COPD exacerbations are incredibly common, managed under respiratory and general medical units for the most part. The duration of higher dose steroids vary however – some give just a few days, others up to two weeks. The REDUCE trial from JAMA this month proves the optimal duration, comparing 5 with 14 days.
Essentially, just over 311 patients were looked at with both intention to treat and per protocol analysis. There wasn’t any difference etween time to re-exacerbation or mortality, meaning that you can get away with a shorter course of steroid. Presumably this would lead to less adverse reactions – this trial didn’t see any difference in hyperglycaemia or hypertension however.
source | JAMA
image | Pulmonary Pathology