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Comparative Efficacies of Inhaled Corticosteroids and Systemic Corticosteroids in Treatment of Chronic Obstructive Pulmonary Disease Exacerbations: A Systematic Review and Meta-Analysis.

Comparative Efficacies of Inhaled Corticosteroids and Systemic Corticosteroids in Treatment of Chronic Obstructive Pulmonary Disease Exacerbations: A Systematic Review and Meta-Analysis.
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Zhai Y, Zhang H, Sun T, Ye M, Liu H, Zheng R,


Zhai Y, Zhang H, Sun T, Ye M, Liu H, Zheng R, (click to view)

Zhai Y, Zhang H, Sun T, Ye M, Liu H, Zheng R,

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Journal of aerosol medicine and pulmonary drug delivery 2017 03 16() doi 10.1089/jamp.2016.1353
Abstract
BACKGROUND
Corticosteroids play an important role in the treatment of chronic obstructive pulmonary disease (COPD) exacerbations, and a global initiative has suggested the use of inhaled corticosteroids (ICSs) as an alternative to systemic corticosteroids (SCs). Here, we report results of a meta-analysis performed to systematically compare the efficacies of ICSs and SCs in the treatment of COPD exacerbations.

METHODS
PubMed, EMBASE, and the Cochrane databases were searched for relevant human clinical trials describing the use of ICSs compared with SCs in the treatment of COPD exacerbations. We compared the results of FEV1%pred and blood gas analyses that had been calculated. Weighted mean differences and fixed effects models were applied by using Revman 5.2.

RESULTS
Five original studies satisfied our inclusion criteria, and no significant heterogeneity was shown. Three studies evaluated the increase of FEV1%pred after treatment for 7 days. There were three and four studies, respectively, that evaluated the increase of SaO2 and PaO2, and three reported the decrease of PaCO2 at 24 hours control, 2-4 days control, and 7-10 days control. All the results showed that both ICSs and SCs were effective in the treatment of COPD exacerbations.

CONCLUSION
ICSs were not inferior to SCs when used in the treatment of COPD exacerbations.

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