Inhaled Corticosteroids (ICS) on Pulmonary Endothelial Function in COPD

The study objective is to determine whether an ICS added for 4 weeks to a baseline treatment with a Long-Acting Beta-adrenergic Agonist (LABA) and Long-Acting Muscarinic Antagonist (LAMA) combination improves pulmonary vascular endothelial function as assessed by the vasodilator response to inhaled albuterol (endothelium-dependent vasodilation) in stable COPD patients treated with a LABA/LAMA without an ICS for at least one month.

Inclusion Criteria: * physician diagnosis of COPD * former smoking history of more than 10 pack-years * baseline post-bronchodilator one-second forced expiratory volume (FEV1) 50-80% of predicted, baseline FEV1 and forced vital capacity (FVC) ratio \40mmHg right ventricular systolic pressure (RVSP) by prior echocardiography * a documented COVID infection within 4 weeks of the screening day * Regular use of home oxygen at rest * Physician diagnosis of obesity hypoventilation syndrome