title: A randomized, controlled multicentric study of inhaled budesonide and intravenous methylprednisolone in the treatment on acute exacerbation of chronic obstructive pulmonary disease.
abstract: Almost all international guidelines recommend corticosteroids for management of exacerbations of chronic obstructive pulmonary disease (COPD), because it leads to improved outcomes of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Nevertheless, due to its side effects, there are still concerns regarding the use of systemic corticosteroid (SC). Inhaled corticosteroids (IC) can be used as an alternative to SC, while reducing the risk of occurrence of side effects.
  
  
  
  To measure the clinical efficacy and side effects of nebulized budesonide and systemic methylprednisolone in AECOPD.
  
  
  
  Valid data from 410 AECOPD patients in 10 hospitals was collected. Patients were randomly divided into 2 groups; budesonide group, treated with nebulized budesonide (2 mg 3 times/day); and methylprednisolone group, treated with intravenously injected methylprednisolone (40 mg/day). COPD assessment test (CAT), arterial blood gas analysis, hospitalization days, adverse effects, fasting blood glucose, serum creatinine, alanine aminotransferase levels, and blood drug were measured and analyzed in both groups.
  
  
  
  Symptoms, pulmonary function and arterial blood gas analysis were significantly improved after treatment in both groups (P < 0.05), with no significant differences between them (P > 0.05), while incidence of adverse events in the budesonide group was lower (P < 0.05). No significant differences in CAT score, days of admission, blood gas analysis results and physiological and biochemical indexes were found between the two groups. Patients treated with methylprednisolone showed a higher degree of PaO2level improvement.
  
  
  
  Results show that inhalation of budesonide (2 mg 3 times/day) and systemic methylprednisolone (40 mg/day) had similar clinical outcome in AECOPD. In conclusion, inhaled budesonide is an alternative to systemic corticosteroids in AECOPD treatment.
authors.affiliation: Department of Respiratory Medicine, The 3rd Hospital of Anhui Medical University, Hefei 1st People's Hospital, Hefei, Anhui, China. Electronic address: imdzh@163.com.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Ding
authors.affiliation: Department of Respiratory Medicine, The 3rd Hospital of Anhui Medical University, Hefei 1st People's Hospital, Hefei, Anhui, China. Electronic address: 919296610@qq.com.
authors.forename: Xiu
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Respiratory Medicine, The 2nd Hospital of Anhui Medical University, Hefei, Anhui, China. Electronic address: luyougolden@hotmail.com.
authors.forename: Youjin
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Respiratory Medicine, Hefei 3rd People's Hospital, Hefei, Anhui, China. Electronic address: rhm2007.ok@163.com.
authors.forename: Guangsheng
authors.initials: G
authors.lastname: Rong
authors.affiliation: Department of Respiratory Medicine, Chaoyang Hospital, Huainan, Anhui, China. Electronic address: fyyrq2013@163.com.
authors.forename: Ruiqing
authors.initials: R
authors.lastname: Yang
authors.affiliation: Department of Respiratory Medicine, Dongfang Hospital, Huainan, Anhui, China. Electronic address: 1197230329@qq.com.
authors.forename: Ruixia
authors.initials: R
authors.lastname: Zhang
authors.affiliation: Department of Respiratory Medicine, Fuyang People's Hospital, Fuyang, Anhui, China. Electronic address: wangguiqin888@126.com.
authors.forename: Guiqin
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Respiratory Medicine, Huaibei 1st People's Hospital, Huaibei, Anhui, China. Electronic address: hbhxnk3055109@163.com.
authors.forename: Xiqiang
authors.initials: X
authors.lastname: Wei
authors.affiliation: Department of Respiratory Medicine, Lu'an 1st People's Hospital, Lu'an, Anhui, China. Electronic address: yyq3319983@163.com.
authors.forename: Yongqing
authors.initials: Y
authors.lastname: Ye
authors.affiliation: Department of Respiratory Medicine, Bengbu 3rd People's Hospital, Bengbu, Anhui, China. Electronic address: zxz1088@sina.com.
authors.forename: Zhaoxia
authors.initials: Z
authors.lastname: Qian
authors.affiliation: Department of Respiratory Medicine, The 2nd Hospital of Anhui Medical University, Hefei, Anhui, China. Electronic address: hongyanliu03@126.com.
authors.forename: Hongyan
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Respiratory Medicine, Hefei 3rd People's Hospital, Hefei, Anhui, China. Electronic address: zhudaifeng1@163.com.
authors.forename: Daifeng
authors.initials: D
authors.lastname: Zhu
authors.affiliation: Department of Respiratory Medicine, Chaoyang Hospital, Huainan, Anhui, China. Electronic address: zhouruiqing1977@163.com.
authors.forename: Ruiqing
authors.initials: R
authors.lastname: Zhou
authors.affiliation: Department of Respiratory Medicine, Dongfang Hospital, Huainan, Anhui, China. Electronic address: kunkun0258@qq.com.
authors.forename: Kun
authors.initials: K
authors.lastname: Zhu
authors.affiliation: Department of Respiratory Medicine, Fuyang People's Hospital, Fuyang, Anhui, China. Electronic address: xiaoni407@126.com.
authors.forename: Rongping
authors.initials: R
authors.lastname: Ni
authors.affiliation: Department of Respiratory Medicine, Huaibei 1st People's Hospital, Huaibei, Anhui, China. Electronic address: neikezz@163.com.
authors.forename: Kui
authors.initials: K
authors.lastname: Xia
authors.affiliation: Department of Respiratory Medicine, Lu'an 1st People's Hospital, Lu'an, Anhui, China. Electronic address: 48557964@qq.com.
authors.forename: Nan
authors.initials: N
authors.lastname: Luo
authors.affiliation: Department of Respiratory Medicine, Hefei Binhu Hospital, Hefei, Anhui, China. Electronic address: pchl331@126.com.
authors.forename: Cong
authors.initials: C
authors.lastname: Pei
mesh_terms: D000208:Acute Disease; D000280:Administration, Inhalation; D000368:Aged; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019819:Budesonide / Q000008:administration & dosage / Q000627:therapeutic use*; D002245:Carbon Dioxide / Q000097:blood; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D016037:Single-Blind Method; D014797:Vital Capacity / Q000187:drug effects
chemical_list: D001993:Bronchodilator Agents; D005938:Glucocorticoids; D002245:Carbon Dioxide; D019819:Budesonide; D010100:Oxygen; D008775:Methylprednisolone
keywords: Chronic obstructive pulmonary disease; Exacerbation; Inhaled corticosteroid; Systemic corticosteroid