A randomized, controlled multicentric study of inhaled budesonide and intravenous methylprednisolone in the treatment on acute exacerbation of chronic obstructive pulmonary disease
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...
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| Veröffentlicht in: | Respiratory medicine 2016-12, Vol.121, p.39-47 |
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| creator | Ding, Zhen Li, Xiu Lu, Youjin Rong, Guangsheng Yang, Ruiqing Zhang, Ruixia Wang, Guiqin Wei, Xiqiang Ye, Yongqing Qian, Zhaoxia Liu, Hongyan Zhu, Daifeng Zhou, Ruiqing Zhu, Kun Ni, Rongping Xia, Kui Luo, Nan Pei, Cong |
| description | 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), artery 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 blood gas analysis were significantly improved after treatment in both groups ( P 0.05), while incidence of adverse events in the budesonide group was lower ( P |
| doi_str_mv | 10.1016/j.rmed.2016.10.013 |
| format | Article |
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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), artery 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 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.</description><identifier>ISSN: 0954-6111</identifier><identifier>EISSN: 1532-3064</identifier><identifier>DOI: 10.1016/j.rmed.2016.10.013</identifier><identifier>PMID: 27888990</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Acute Disease ; Administration, Inhalation ; Aged ; Bronchodilator Agents - administration & dosage ; Bronchodilator Agents - therapeutic use ; Budesonide - administration & dosage ; Budesonide - therapeutic use ; Carbon Dioxide - blood ; Chronic obstructive pulmonary disease ; Drug dosages ; Dyspnea ; Exacerbation ; Female ; Forced Expiratory Volume - drug effects ; Glucocorticoids - administration & dosage ; Glucocorticoids - therapeutic use ; Humans ; Inhaled corticosteroid ; Injections, Intravenous ; Male ; Methylprednisolone - administration & dosage ; Methylprednisolone - therapeutic use ; Middle Aged ; Mortality ; Oxygen - blood ; Partial Pressure ; Pulmonary Disease, Chronic Obstructive - blood ; Pulmonary Disease, Chronic Obstructive - drug therapy ; Pulmonary Disease, Chronic Obstructive - physiopathology ; Pulmonary/Respiratory ; Single-Blind Method ; Systemic corticosteroid ; Ventilation ; Vital Capacity - drug effects</subject><ispartof>Respiratory medicine, 2016-12, Vol.121, p.39-47</ispartof><rights>2016 Elsevier Ltd</rights><rights>Copyright © 2016 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Limited Dec 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c586t-e6f61553cdeb40b249955e89b049d9de29b37910adb601bbb00edfab1b7b29923</citedby><cites>FETCH-LOGICAL-c586t-e6f61553cdeb40b249955e89b049d9de29b37910adb601bbb00edfab1b7b29923</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0954611116302669$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27888990$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ding, Zhen</creatorcontrib><creatorcontrib>Li, Xiu</creatorcontrib><creatorcontrib>Lu, Youjin</creatorcontrib><creatorcontrib>Rong, Guangsheng</creatorcontrib><creatorcontrib>Yang, Ruiqing</creatorcontrib><creatorcontrib>Zhang, Ruixia</creatorcontrib><creatorcontrib>Wang, Guiqin</creatorcontrib><creatorcontrib>Wei, Xiqiang</creatorcontrib><creatorcontrib>Ye, Yongqing</creatorcontrib><creatorcontrib>Qian, Zhaoxia</creatorcontrib><creatorcontrib>Liu, Hongyan</creatorcontrib><creatorcontrib>Zhu, Daifeng</creatorcontrib><creatorcontrib>Zhou, Ruiqing</creatorcontrib><creatorcontrib>Zhu, Kun</creatorcontrib><creatorcontrib>Ni, Rongping</creatorcontrib><creatorcontrib>Xia, Kui</creatorcontrib><creatorcontrib>Luo, Nan</creatorcontrib><creatorcontrib>Pei, Cong</creatorcontrib><title>A randomized, controlled multicentric study of inhaled budesonide and intravenous methylprednisolone in the treatment on acute exacerbation of chronic obstructive pulmonary disease</title><title>Respiratory medicine</title><addtitle>Respir Med</addtitle><description>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), artery 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 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.