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A randomized, controlled multicentric study of inhaled budesonide and intravenous methylprednisolone in the treatment on acute exacerbation of chronic obstructive pulmonary disease.

Abstract：

BACKGROUND:Almost all international guidelines recommend corticosteroids for management of exacerbations of chronic obstructive pulmonary disease (COPD), because it leads to improved outcomes of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Nevertheless, due to its side effects, there are still concerns regarding the use of systemic corticosteroid (SC). Inhaled corticosteroids (IC) can be used as an alternative to SC, while reducing the risk of occurrence of side effects. PURPOSE:To measure the clinical efficacy and side effects of nebulized budesonide and systemic methylprednisolone in AECOPD. METHODS:Valid data from 410 AECOPD patients in 10 hospitals was collected. Patients were randomly divided into 2 groups; budesonide group, treated with nebulized budesonide (2 mg 3 times/day); and methylprednisolone group, treated with intravenously injected methylprednisolone (40 mg/day). COPD assessment test (CAT), arterial blood gas analysis, hospitalization days, adverse effects, fasting blood glucose, serum creatinine, alanine aminotransferase levels, and blood drug were measured and analyzed in both groups. RESULTS:Symptoms, pulmonary function and arterial blood gas analysis were significantly improved after treatment in both groups (P < 0.05), with no significant differences between them (P > 0.05), while incidence of adverse events in the budesonide group was lower (P < 0.05). No significant differences in CAT score, days of admission, blood gas analysis results and physiological and biochemical indexes were found between the two groups. Patients treated with methylprednisolone showed a higher degree of PaO2 level improvement. CONCLUSION:Results show that inhalation of budesonide (2 mg 3 times/day) and systemic methylprednisolone (40 mg/day) had similar clinical outcome in AECOPD. In conclusion, inhaled budesonide is an alternative to systemic corticosteroids in AECOPD treatment.

journal_name

Respir Med

journal_title

Respiratory medicine

authors

Ding Z,Li X,Lu Y,Rong G,Yang R,Zhang R,Wang G,Wei X,Ye Y,Qian Z,Liu H,Zhu D,Zhou R,Zhu K,Ni R,Xia K,Luo N,Pei C

doi

10.1016/j.rmed.2016.10.013

subject

Has Abstract

pub_date

2016-12-01 00:00:00

pages

39-47

eissn

0954-6111

issn

1532-3064

pii

S0954-6111(16)30266-9

journal_volume

121

pub_type

杂志文章,多中心研究,随机对照试验

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A randomized, controlled multicentric study of inhaled budesonide and intravenous methylprednisolone in the treatment on acute exacerbation of chronic obstructive pulmonary disease.