A revised treatment approach for hospitalized patients with eosinophilic and neutrophilic exacerbations of chronic obstructive pulmonary disease | Aksoy et al
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| 2018 | 2727 | 40–60 mg/day for 5–7 days (low dose vs placebo) | 45% mortality in eosinophilic AECOPD without steroids versus 0.6% with steroids (p=0.001). 71% mortality in neutrophilic AECOPD without steroids versus 1.4% with steroids (p=0.19). | Not discussed | 30% readmission in eosinophilic AECOPD not taking steroids versus 81% taking steroids (p<0.001). 70% readmission in neutrophilic AECOPD versus 19% taking steroids (p<0.001). |
Short term versus conventional glucocorticoid therapy in acute exacerbations of chronic obstructive pulmonary disease, the REDUCE randomized clinical trial (reduction in the use of corticosteroids in exacerbated COPD) | Leuppi et al
14
| 2013 | 314 | Intervention: prednisone, 40 mg/day, for 5 days followed by placebo for 9 days {n=157) or prednisone, 40 mg/day for 14 days {n=157). Day 1 treatment was intravenous methylprednisolone; all other treatments were oral (low dose vs placebo) | Differences in mortality between 5-day and 14-day treatment course (7.7% and 8.4%) were not significant. | Patients under short-term treatment had a shorter hospital stay with a median of 8 days compared with 9 days in the conventional treatment group (p=0.04). | Differences in readmission for exacerbation between 5 day and 14 days (35.9% and 36.8%) were not significant. |
Systemic steroids in acute exacerbation of COPD—from guidelines to bedside | Wang et al
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| 2011 | 164 | Patients receiving more than 60 mg/day were designated to the high-dose group; those receiving less than or equal to 60 mg/day to the low-dose group and those who did not receive any steroids during admission to the NIL group (high dose vs low dose) | The mortality rate in the low-dose group was the lowest among the three groups (6.5%, 0%, 7.8% in hig dose, low dose and NIL, respectively); (low dose vs high dose and NIL groups, p=0.042 and 0.063). | There were no statistical differences in hospital stay between the three groups. | Not discussed |