Article Text
Statistics from Altmetric.com
QUESTION: In patients who are hospitalised with exacerbations of chronic obstructive pulmonary disease (COPD), do glucocorticoids reduce the rate of first treatment failure?
Design
Randomised (allocation concealed*), blinded (clinicians and patients),* placebo-controlled trial with follow-up at 1, 3, and 6 months.
Setting
25 US Veterans Affairs medical centres.
Patients
271 patients (mean age 68 y, 99% men, 83% white) admitted to hospital with COPD. Inclusion criteria were age ≥50 years, history of ≥30 pack-years of smoking, and FEV1 ≤1.5 l or inability to have spirometry because of dyspnoea. Exclusion criteria were asthma, recent use of study drugs, or expected survival <1 year.
Intervention
Patients received broad-spectrum antibiotics for 1 week and inhaled β-adrenergic agonist, ipratropium bromide, and triamcinolone acetonide for 6 months. Medications other than study drugs …