Chest
Original ResearchCOPDOral or IV Prednisolone in the Treatment of COPD Exacerbations
Section snippets
Patients
Patients referred to the Isala klinieken hospital for an exacerbation of COPD were enrolled in the study from June 2001 to June 2003. Inclusion criteria were an age of > 40 years, a history of at least 10 pack-years of cigarette smoking, and evidence of airflow limitation. Airflow limitation was defined as an FEV1/FVC ratio of < 70% and an FEV1 of < 80% predicted (at least Global Initiative for Chronic Obstructive Lung Disease [GOLD] severity stage II).1617 An exacerbation of COPD was defined
Study Population
A total of 435 individuals with a total of 581 exacerbation episodes were referred to the Isala klinieken for an exacerbation of COPD. A total of 210 patients were eligible, of whom 107 were randomized to receive IV prednisolone, and 103 to receive oral prednisolone. Six patients withdrew consent before day 4 of the study, two patients in the IV prednisolone group and four patients in the oral prednisolone group. Another 11 patients were excluded from the per-protocol analysis because they did
Discussion
The administration of systemic corticosteroids for treatment of exacerbations of COPD was already widespread long before good evidence for its use became available in 1999.56 At least 10 studies567891011121314 have now studied the effects of systemic steroids in the treatment of exacerbations of COPD, but these studies varied considerably in terms of corticosteroid dosage, length of treatment, and route of administration. Customs vary considerably between and within countries. The GOLD,16 the
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The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.