved to relieve acute bronchospasm.
Also called: ICS, inhaled steroids, steroid inhaler, controller inhaler, fluticasone, Flovent, Arnuity, budesonide, Pulmicort, fluticasone-salmeterol, Advair, Wixela, AirDuo, budesonide-formoterol, Symbicort, Breyna, fluticasone-vilanterol, Breo, triple inhaler, fluticasone-umeclidinium-vilanterol, Trelegy, budesonide-glycopyrrolate-formoterol, Breztri, SMART, MART
Taken for: asthma control, preventing asthma attacks, COPD flare-ups, as-needed asthma relief with budesonide-formoterol, maintenance and reliever therapy, lung function, coming off oral steroids

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

Shown to help8

StrongShown to improve lung function, morning peak flow and symptoms against placebo in mild to moderate asthma, and to cut withdrawals for asthma attacks on budesonide by about 83%.
StrongShown to cut moderate or severe COPD exacerbations against dual inhalers, and to lower deaths against two bronchodilators without a steroid, but not against a steroid-bronchodilator pair.
ModerateShown to cut asthma exacerbations needing oral steroids from 15% to 11% when a long-acting beta-agonist was added to an inhaled steroid in adults.
ModerateShown to cut exacerbations needing oral steroids by about half against a reliever alone in mild asthma, and to match regular inhaled steroids with less steroid taken.
ModerateShown to cut asthma exacerbations by about a third against fixed-dose combination controllers, 6.4 fewer per 100 people aged 12 and older.
ModerateShown to reduce COPD exacerbations by about 0.2 to 0.3 a year and slow the decline in quality of life, with no effect on deaths.
ModerateShown to lower COPD exacerbations to about 0.76 a year per 1 a year on a long-acting beta-agonist alone, with no difference in deaths and more pneumonia.
LimitedOne large trial found low-dose budesonide cut the risk of a severe asthma exacerbation by 44% over 3 years in mild persistent asthma of recent onset.

Reported risks9

StrongShown to raise serious pneumonia in people with COPD, about 18 more per 1,000 over 18 months on fluticasone, without a change in deaths.Very common
ModerateShown in label trials to raise upper respiratory infections and headache against placebo, with upper respiratory infections in 21% to 27% on fluticasone-salmeterol against 14%.Very common
ModerateShown to raise mouth and throat thrush and hoarseness against placebo. In a COPD label trial, thrush occurred in 10% on fluticasone-salmeterol against 1% on placebo.Common
ModerateLinked to adrenal insufficiency in about 6.8% of people with asthma using only inhaled steroids, more at high doses and after more than a year.Common
ModerateShown to slow children's growth by about 0.48 cm in the first year, with a smaller effect after. Children on budesonide were 1.2 cm shorter as adults.How often is not known
ModerateMixed results: one meta-analysis linked inhaled steroids to about 1.27 times the fracture risk in COPD trials, while a Cochrane review found no major effect on fractures over three years.How often is not known
ModerateLinked to about 1.5 times the odds of cataract in a meta-analysis of four studies. The label reports glaucoma and cataracts with long-term use.How often is not known
LimitedLinked to a 34% higher rate of new diabetes and of progression to insulin in one large cohort, highest at fluticasone 1,000 μg a day or more.How often is not known
LimitedThe label states use with strong CYP3A4 inhibitors such as ritonavir, ketoconazole or clarithromycin can raise steroid levels and heart side effects. It gives no rate.How often is not known

What people take it for, and what was found

Shown to help8

Strong

Lung function and symptoms in asthma

Shown to improve lung function, morning peak flow and symptoms against placebo in mild to moderate asthma, and to cut withdrawals for asthma attacks on budesonide by about 83%.

