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Systemic corticosteroids in chronic obstructive pulmonary disease: An overview of Cochrane systematic reviews

Wood-Baker, R, Walters, JAE and Walters, EH 2007 , 'Systemic corticosteroids in chronic obstructive pulmonary disease: An overview of Cochrane systematic reviews' , Respiratory Medicine, vol. 101, no. 3 , pp. 371-377 , doi:

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Chronic obstructive pulmonary disease (COPD) is characterized by symptoms of cough,
sputum and breathlessness, which become worse during acute exacerbations. The airway
inflammation associated with COPD has led to trials of the effect of systemic
corticosteroids in COPD assessed in two Cochrane systematic reviews. In stable COPD,
compared with placebo, oral corticosteroid treatment increased mean FEV1 by 53 ml and
mean 12-min walking distance by 29 m, but at an increased risk of any drug-related adverse
event (OR 7.8). In acute exacerbations, oral corticosteroid treatment decreased the
chance of treatment failure (OR 0.48), improved mean FEV1 at 72 h by 140 ml and improved
arterial blood gases, but increased the risk of drug-related adverse events (OR 2.3). Thus,
treatment of stable and acute exacerbations of COPD with systemic corticosteroids results
in statistically significant average benefits, but at an increased risk of adverse events. In
stable COPD, there is little support for the use of systemic corticosteroid treatment, as
data on long-term outcomes are lacking. For acute exacerbations, the evidence to support
the use of systemic corticosteroids is stronger, but further research is required to define
the optimum dose, route and duration.
& 2006 Elsevier Ltd. All rights reserved.

Item Type: Article
Authors/Creators:Wood-Baker, R and Walters, JAE and Walters, EH
Keywords: Pulmonary disease; Chronic obstructive; Adrenal cortex hormones
Journal or Publication Title: Respiratory Medicine
ISSN: 0954-6111
DOI / ID Number:
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