Recently, a step-by-step pharmacologic therapy for chronic obstructive pulmonary disease (COPD) has been recommended by several principal organizations. The characteristic of this therapy is that it is a stepwise approach organized according to the severity of disease and is mainly composed of bronchodilators including beta 2-agonists and anticholinergic agents, theophylline, and oral corticosteroids, and the goal of this therapy is to induce bronchodilation, decrease the inflammatory reaction, and facilitate expectoration. Since the effectiveness of one of the inhaled corticosteroids has been also indicated by the multicentre randomised trial in a few years, they may have an important role in the long-term treatment of COPD.