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Glucocorticoids reduced short-term treatment failure in exacerbations of chronic obstructive pulmonary disease

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 QUESTION: In patients who are hospitalised with exacerbations of chronic obstructive pulmonary disease (COPD), do glucocorticoids reduce the rate of first treatment failure?


Randomised (allocation concealed*), blinded (clinicians and patients),* placebo-controlled trial with follow-up at 1, 3, and 6 months.


25 US Veterans Affairs medical centres.


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.


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 …

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  • Source of funding: Department of Veterans Affairs Cooperative Studies Program.

  • For correspondence: Dr D E Niewoehner, Pulmonary Section (111N), Veterans Affairs Medical Center, 1 Veterans Drive, Minneapolis, MN 55417, USA. FAX 612-727-5634.

  • * See glossary.