title: Comparative Efficacies of Inhaled Corticosteroids and Systemic Corticosteroids in Treatment of Chronic Obstructive Pulmonary Disease Exacerbations: A Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  Corticosteroids play an important role in the treatment of chronic obstructive pulmonary disease (COPD) exacerbations, and a global initiative has suggested the use of inhaled corticosteroids (ICSs) as an alternative to systemic corticosteroids (SCs). Here, we report results of a meta-analysis performed to systematically compare the efficacies of ICSs and SCs in the treatment of COPD exacerbations.
  
  
  METHODS
  PubMed, EMBASE, and the Cochrane databases were searched for relevant human clinical trials describing the use of ICSs compared with SCs in the treatment of COPD exacerbations. We compared the results of FEV1%pred and blood gas analyses that had been calculated. Weighted mean differences and fixed effects models were applied by using Revman 5.2.
  
  
  RESULTS
  Five original studies satisfied our inclusion criteria, and no significant heterogeneity was shown. Three studies evaluated the increase of FEV1%pred after treatment for 7 days. There were three and four studies, respectively, that evaluated the increase of SaO2and PaO2, and three reported the decrease of PaCO2at 24 hours control, 2-4 days control, and 7-10 days control. All the results showed that both ICSs and SCs were effective in the treatment of COPD exacerbations.
  
  
  CONCLUSIONS
  ICSs were not inferior to SCs when used in the treatment of COPD exacerbations.
authors.affiliation: 1 Department of Respiratory Medicine, People's Hospital of Liaoning Province , Shenyang, China .|2 Department of Respiratory Medicine, Shengjing Hospital of China Medical University , Shenyang, China .
authors.forename: Yuhan
authors.initials: Y
authors.lastname: Zhai
authors.affiliation: 2 Department of Respiratory Medicine, Shengjing Hospital of China Medical University , Shenyang, China .
authors.forename: He
authors.initials: H
authors.lastname: Zhang
authors.affiliation: 2 Department of Respiratory Medicine, Shengjing Hospital of China Medical University , Shenyang, China .
authors.forename: Tingli
authors.initials: T
authors.lastname: Sun
authors.affiliation: 2 Department of Respiratory Medicine, Shengjing Hospital of China Medical University , Shenyang, China .
authors.forename: Maosheng
authors.initials: M
authors.lastname: Ye
authors.affiliation: 3 Epidemiology and Health Statistics, School of Public Health, China Medical University , Shenyang, China .
authors.forename: Hongbo
authors.initials: H
authors.lastname: Liu
authors.affiliation: 2 Department of Respiratory Medicine, Shengjing Hospital of China Medical University , Shenyang, China .
authors.forename: Rui
authors.initials: R
authors.lastname: Zheng
mesh_terms: D000280:Administration, Inhalation; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents; D005938:Glucocorticoids
keywords: chronic obstructive pulmonary disease; inhaled corticosteroids; meta-analysis; systemic corticosteroids