Compared with placebo [1][2]

The numbers and sources

Effect: Fluticasone at 100 to 1,000 mcg a day raised FEV1 by 0.1 to 0.43 L and morning peak flow by 23 to 46 L/min, improved symptom scores and cut rescue inhaler use by 1 to 1.4 puffs a day. At 1,000 to 1,500 mcg a day, more people could stop oral prednisolone (Peto OR 14.07) [1]. Budesonide raised FEV1 by 3.7% of predicted and morning peak flow by 29 L/min, and withdrawal for asthma exacerbation was less likely (RR 0.17, 95% CI 0.09 to 0.33) [2].
Population: 86 studies with 16,160 participants [1]; 43 studies with 2,801 participants [2].
Sources: [1], [2]
Caveats: Low doses of fluticasone gave only slightly smaller gains than high doses [1]. Budesonide doses of 500 to 800 mcg a day showed slightly larger effects than lower doses, with no added gain at high doses [2].

Limited

Severe asthma attacks in recent-onset mild asthma

One large trial found low-dose budesonide cut the risk of a severe asthma exacerbation by 44% over 3 years in mild persistent asthma of recent onset.

Compared with placebo [3]

The numbers and sources

Effect: At least one severe asthma exacerbation occurred in 117 of 3,597 people on budesonide and 198 of 3,568 on placebo (HR 0.56, 95% CI 0.45 to 0.71) [3].
Population: 7,241 people in 32 countries who had had mild persistent asthma for under 2 years and no regular steroid treatment [3].
Sources: [3]
Caveats: Children under 11 grew 1.34 cm less over 3 years (see Risks) [3].
Why limited: This rests on one trial, of 7,241 people. Strength counts independent studies that agree, so one trial is limited at any size.

Moderate

Adding a long-acting bronchodilator (combination inhalers) in asthma

Shown to cut asthma exacerbations needing oral steroids from 15% to 11% when a long-acting beta-agonist was added to an inhaled steroid in adults.

Compared with the same dose of inhaled steroid alone [4][5]

The numbers and sources

Effect: Adding a long-acting beta-agonist cut exacerbations needing oral steroids from 15% to 11% (RR 0.77, 95% CI 0.68 to 0.87), cut rescue use by 0.58 puffs a day and halved withdrawals for poor control (RR 0.50). In children the estimate was not significant (RR 0.89, 95% CI 0.58 to 1.39) [4]. In four 26-week safety trials, at least one asthma exacerbation occurred in 9.8% on a combination inhaler and 11.7% on an inhaled steroid alone (RR 0.83, 95% CI 0.78 to 0.89) [5].
Population: 21,248 participants, 4,625 of them children, in 77 trials [4]; 36,010 people aged 12 and older [5].
Sources: [4], [5]
Caveats: Higher than usual doses of the long-acting beta-agonist gave less benefit [4].

Moderate

As-needed budesonide-formoterol in mild asthma

Shown to cut exacerbations needing oral steroids by about half against a reliever alone in mild asthma, and to match regular inhaled steroids with less steroid taken.

Compared with an as-needed fast-acting bronchodilator alone [6]; as-needed albuterol [7]; regular inhaled steroid with an as-needed reliever [6][7]

The numbers and sources

Effect: Against a fast-acting reliever alone, exacerbations needing oral steroids fell from 109 to 52 per 1,000 (OR 0.45, 95% CI 0.34 to 0.60). Against regular inhaled steroids, they were 65 and 81 per 1,000 (OR 0.79, 95% CI 0.59 to 1.07), with 154 μg a day less inhaled steroid [6]. In one 52-week trial, the annual exacerbation rate was 0.195 on budesonide-formoterol as needed and 0.400 on albuterol as needed (relative rate 0.49), and did not differ from regular budesonide (relative rate 1.12, 95% CI 0.70 to 1.79) [7].
Population: 9,657 participants aged 12 and older in 6 trials, mean age 36 to 43 [6]; 668 adults with mild asthma [7].
Sources: [6], [7]
Caveats: All trials used budesonide 200 μg with formoterol 6 μg in a dry powder inhaler [6]. One trial was open-label and part funded by AstraZeneca [7].

