The use of corticosteroids in exacerbations of chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a progressive disease characterized by a high mortality rate. Due to the ever-growing social and economic burden, considerable attention is paid to the optimal management of patients with COPD and related exacerbations. Currently glucocorticoid (GC) remains the standard treatment for COPD exacerbations, that is based on their documented efficacy in reducing the severity of bronchial, improving gas exchange (increased forced expiratory volume in 1 second and PaO2), as well as dyspnea, decreased hospital stays and the percentage relapse over the next 30 days. Oral GC preferred over parenteral, both in terms of cost and ease of use. Inhaled GC can be used in non-severe exacerbations of COPD as an alternative to systemic steroid until other studies will be obtained.Despite the absence of large randomized controlled studies, the available data support a shorter period of treatment GK than previously recommended by the 10-14-day course of therapy. In particular, the results of a recently published randomized, double-blind, placebo-controlled studies have shown that 5-day course of systemic GC showed no less effective than the traditional 14-day regimen. Given these data, it is likely many patients are unnecessarily exposed to the negative impact of a longer course of treatment GK.It should be noted that the application of the Civil Code in exacerbations of COPD, a number of issues still remain open. For example, there are no studies on the direct comparison of different modes of HA and their use in patients with varying severity of exacerbations of COPD.

chronic obstructive pulmonary disease, exacerbation, glucocorticoids