Table 4.

SUMMARY OF RANDOMIZED CONTROLLED TRIALS OF CORTICOSTEROIDS FOR ACUTE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Study		Population	Intervention	n	Outcome	P
Niewoehner et al88	1999	Inpatients	Steroid × 8 wks	80	Faster recovery of FEV1	<0.05
		FEV1 < 0.8 L	Steroid × 2 wks	80	Fewer treatment failures	<0.05
			Placebo	111	No difference between 2 and 8 wks	ns
Davies et al (A)35	1997	Inpatients	Prednisolone × 2 wks	28	Faster recovery of FEV1	<0.05
		FEV1 = 0.61 L	Placebo	22
Thompson et al125	1996	Outpatients	Prednisone × 9 d	13	Improved FEV1 and oxygenation	<0.05
		FEV1 = 1.3 L	Placebo	14	Fewer treatment failures	<0.05
Bullard et al22	1996	ER patients	Steroid × 5 d	60	Faster recovery of FEV1 by 6 hr	<0.05
		FEV1 < 0.55 L	Placebo	52
Rostom et al (A)102	1994	Inpatients	Steroid × 30 d	Total	No difference in FEV1 at 30 d	ns
			Placebo	30	20% dropout rate
Emerman et al43	1989	ER patients	MPS 100 mg IV × 1	52	No difference in FEV1	ns
		FEV1 < 30%	Placebo	44	No difference in admission rates
Albert et al3	1980	Inpatients	MPS × 3 d	22	Faster recovery of FEV1	<0.01
		FEV1 < 0.64	Placebo	22	No difference in ABGs	ns
FEV1 = Forced expiratory volume in one second; A = published in abstract form only; ER = emergency room; MPS = methylprednisolone; ABG = arterial blood gas; IV = intravenously; ns = not significant.