Moderate

One combination inhaler for both daily control and relief (SMART)

Shown to cut asthma exacerbations by about a third against fixed-dose combination controllers, 6.4 fewer per 100 people aged 12 and older.

Compared with the same or higher dose of inhaled steroid and long-acting beta-agonist as controller, or inhaled steroid alone [8]

The numbers and sources

Effect: In people aged 12 and older, using one budesonide-formoterol inhaler for both control and relief lowered exacerbation risk against the same controller dose (RR 0.68, 95% CI 0.58 to 0.80, risk difference -6.4%) and a higher controller dose (RR 0.77, risk difference -2.8%). In children aged 4 to 11, risk fell against a higher steroid dose (RR 0.55) and against the same combination dose (RR 0.38) [8].
Population: 22,748 patients in 16 randomized trials, 341 of them aged 4 to 11 [8].
Sources: [8]
Caveats: 15 of the 16 trials tested budesonide-formoterol. The children's results rest on few patients [8].

Moderate

Flare-ups in COPD, inhaled steroid alone

Shown to reduce COPD exacerbations by about 0.2 to 0.3 a year and slow the decline in quality of life, with no effect on deaths.

Compared with placebo [9]

The numbers and sources

Effect: Long-term inhaled steroids lowered the exacerbation rate (MD -0.26 per person per year, 95% CI -0.37 to -0.14) and slowed the decline in quality of life (MD -1.22 units a year). They did not consistently slow FEV1 decline (MD 5.80 mL a year, 95% CI -0.28 to 11.88) and did not change mortality (OR 0.98, 95% CI 0.83 to 1.16) [9].
Population: 16,154 participants with COPD in 55 trials [9].
Sources: [9]
Caveats: One large trial found a significant slowing of FEV1 decline, but the pooled results were inconsistent [9].

Moderate

Combination inhaler against a long-acting bronchodilator alone in COPD

Shown to lower COPD exacerbations to about 0.76 a year per 1 a year on a long-acting beta-agonist alone, with no difference in deaths and more pneumonia.

Compared with the same long-acting beta-agonist alone [10]

The numbers and sources

Effect: Combination inhalers lowered the exacerbation rate (rate ratio 0.76, 95% CI 0.68 to 0.84). Mortality did not differ (OR 0.92). Pneumonia was more common (OR 1.55) [10].
Population: 11,794 people with severe COPD in 14 trials, 10 of fluticasone-salmeterol and 4 of budesonide-formoterol [10].
Sources: [10]
Caveats: Low-quality evidence for exacerbations, with high withdrawal rates and heterogeneity (I² 68%) [10].

Strong

Triple inhalers in COPD

Shown to cut moderate or severe COPD exacerbations against dual inhalers, and to lower deaths against two bronchodilators without a steroid, but not against a steroid-bronchodilator pair.

Compared with a long-acting antimuscarinic alone, a long-acting antimuscarinic with a long-acting beta-agonist, or an inhaled steroid with a long-acting beta-agonist [11][12][13]

The numbers and sources

Effect: Triple therapy lowered moderate or severe exacerbations against an antimuscarinic alone (rate ratio 0.71), two bronchodilators (0.78) and a steroid-beta-agonist pair (0.77). Pneumonia was higher than with two bronchodilators (RR 1.53) [11]. Over 52 weeks, deaths were lower than with two bronchodilators (RR 0.69, 95% CI 0.53 to 0.90) but not than with a steroid-beta-agonist pair (RR 0.94, 95% CI 0.72 to 1.24) [12]. A 2025 analysis also found fewer deaths than with two bronchodilators (RR 0.76, 95% CI 0.60 to 0.97) [13].
Population: 21 trials [11]; 6 trials with 22,669 patients [12]; randomized trials in moderate to severe COPD [13].
Sources: [11], [12], [13]
Caveats: Most trials enrolled people with advanced COPD and recent exacerbations [11]. The three analyses share many trials.

