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Role of Short Term Corticosteroids on Acute COPD Exacerbations

posted Mar 9, 2014, 1:27 PM by Yasser Mohamed Abdelhamid   [ updated Mar 18, 2014, 12:18 PM ]
Expert guidelines recommend 10-14 days systemic corticosteroids for treatment of COPD exacerbations. But this is based largely on one clinical trial more than a decade ago, which did not examine shorter treatment courses. 

Steroids help resolve COPD exacerbations, and probably save lives. But steroids cause hyperglycemia, which can be harmful, and regular (long-term) use of corticosteroids is linked to higher mortality in people with COPD

Swiss researchers Jörg D. Leuppi et al add their piece to the puzzle in the May 2013 JAMA .They randomized 314 people mostly with severe COPD (mean FEV1 31%) having severe COPD exacerbations to receive either 5 days of 40 mg prednisone followed by 9 days of placebo, or 14 days of 40 mg prednisone.

They found no statistically significant difference between the short and the long treatment courses regarding frequency of exacerbations , time till next exacerbation, need for mechanical ventilation, hyperglycaemia or mortality

Will that study change the way you treat COPD exacerbations?
Yasser Mohamed Abdelhamid,
Mar 9, 2014, 1:27 PM