Two Different Dosages of Nebulized Steroid Versus Parenteral Steroid in the Management of COPD Exacerbations
Status:
Completed
Trial end date:
2013-05-01
Target enrollment:
Participant gender:
Summary
Chronic obstructive pulmonary disease (COPD) is a common disease that has a chronic and
progressive course. Patients with COPD may have exacerbations one to four times in a year.
Numbers of exacerbations are important because of increased morbidity and mortality and
healthcare costs.
Systemic corticosteroids (SC) are recommended in the management of exacerbations of COPD as
well as bronchodilator, oxygen and antibacterial treatment by all international guidelines.
However, there are still some concerns about systemic corticosteroid use because COPD
patients are older and relatively immobilized. In addition, exacerbation rate is
significantly higher in a group of COPD patients, and these patients need higher amounts of
SC in order to control of exacerbation. It results in some adverse effects such as
osteoporosis and bone fractures, thinning of the skin, posterior subcapsular cataract
formation, glucose intolerance and myopathy. Thus, this condition leads clinicians to seek
alternative options. However, there are few studies showing that nebulized steroids (NS) are
as effective as SC in exacerbations of COPD and the optimal NS dose is not certain.
The investigators aimed to determine the optimal NS dose and evaluate the efficacy and safety
of NS compared with SC in the treatment of patients with COPD exacerbations requiring
hospitalization.