IV or Oral Steroids for COPD Exacerbations?

Patients hospitalized for chronic obstructive pulmonary disease exacerbations often receive IV corticosteroids. In this randomized, double-blind trial, researchers in the Netherlands examined whether IV therapy offers any advantage over oral therapy in 210 patients hospitalized for COPD exacerbations; those with severe respiratory acidosis were excluded.

Patients received either IV or oral prednisolone (60 mg daily) plus corresponding placebos for 5 days, followed by a week of tapering oral prednisolone. At 90 days, no differences between groups were observed in the composite primary outcome — death, intensive care unit admission, readmission to the hospital for COPD, or predefined intensification of treatment. Early treatment failure (withi…