Doses studied

The fluticasone trials used 100 to 1,000 mcg a day, with 1,000 to 1,500 mcg a day in people on oral steroids [1]. The early intervention trial used budesonide 400 μg once daily, or 200 μg in children under 11 [3], and the childhood height trial used budesonide 400 μg a day for 4 to 6 years [14]. The as-needed trials used budesonide 200 μg with formoterol 6 μg per inhalation [6]. The fluticasone-salmeterol label trials used 100/50 or 250/50 mcg twice daily in asthma and 250/50 or 500/50 mcg twice daily in COPD [15]. The budesonide-formoterol 160/4.5 inhaler is the strength approved for COPD [16].

Risks

Reported risks8

StrongVery common

Pneumonia in COPD

Shown to raise serious pneumonia in people with COPD, about 18 more per 1,000 over 18 months on fluticasone, without a change in deaths.

The numbers and sources

How common: Very common: more than 1 in 10 people.
Effect: Fluticasone raised non-fatal serious pneumonia (OR 1.78, 95% CI 1.50 to 2.12), 18 more per 1,000 over 18 months, whether or not combined with a long-acting beta-agonist. Budesonide also raised it (OR 1.62, 95% CI 1.00 to 2.62). Mortality did not differ [17]. Inhaled steroids raised pneumonia in long-term COPD trials (OR 1.56) [9], and combination inhalers did against a long-acting beta-agonist alone (OR 1.55) [10]. In a 3-year label trial, pneumonia was reported in 16% on fluticasone-salmeterol 500/50 and 9% on placebo, and in a 1-year trial in 7% on 250/50 and 3% on salmeterol [15].
Population: 43 trials, 26 of fluticasone with 21,247 people and 17 of budesonide with 10,150 [17]; 6,184 people in a 3-year trial and 1,579 in two 1-year trials [15].
Sources: [17], [9], [10], [15]
Caveats: Pneumonia and COPD flare-ups overlap in their features, which makes diagnosis uncertain [17]. The band above is the 3-year trial rate.

ModerateVery common

Upper airway infections and headache

Shown in label trials to raise upper respiratory infections and headache against placebo, with upper respiratory infections in 21% to 27% on fluticasone-salmeterol against 14%.

The numbers and sources

How common: Very common: more than 1 in 10 people.
Effect: In 12-week asthma trials, rates on fluticasone-salmeterol 100/50 and 250/50 against placebo were upper respiratory tract infection 27% and 21% against 14%, pharyngitis 13% and 10% against 6%, headache 12% and 13% against 7%, and nausea and vomiting 4% and 6% against 1% [15].
Population: 705 adults and adolescents with asthma in two US trials [15].
Sources: [15]
Caveats: Average exposure was 60 to 79 days on active drugs and 42 days on placebo, so placebo rates may be lower partly from shorter exposure [15].

ModerateCommon

Thrush and hoarseness

Shown to raise mouth and throat thrush and hoarseness against placebo. In a COPD label trial, thrush occurred in 10% on fluticasone-salmeterol against 1% on placebo.

The numbers and sources

How common: Common: between 1 in 100 and 1 in 10 people.
Effect: In COPD, inhaled steroids raised oral candidiasis (OR 2.65, 95% CI 2.03 to 3.46) and hoarseness [9]. Fluticasone at all doses raised sore throat, hoarseness and oral candidiasis in asthma [1], while budesonide showed no difference from placebo in throat soreness, hoarseness or candidiasis [2]. In asthma label trials, oral candidiasis occurred in 1% to 4% on fluticasone-salmeterol and 0% on placebo, and hoarseness in 2% to 5% against under 1%. In a 6-month COPD trial, mouth and throat candidiasis occurred in 10% and 1% [15].
Population: 5,586 people with COPD for the candidiasis estimate [9]; asthma trials of fluticasone and budesonide [1][2]; 705 adults and adolescents with asthma and 723 adults with COPD in label trials [15].
Sources: [9], [1], [2], [15]
Caveats: The budesonide review found no excess, unlike the fluticasone review [1][2]. Rates differ by dose and condition.

