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Inhaled corticosteroids (ICS) combined with bronchodilators can reduce the frequency of exacerbations in some patients with chronic obstructive pulmonary disease (COPD). There is evidence, however, that ICS are frequently used in patients where their benefit has not been established. This guideline from the European Respiratory Society contains:
- conditional recommendation for the withdrawal of ICS in patients with COPD without a history of frequent exacerbations
- strong recommendation not to withdraw ICS in patients with blood eosinophil counts ⩾300 eosinophils·μL−1
- strong recommendation to treat with one or two long-acting bronchodilators if ICS are withdrawn.