Systemic corticosteroid for COPD exacerbations, whether the higher dose is better? A meta-analysis of randomized controlled trials

摘要: Background Systemic corticosteroids (SCS) have been shown to improve the outcome of acute exacerbation chronic obstructive pulmonary disease (AECOPD). However, optimal dose remains controversial. Objectives We performed a meta-analysis evaluate whether high-dose SCS is better. Methods We searched PubMed, EMBASE, CPCI-S and CENTRAL databases, references reviews or meta-analyses identify randomized controlled trials using in AECOPD. We routine effects on treatment failure rate forced expiratory volume 1 s (FEV1) improvement compared with placebo Subgroup analysis was by dividing studies into group [initial ≥80 mg prednisone equivalent (PE)/day] low-dose (initial 30–80 mg PE/day) all patients only inpatients. Meta-regression initial as an independent factor. classified suspected adverse several groups combined them separately. Results Our search yielded 12 involving 1172 patients. use associated significant reduction [risk ratio 0.58; 95% confidence interval (CI): 0.46–0.73] ▵FEV1 (0.11 L; CI: 0.08–0.14 L). The regimen did not show superiority regimen. No obvious correlation found between effect dose. led increase hyperglycemia risk. obviously higher risk effects. Conclusion SCS can reduce lung function 30–80 mg/day PE) proper for treating