</description><subject>Acute Disease</subject><subject>Administration, Inhalation</subject><subject>Aged</subject><subject>Bronchodilator Agents - administration & dosage</subject><subject>Bronchodilator Agents - therapeutic use</subject><subject>Budesonide - administration & dosage</subject><subject>Budesonide - therapeutic use</subject><subject>Carbon Dioxide - blood</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Drug dosages</subject><subject>Dyspnea</subject><subject>Exacerbation</subject><subject>Female</subject><subject>Forced Expiratory Volume - drug effects</subject><subject>Glucocorticoids - administration & dosage</subject><subject>Glucocorticoids - therapeutic use</subject><subject>Humans</subject><subject>Inhaled corticosteroid</subject><subject>Injections, Intravenous</subject><subject>Male</subject><subject>Methylprednisolone - administration & dosage</subject><subject>Methylprednisolone - therapeutic use</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Oxygen - blood</subject><subject>Partial Pressure</subject><subject>Pulmonary Disease, Chronic Obstructive - blood</subject><subject>Pulmonary Disease, Chronic Obstructive - drug therapy</subject><subject>Pulmonary Disease, Chronic Obstructive - physiopathology</subject><subject>Pulmonary/Respiratory</subject><subject>Single-Blind Method</subject><subject>Systemic corticosteroid</subject><subject>Ventilation</subject><subject>Vital Capacity - drug effects</subject><issn>0954-6111</issn><issn>1532-3064</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNks2KFDEUhQtRnJ7RF3AhATcuptukKqmugAwMg38w4EJdh_zcptOmkjZJNbbP5QN6i55BmIW4SnLuuQfu_dI0LxhdMcr6N7tVHsGtWryjsKKse9QsmOjaZUd7_rhZUCn4smeMnTXnpewopZJz-rQ5a9fDMEhJF83va5J1dGn0v8BdEptizSkEcGScQvUW8O0tKXVyR5I2xMetnqtmclBS9A4ItqNcsz5ATFMhI9TtMewzuOhLCikClkndAqkZdB0xkqRItJ0qEPipLWSjq0cJ8-02Y6olyZSaJ1v9Ach-CmOKOh-J8wV0gWfNk40OBZ7fnRfNt_fvvt58XN5-_vDp5vp2acXQ1yX0m54J0VkHhlPTcimFgEEayqWTDlppurVkVDvTU2aMoRTcRhtm1qaVsu0umten3H1OPyYoVY2-WAhBR8BJFRsEXQ98EN1_WDnvBBeMo_XVA-suTTniILNrjYSQE7rak8vmVEqGjdpnP-ISFKNqxq92asavZvyzhvix6eVd9GTm2n3LPW80vD0ZANd28JBVsR6iBecz2Kpc8v_Ov3rQboNHXDp8hyOUv3Oo0iqqvswfcP5_rO9o2_ey-wMXU9q6</recordid><startdate>20161201</startdate><enddate>20161201</enddate><creator>Ding, Zhen</creator><creator>Li, Xiu</creator><creator>Lu, Youjin</creator><creator>Rong, Guangsheng</creator><creator>Yang, Ruiqing</creator><creator>Zhang, Ruixia</creator><creator>Wang, Guiqin</creator><creator>Wei, Xiqiang</creator><creator>Ye, Yongqing</creator><creator>Qian, Zhaoxia</creator><creator>Liu, Hongyan</creator><creator>Zhu, Daifeng</creator><creator>Zhou, Ruiqing</creator><creator>Zhu, Kun</creator><creator>Ni, Rongping</creator><creator>Xia, Kui</creator><creator>Luo, Nan</creator><creator>Pei, Cong</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>ASE</scope><scope>FPQ</scope><scope>H94</scope><scope>K6X</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>7ST</scope><scope>C1K</scope><scope>SOI</scope></search><sort><creationdate>20161201</creationdate><title>A randomized, controlled multicentric study of inhaled budesonide and intravenous methylprednisolone in the treatment on acute exacerbation of chronic obstructive pulmonary disease</title><author>Ding, Zhen ; Li, Xiu ; Lu, Youjin ; Rong, Guangsheng ; Yang, Ruiqing ; Zhang, Ruixia ; Wang, Guiqin ; Wei, Xiqiang ; Ye, Yongqing ; Qian, Zhaoxia ; Liu, Hongyan ; Zhu, Daifeng ; Zhou, Ruiqing ; Zhu, Kun ; Ni, Rongping ; Xia, Kui ; Luo, Nan ; Pei, Cong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c586t-e6f61553cdeb40b249955e89b049d9de29b37910adb601bbb00edfab1b7b29923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Acute Disease</topic><topic>Administration, Inhalation</topic><topic>Aged</topic><topic>Bronchodilator Agents - administration & dosage</topic><topic>Bronchodilator Agents - therapeutic use</topic><topic>Budesonide - administration & dosage</topic><topic>Budesonide - therapeutic use</topic><topic>Carbon Dioxide - blood</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Drug dosages</topic><topic>Dyspnea</topic><topic>Exacerbation</topic><topic>Female</topic><topic>Forced