ModerateCommon

Adrenal suppression

Linked to adrenal insufficiency in about 6.8% of people with asthma using only inhaled steroids, more at high doses and after more than a year.

The numbers and sources

How common: Common: between 1 in 100 and 1 in 10 people.
Effect: Adrenal insufficiency was found in 6.8% (95% CI 3.8 to 12.0) of people with asthma on inhaled steroids only. In asthma, rates ranged from 2.4% at low doses to 21.5% at high doses, and from 1.4% after under 28 days to 27.4% after more than a year [22]. The label warns of hypercorticism and adrenal suppression, particularly at higher doses [15].
Population: 3,753 participants in 74 articles across all steroid routes [22].
Sources: [22], [15]
Caveats: Studies used different tests and cut-offs, and most rates come from tested patients rather than random samples [22].

ModerateStudied in childrenHow often is not known

Slower growth in children

Shown to slow children's growth by about 0.48 cm in the first year, with a smaller effect after. Children on budesonide were 1.2 cm shorter as adults.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: Against placebo or non-steroid drugs, inhaled steroids lowered growth velocity by 0.48 cm a year (95% CI -0.65 to -0.30) in the first year. In the second year the difference was not significant (MD -0.19 cm a year) [18]. In the early intervention trial, children under 11 on budesonide grew 1.34 cm less over 3 years [3]. In a trial following children into adulthood, adult height was 1.2 cm lower on budesonide than placebo (95% CI -1.9 to -0.5), similar to the gap after 2 years, and higher doses in the first 2 years were linked to lower adult height [14].
Population: 8,471 children with mild to moderate persistent asthma in 25 trials [18]; children aged 5 to 13 at the start, 943 measured as adults [14].
Sources: [18], [3], [14]
Caveats: The effect differed by drug [18]. The loss in adult height was not progressive or cumulative [14].

LimitedHow often is not known

New or worsening diabetes

Linked to a 34% higher rate of new diabetes and of progression to insulin in one large cohort, highest at fluticasone 1,000 μg a day or more.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: Current inhaled steroid use was associated with diabetes onset (RR 1.34, 95% CI 1.29 to 1.39) and progression to insulin (RR 1.34), and at the highest doses with RR 1.64 and 1.54 [20].
Population: 388,584 patients with respiratory disease followed 5.5 years [20].
Sources: [20]
Caveats: Observational. People needing higher steroid doses may differ in other ways [20].

ModerateHow often is not known

Cataracts and glaucoma

Linked to about 1.5 times the odds of cataract in a meta-analysis of four studies. The label reports glaucoma and cataracts with long-term use.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: Inhaled steroid use was associated with cataract (pooled OR 1.48, 95% CI 1.30 to 1.68), a number needed to harm of 16 [21]. The label reports glaucoma, raised eye pressure and cataracts with long-term use. In a 3-year COPD trial subset, new glaucoma was 2% on fluticasone-salmeterol, 5% on fluticasone alone and 2% on placebo, and cataract conclusions could not be drawn [15].
Population: 4 studies [21]; 658 people with COPD in an eye substudy [15].
Sources: [21], [15]
Caveats: The meta-analysis is small and from 2006 [21].

LimitedHow often is not known

Interactions with ritonavir and other strong CYP3A4 inhibitors

The label states use with strong CYP3A4 inhibitors such as ritonavir, ketoconazole or clarithromycin can raise steroid levels and heart side effects. It gives no rate.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: The fluticasone-salmeterol label states that strong CYP3A4 inhibitors, including ritonavir, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, saquinavir, ketoconazole and telithromycin, may raise systemic corticosteroid and cardiovascular adverse effects [15].
Population: Labeling statement drawn from pharmacokinetic data [15].
Sources: [15]
Caveats: No rate of harm is given.

