Fig. 3

Use of ICS in patients with COPD exacerbations according to recommendations in GOLD Report 2023 [29]. *Single inhaler therapy may be more convenient and effective than multiple inhalers. **Consider de-escalation of ICS if pneumonia or other considerable side-effects. In case of blood eos ≥ 300 cells/µl de-escalation is more likely to be associated with the development of exacerbations. Eos blood eosinophil count, ICS inhaled corticosteroid, LABA long-acting beta2-agonist, LAMA long-acting muscarinic antagonist