TABLE 3.

CORTICOSTEROID THERAPY DURING ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Study (yr)	Number of Patients	Design	Results
Albert (1980)*	44	RCT	Steroids improved FEV1
Emmerman (1989)†	100	RCT	Steroids had no effect
Bullard (1996)‡	138	RCT	Steroids improved FEV1, not hospitalization rates
Thompson (1996)§	27	RCT	Steroids improved FEV1
Davies (1999)‖	56	RCT	Steroids improved FEV1, not subsequent walk test or FEV1
Niewoehner (1999)¶	271	RCT	Steroids reduced treatment failures, not long-term outcome

Definition of abbreviation: RCT = randomized controlled trial.

Data from Reference 40.

^*Albert RK, Martin TR, Lewis SW. Controlled clinical trial of methylprednisolone in patients with chronic bronchitis and acute respiratory insufficiency. Ann Intern Med 1980;92:753–758.

^†Emerman CL, Connors AF, Lukens TW, May ME, Effron D. A randomized controlled trial of methylprednisolone in the emergency treatment of acute exacerbations of COPD. Chest 1989;95:563–567.

^‡Bullard W, Burgi H, Landis E. Early corticosteroid use in acute exacerbations of chronic airflow obstruction. Am J Emerg Med 1996;14:139–143.

^§Thompson WH, Nielson CP, Carvalho P, Charan NB, Crowley JJ. Controlled trial of oral prednisone in outpatients with acute COPD exacerbation. Am J Respir Crit Care Med 1996;154:407–412.

^‖Davies L, Angus RM, Calverley PMA. Oral corticosteroids in patients admitted to hospital with exacerbations of chronic obstructive pulmonary disease: a prospective randomised controlled trial. Lancet 1999;354:456–460.

^¶Niewoehner DE, Erbland ML, Deupree RH, Collins D, Gross NJ, Light RW, Anderson P, Morgan NA. Effect of systemic glucocorticoids on exacerbations of chronic obstructive pulmonary disease. N Engl J Med 1999;340:1941–1947.