Mixed results1

ModerateHow often is not known

Fractures

Mixed results: one meta-analysis linked inhaled steroids to about 1.27 times the fracture risk in COPD trials, while a Cochrane review found no major effect on fractures over three years.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: In COPD trials, fluticasone and budesonide were associated with fractures (Peto OR 1.27, 95% CI 1.01 to 1.58), and in observational studies with OR 1.21, rising 9% per 500 μg of beclomethasone-equivalent dose [19]. A Cochrane review found long-term studies that measured bone effects generally showed no major effect on fractures or bone density over three years [9].
Population: 17,513 participants in 16 trials and 69,000 in 7 observational studies [19]; long-term COPD trials [9].
Sources: [19], [9]
Caveats: The pooled trial estimate is just significant, and most trials were of fluticasone [19].

Checked, no increase found2

Moderate

Serious asthma events with combination inhalers

Not shown to raise serious asthma events when a long-acting beta-agonist was combined with an inhaled steroid, 0.66% against 0.60% on the steroid alone.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: Hospitalization, intubation or death from asthma occurred in 0.66% on a combination inhaler and 0.60% on an inhaled steroid alone (RR 1.09, 95% CI 0.83 to 1.43). There were three asthma intubations and two asthma deaths, both deaths on combination therapy [5]. The label states that a long-acting beta-agonist used alone, without an inhaled steroid, raises the risk of asthma-related death [15].
Population: 36,010 people aged 12 and older in four 26-week trials [5].
Sources: [5], [15]
Caveats: The label states the trials were not designed to rule out all risk [15].

LimitedStudied in pregnancy

Pregnancy

The budesonide-formoterol label states that studies of pregnant women have not shown inhaled budesonide raises the risk of birth abnormalities. Animal studies at some doses did.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: The label states studies of pregnant women have not shown that inhaled budesonide alone increases the risk of abnormalities. There are no adequate studies of formoterol or the combination in pregnancy. In rats, the inhaled combination was teratogenic below the maximum human dose [16].
Population: Human pregnancy studies and animal studies summarized in labeling [16].
Sources: [16]
Caveats: The label notes rodents are more prone than humans to steroid birth effects [16].

Claims tested and not found

That combination inhalers raise the risk of asthma death or hospitalization. In 36,010 people, serious asthma events did not differ from an inhaled steroid alone (RR 1.09, 95% CI 0.83 to 1.43) [5].
That inhaled steroids alone lower deaths in COPD. Mortality did not differ from placebo (OR 0.98, 95% CI 0.83 to 1.16) [9].
That childhood growth loss on inhaled steroids keeps adding up year after year. The adult height gap of 1.2 cm matched the gap after the first 2 years and was not cumulative [14].

