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COPD: Abdullah Sayiner, Zeynep Ayfer Aytemur, Murat Cirit, and Ipek Ünsal Systemic Glucocorticoids in Severe Exacerbations of COPD Chest 2001; 119: 726-730 [Abstract] [Full text] [PDF]

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Role of Glucocorticoids in COPD

Dr S K Agarwal   (18 March 2002)

Role of Glucocorticoids in COPD 18 March 2002
Dr S K Agarwal, Head, Department of Chest Diseases, Institute of Medical Sciences, BHU, Varanasi Send letter to journal: Re: Role of Glucocorticoids in COPD sk_agarwal{at}satyam.net.in Dr S K Agarwal	There is discrepancy between the responses to corticosteroids in acute and chronic COPD which may be related to differences in the inflammation response (such as increased numbers of eosinophils) or airway oedema in exacerbations. In the present study (1) the systemic steroid was used for 10 days whereas others have used for even 56 days. There is a beneficial effect of systemic corticosteroids in treating acute exacerbations of COPD, with improved clinical outcome and reduced length of hospitalization.It’s quite common to see patients of stable COPD receiving inhaled or oral steroid. However, the inflammation in stable COPD in not suppressed by inhaled or oral corticosteroids, even at high doses. This lack of effect may be due to the fact that corticosteroids prolong the survival of neutrophils and do not suppress neutrophilic inflammation in COPD. There is no evidence that long-term treatment with high doses of inhaled reduce the progression of COPD, even when the treatment is started before the patient is symptomatic. Inhaled corticosteroids may slightly reduce the severity of acute exacerbations, but it is unlikely that their use can be justified in view of the risk of systemic side effects. Reference: 1.Sayiner A, Aytamur ZA, Cirit M and Unsal I. Systemic Glucosteroids in Exacerbation of COPD, Chest,2001,119:726-730