Expiratory Volume - drug effects</topic><topic>Glucocorticoids - administration & dosage</topic><topic>Glucocorticoids - therapeutic use</topic><topic>Humans</topic><topic>Inhaled corticosteroid</topic><topic>Injections, Intravenous</topic><topic>Male</topic><topic>Methylprednisolone - administration & dosage</topic><topic>Methylprednisolone - therapeutic use</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Oxygen - blood</topic><topic>Partial Pressure</topic><topic>Pulmonary Disease, Chronic Obstructive - blood</topic><topic>Pulmonary Disease, Chronic Obstructive - drug therapy</topic><topic>Pulmonary Disease, Chronic Obstructive - physiopathology</topic><topic>Pulmonary/Respiratory</topic><topic>Single-Blind Method</topic><topic>Systemic corticosteroid</topic><topic>Ventilation</topic><topic>Vital Capacity - drug effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ding, Zhen</creatorcontrib><creatorcontrib>Li, Xiu</creatorcontrib><creatorcontrib>Lu, Youjin</creatorcontrib><creatorcontrib>Rong, Guangsheng</creatorcontrib><creatorcontrib>Yang, Ruiqing</creatorcontrib><creatorcontrib>Zhang, Ruixia</creatorcontrib><creatorcontrib>Wang, Guiqin</creatorcontrib><creatorcontrib>Wei, Xiqiang</creatorcontrib><creatorcontrib>Ye, Yongqing</creatorcontrib><creatorcontrib>Qian, Zhaoxia</creatorcontrib><creatorcontrib>Liu, Hongyan</creatorcontrib><creatorcontrib>Zhu, Daifeng</creatorcontrib><creatorcontrib>Zhou, Ruiqing</creatorcontrib><creatorcontrib>Zhu, Kun</creatorcontrib><creatorcontrib>Ni, Rongping</creatorcontrib><creatorcontrib>Xia, Kui</creatorcontrib><creatorcontrib>Luo, Nan</creatorcontrib><creatorcontrib>Pei, Cong</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>Environment Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Environment Abstracts</collection><jtitle>Respiratory medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ding, Zhen</au><au>Li, Xiu</au><au>Lu, Youjin</au><au>Rong, Guangsheng</au><au>Yang, Ruiqing</au><au>Zhang, Ruixia</au><au>Wang, Guiqin</au><au>Wei, Xiqiang</au><au>Ye, Yongqing</au><au>Qian, Zhaoxia</au><au>Liu, Hongyan</au><au>Zhu, Daifeng</au><au>Zhou, Ruiqing</au><au>Zhu, Kun</au><au>Ni, Rongping</au><au>Xia, Kui</au><au>Luo, Nan</au><au>Pei, Cong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A randomized, controlled multicentric study of inhaled budesonide and intravenous methylprednisolone in the treatment on acute exacerbation of chronic obstructive pulmonary disease</atitle><jtitle>Respiratory medicine</jtitle><addtitle>Respir Med</addtitle><date>2016-12-01</date><risdate>2016</risdate><volume>121</volume><spage>39</spage><epage>47</epage><pages>39-47</pages><issn>0954-6111</issn><eissn>1532-3064</eissn><abstract>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), artery 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 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.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>27888990</pmid><doi>10.1016/j.rmed.2016.10.013</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acute Disease Administration, Inhalation Aged Bronchodilator Agents - administration & dosage Bronchodilator Agents - therapeutic use Budesonide - administration & dosage Budesonide - therapeutic use Carbon Dioxide - blood Chronic obstructive pulmonary disease Drug dosages Dyspnea Exacerbation Female Forced Expiratory Volume - drug effects Glucocorticoids - administration & dosage Glucocorticoids - therapeutic use Humans Inhaled corticosteroid Injections, Intravenous Male Methylprednisolone - administration & dosage Methylprednisolone - therapeutic use Middle Aged Mortality Oxygen - blood Partial Pressure Pulmonary Disease, Chronic Obstructive - blood Pulmonary Disease, Chronic Obstructive - drug therapy Pulmonary Disease, Chronic Obstructive - physiopathology Pulmonary/Respiratory Single-Blind Method Systemic corticosteroid Ventilation Vital Capacity - drug effects |
| title | A randomized, controlled multicentric study of inhaled budesonide and intravenous methylprednisolone in the treatment on acute exacerbation of chronic obstructive pulmonary disease |
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