Comparison of the Efficacy of Nebulised Budesonide with Parenteral Corticosteroids in the Treatment of Acute Exacerbations of Chronic Obstructive Pulmonary Disease
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To compare the efficacy and safety of nebulised budesonide and systemic corticosteroid in the treatment of acute exacerbations of chronic obstructive pulmonary disease (COPD).
Randomised, double-blind, placebo-controlled, parallel-group trial.
Patients and interventions
A total of 40 patients who had moderate to severe acute exacerbations of COPD and required hospitalisation were enrolled in the study. The patients were randomised to receive either nebulised budesonide 8mg daily (n = 21) or systemic (intravenous) prednisolone 40mg daily (n = 19). Airway obstruction (peak expiratory flow rate [PEFR]) and gas exchange (arterial partial pressure of oxygen [PaO2] and carbon dioxide [PaCO2], pH and oxygen saturation [SaO2]) were evaluated at 30 min, at 6, 24 and 48 hours, and at day 10.
There were no significant differences between groups at baseline. In both groups, differences were significant for PEFR, SaO2 and PaO2 (p < 0.001), but not for PaCO2 and pH, in comparison with their baseline values. There were no significant differences between groups for all parameters (PEFR, PaO2, PaCO2, pH and SaO2) at all time periods. No adverse events were recorded in either group.
Our study suggests that nebulised budesonide may be an alternative to parenteral corticosteroids in the treatment of acute exacerbations of COPD.
KeywordsChronic Obstructive Pulmonary Disease Budesonide Acute Exacerbation Systemic Corticosteroid Peak Expiratory Flow Rate
The authors have provided no information on sources of funding or on conflicts of interest directly relevant to the content of this study.
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