Zhen Ding1, Xiu Li2, Youjin Lu3, Guangsheng Rong4, Ruiqing Yang5, Ruixia Zhang6, Guiqin Wang7, Xiqiang Wei8, Yongqing Ye9, Zhaoxia Qian10, Hongyan Liu11, Daifeng Zhu12, Ruiqing Zhou13, Kun Zhu14, Rongping Ni15, Kui Xia16, Nan Luo17, Cong Pei18. 1. Department of Respiratory Medicine, The 3rd Hospital of Anhui Medical University, Hefei 1st People's Hospital, Hefei, Anhui, China. Electronic address: imdzh@163.com. 2. Department of Respiratory Medicine, The 3rd Hospital of Anhui Medical University, Hefei 1st People's Hospital, Hefei, Anhui, China. Electronic address: 919296610@qq.com. 3. Department of Respiratory Medicine, The 2nd Hospital of Anhui Medical University, Hefei, Anhui, China. Electronic address: luyougolden@hotmail.com. 4. Department of Respiratory Medicine, Hefei 3rd People's Hospital, Hefei, Anhui, China. Electronic address: rhm2007.ok@163.com. 5. Department of Respiratory Medicine, Chaoyang Hospital, Huainan, Anhui, China. Electronic address: fyyrq2013@163.com. 6. Department of Respiratory Medicine, Dongfang Hospital, Huainan, Anhui, China. Electronic address: 1197230329@qq.com. 7. Department of Respiratory Medicine, Fuyang People's Hospital, Fuyang, Anhui, China. Electronic address: wangguiqin888@126.com. 8. Department of Respiratory Medicine, Huaibei 1st People's Hospital, Huaibei, Anhui, China. Electronic address: hbhxnk3055109@163.com. 9. Department of Respiratory Medicine, Lu'an 1st People's Hospital, Lu'an, Anhui, China. Electronic address: yyq3319983@163.com. 10. Department of Respiratory Medicine, Bengbu 3rd People's Hospital, Bengbu, Anhui, China. Electronic address: zxz1088@sina.com. 11. Department of Respiratory Medicine, The 2nd Hospital of Anhui Medical University, Hefei, Anhui, China. Electronic address: hongyanliu03@126.com. 12. Department of Respiratory Medicine, Hefei 3rd People's Hospital, Hefei, Anhui, China. Electronic address: zhudaifeng1@163.com. 13. Department of Respiratory Medicine, Chaoyang Hospital, Huainan, Anhui, China. Electronic address: zhouruiqing1977@163.com. 14. Department of Respiratory Medicine, Dongfang Hospital, Huainan, Anhui, China. Electronic address: kunkun0258@qq.com. 15. Department of Respiratory Medicine, Fuyang People's Hospital, Fuyang, Anhui, China. Electronic address: xiaoni407@126.com. 16. Department of Respiratory Medicine, Huaibei 1st People's Hospital, Huaibei, Anhui, China. Electronic address: neikezz@163.com. 17. Department of Respiratory Medicine, Lu'an 1st People's Hospital, Lu'an, Anhui, China. Electronic address: 48557964@qq.com. 18. Department of Respiratory Medicine, Hefei Binhu Hospital, Hefei, Anhui, China. Electronic address: pchl331@126.com.
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. Copyright Â
RCT Entities:
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. Copyright Â