Sources

Adams NP, Bestall JC, Lasserson TJ, et al. Fluticasone versus placebo for chronic asthma in adults and children. Cochrane Database of Systematic Reviews. 2008. https://doi.org/10.1002/14651858.CD003135.pub4
Adams N, Bestall J, Jones PW. Budesonide for chronic asthma in children and adults. Cochrane Database of Systematic Reviews. 2001. https://pubmed.ncbi.nlm.nih.gov/11687183/
Pauwels RA, Pedersen S, Busse WW, et al. Early intervention with budesonide in mild persistent asthma: a randomised, double-blind trial. The Lancet. 2003. https://doi.org/10.1016/S0140-6736(03)12891-7
Ducharme FM, Ni Chroinin M, Greenstone I, et al. Addition of long-acting beta2-agonists to inhaled corticosteroids versus same dose inhaled corticosteroids for chronic asthma in adults and children. Cochrane Database of Systematic Reviews. 2010. https://doi.org/10.1002/14651858.CD005535.pub2
Busse WW, Bateman ED, Caplan AL, et al. Combined Analysis of Asthma Safety Trials of Long-Acting β2-Agonists. New England Journal of Medicine. 2018. https://doi.org/10.1056/NEJMoa1716868
Crossingham I, Turner S, Ramakrishnan S, et al. Combination fixed-dose beta agonist and steroid inhaler as required for adults or children with mild asthma. Cochrane Database of Systematic Reviews. 2021. https://doi.org/10.1002/14651858.CD013518.pub2
Beasley R, Holliday M, Reddel HK, et al. Controlled Trial of Budesonide-Formoterol as Needed for Mild Asthma. New England Journal of Medicine. 2019. https://doi.org/10.1056/NEJMoa1901963
Sobieraj DM, Weeda ER, Nguyen E, et al. Association of Inhaled Corticosteroids and Long-Acting β-Agonists as Controller and Quick Relief Therapy With Exacerbations and Symptom Control in Persistent Asthma: A Systematic Review and Meta-analysis. JAMA. 2018. https://doi.org/10.1001/jama.2018.2769
Yang IA, Clarke MS, Sim EH, et al. Inhaled corticosteroids for stable chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2012. https://doi.org/10.1002/14651858.CD002991.pub3
Nannini LJ, Lasserson TJ, Poole P. Combined corticosteroid and long-acting beta(2)-agonist in one inhaler versus long-acting beta(2)-agonists for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2012. https://doi.org/10.1002/14651858.CD006829.pub2
Zheng Y, Zhu J, Liu Y, et al. Triple therapy in the management of chronic obstructive pulmonary disease: systematic review and meta-analysis. BMJ. 2018. https://doi.org/10.1136/bmj.k4388
Lai CC, Chen CH, Chen KH, et al. The Impact of 52-Week Single Inhaler Device Triple Therapy versus Dual Therapy on the Mortality of COPD Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Life. 2022. https://doi.org/10.3390/life12020173
Li Y, Li J, Yang H, et al. Effect of triple therapy on mortality and cardiovascular risk in patients with moderate to severe COPD: a meta-analysis of randomized controlled trials. BMC Pulmonary Medicine. 2025. https://doi.org/10.1186/s12890-025-03823-6
Kelly HW, Sternberg AL, Lescher R, et al. Effect of inhaled glucocorticoids in childhood on adult height. New England Journal of Medicine. 2012. https://doi.org/10.1056/NEJMoa1203229
U.S. Food and Drug Administration. ADVAIR DISKUS (fluticasone propionate and salmeterol inhalation powder), prescribing information. 2026. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4eeb5f6a-593f-4a9e-9692-adefa2caf8fc
U.S. Food and Drug Administration. SYMBICORT (budesonide and formoterol fumarate dihydrate) inhalation aerosol, prescribing information. 2019. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=fafa4cf1-99c2-43d5-73ad-51f256de3be0
Kew KM, Seniukovich A. Inhaled steroids and risk of pneumonia for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2014. https://doi.org/10.1002/14651858.CD010115.pub2
Zhang L, Prietsch SO, Ducharme FM. Inhaled corticosteroids in children with persistent asthma: effects on growth. Cochrane Database of Systematic Reviews. 2014. https://doi.org/10.1002/14651858.CD009471.pub2
Loke YK, Cavallazzi R, Singh S. Risk of fractures with inhaled corticosteroids in COPD: systematic review and meta-analysis of randomised controlled trials and observational studies. Thorax. 2011. https://doi.org/10.1136/thx.2011.160028
Suissa S, Kezouh A, Ernst P. Inhaled corticosteroids and the risks of diabetes onset and progression. American Journal of Medicine. 2010. https://doi.org/10.1016/j.amjmed.2010.06.019
Uboweja A, Malhotra S, Pandhi P. Effect of inhaled corticosteroids on risk of development of cataract: a meta-analysis. Fundamental & Clinical Pharmacology. 2006. https://doi.org/10.1111/j.1472-8206.2006.00397.x
Broersen LH, Pereira AM, Jørgensen JO, et al. Adrenal Insufficiency in Corticosteroids Use: Systematic Review and Meta-Analysis. Journal of Clinical Endocrinology and Metabolism. 2015. https://doi.org/10.1210/jc.2015-1218

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