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Objectives: To conduct a systematic review and meta-analysis regarding the efficacy and safety of inhaled corticosteroids for COPD exacerbations.Method: A comprehensive search was conducted for all English-language articles published between January 1, 2000, and June 30, 2012, via MEDLINE and EMBASE (including reference lists and author contact information), and reviewed articles that had examined, compared, or evaluated the effect of inhalers to other pharmacologic interventions for COPD. Two independent review authors independently extracted the data and the results were extracted with a predetermined significance level and a fixed random-effect pooled mean difference (REMD) adjusted for random effects in order to compare the intervention groups, and to assess the magnitude and significance of the treatment effect of inhaled corticosteroids for COPD exacerbations .Findings: A total of 12 studies meeting the inclusion criteria were identified. Four studies (including 11 of the 12 included in this review) assessed the efficacy of inhalers compared with the control group during treatment, 6/12 studies reported significant differences across inhaler groups, and 5/12 studies reported significant differences across the inhaler groups in outcome measures assessed after cessation of treatment. The effectiveness of inhaled corticosteroids as a treatment for exacerbation is similar to that of a medication to treat acute pulmonary edema, and the overall treatment effect of inhalers is stronger than that of a medication to treat chronic bronchitis. All inhaler groups showed beneficial responses to inhaler therapy, and the relative differences were small.Conclusions: There is no convincing evidence to support using inhaled corticosteroids as a treatment for COPD exacerbations. There appears to be a strong correlation between the clinical manifestation of COPD and the use of inhaled corticosteroids to treat COPD exacerbations. Additional research is required to determine the precise rationale behind using inhaled corticosteroids to treat COPD exacerbations. It is hypothesized that this approach will help to increase quality of life for patients who may benefit by using this medication.References1. National Center for Complementary and Alternative Medicine. National Clinical Practice Guidelines on Chronic Pulmonary Edema Treatment. 2012. Accessed May 17, 2015. http://www.nccam.org/topics/clinical/chronic-pulmonary-edema-treatment-nccam/2. Hennig L, Voss J, Reimers A, Pecsi-Kunitski S, Wurth A, Friesner A (2013). Long-term safety and effectiveness of inhaled cortRelated Article: