Bronchodilator Therapy with or without Inhaled Corticosteroid Therapy for Obstructive Airways Disease

To the Editor: I wish to comment on the dose of beclomethasone used by Kerstjens et al. (Nov. 12 issue) 1 in their study of bronchodilator therapy with and without inhaled corticosteroids for chronic obstructive pulmonary disease (COPD). Readers should be aware that preparations of beclomethasone that are currently available in this country yield 42 μg per puff. The dose used by Kerstjens et al. was 800 μg per day. Thus, a patient would require approximately 20 puffs a day to reach this dose. A 200-puff canister retails for approximately $33. A patient using 20 puffs a day would need three . . .