Does addition of inhaled steroid to combined bronchodilator therapy affect health status in patients with COPD?
OBJECTIVE
Withdrawal of corticosteroid is associated with a deterioration of health status in COPD. In this study the aim was to determine whether high dose inhaled corticosteroid improves quality of life in patients with COPD.


METHODS
In total, 38 male patients with moderate COPD were included in the study. Baseline quality of life scores were determined using a Turkish version of the St George's Respiratory Questionnaire (SGRQ). Patients were randomly divided into two groups. Group 1 consisted of 20 patients who received existing bronchodilator therapy plus inhaled corticosteroid (800 micro g budesonide) for 12 weeks, while 18 patients in group 2 received bronchodilator and placebo. The SGRQ was repeated after the treatment period.


RESULTS
All patients were male and mean age was 67 +/- 8.2 years. Symptom, activity, impact, and total scores were assessed and a difference of four units with treatment was considered to be clinically significant. Total score and activity score were decreased by six units and eight units, respectively, in the placebo group while symptom and impact scores did not change significantly. Total scores and the three component scores improved significantly in the corticosteroid group compared to the placebo group (Deltatotal score: -22 in corticosteroid group, -6 in placebo group, P < 0.01).


CONCLUSIONS
Inhaled corticosteroid improved quality of life scores in patients with COPD, without significant improvement in airflow obstruction parameters. Since improvement of health status is one of the important aims in COPD treatment, use of inhaled corticosteroids should be considered from this perspective.
Yildiz
Fusun
F
Chest Disease Department, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey. dr_basyigit@yahoo.com
Basyigit
Ilknur
I
Yildirim
Elif
E
Boyaci
Hasim
H
Ilgazli
Ahmet
A
D000280:Administration, Inhalation; D000368:Aged; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019819:Budesonide / Q000627:therapeutic use*; D002245:Carbon Dioxide / Q000097:blood; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D011788:Quality of Life; D012129:Respiratory Function Tests
D001993:Bronchodilator Agents; D002245:Carbon Dioxide; D019819:Budesonide; D010100:Oxygen