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Thursday, August 12, 2010

Oral steroids to treat COPD???

There was an interesting study done recently regarding steroid use in COPD patients admitted to the hospital.

The study, reported in the June 16 issue of The Journal of the American Medical Association, shows that COPD patients who are given high doses of steroids are more likely to need a longer stay in the hospital, with a greater chance of needing a ventilator, than COPD patients treated with low dose oral steroids.

Likewise, the study shows the benefits of high dose systemic steroids is no greater than low dose oral steroids.

This is contrary evidence to the standard practice of treating patients suffering from COPD exacerbations with high doses of steroids to control inflammation in their lungs. Currently, up to 90% of COPD patients admitted are treated with high dose steroids.

The report was discussed in this Web MD article by Denise Mann. You can check it out if you so desire. Mann notes that COPD experts are still at odds as to what the actual best dose of steroid is, although this study used a dose of 20-60 milligrams as the oral steroid dose.

Of course the requirement of high doses of steroids places COPD patients at risk for many side effects, and therefore if all that is needed is a smaller dose this would be great news for many patients. Although more research, and many years of convincing, will probably be needed before any significant recommendations are made in this regards.

However, according to Dr. Richard Mularski, a pulmonologist who wrote an editorial on the study, "We really think that doctors should be following hospital guidelines and treating patients with oral steroids, at least for those who are able to take oral steroids."

Obviously this is just one study, yet it'll be interesting nonetheless.

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