Short Steroid Course Non-Inferior for COPD Exacerbations
(HealthDay News) – For patients presenting to the emergency department with acute chronic obstructive pulmonary disease (COPD) exacerbations, five days of treatment with glucocorticoids is non-inferior to conventional 14-day therapy for reexacerbation within six months, according to a study published online May 21 in the Journal of the American Medical Association to coincide with presentation at the annual meeting of the American Thoracic Society, held from May 17–22 in Philadelphia.
Jörg D. Leuppi, MD, PhD, from the University Hospital of Basel in Switzerland, and colleagues assessed whether five-day systemic glucocorticoid therapy is non-inferior to conventional 14-day treatment for patients who present to the emergency department with acute COPD exacerbations. Three hundred fourteen patients were randomized and 311 and 296, respectively, were included in the intention-to-treat and per-protocol analyses.
The researchers found that in the intention-to-treat and per-protocol analyses the hazard ratios for short-term vs. conventional treatment were significant for non-inferiority and met the prespecified non-inferiority criterion. The primary end point of time to next exacerbation within 180 days was met by 35.9% and 36.8% of patients in the short-term and conventional treatment groups, respectively. The median time to reexacerbation was 43.5 and 29 days, respectively, with short-term and conventional treatment. No between-group differences were seen in the time to death; the combined end point of exacerbation, death, or both; or in recovery of lung function.
"In summary, in our study a five-day glucocorticoid treatment course was non-inferior to a 14-day course with respect to reexacerbation during six months of follow-up," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.