Should Steroid Dosing in COPD Exacerbations Be Individualized?

Personalized systemic corticosteroid regimens for chronic obstructive pulmonary disease were associated with less treatment failure than was fixed dosing.

Evidence suggests that shorter courses of systemic corticosteroids are preferable for patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease (COPD; NEJM JW Hosp Med Aug 2013 and JAMA 2013; 309:2223), but the optimal dosage is unknown. Researchers performed a randomized trial at four hospitals in China, comparing personalized-dose corticosteroids versus fixed doses (40 mg prednisone equivalent, daily for 5 days) in 248 adult patients hospitalized with acute COPD exacerbations. Personalized corticosteroid dosing was based on five factors that included symptom scales, previous steroid dosing, inflammatory markers, and blood gas results.

The primary outcome, treatment failure (a composite of death, mechanical ven…

Reviewing Author

Neil H. Winawer, MD, SFHM

Disclosures

Nothing to disclose

Neil H. Winawer, MD, SFHM

Disclosures

Nothing to disclose

Should Steroid Dosing in COPD Exacerbations Be Individualized?

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Reviewing Author