title: Methyl prednisolone vs Dexamethasone in Management of COPD Exacerbation; a Randomized Clinical Trial.
abstract: BACKGROUND
  Corticosteroids are routinely used in management of chronic obstructive pulmonary disease (COPD) exacerbation. The main purpose of present study was to compare the efficacy of methyl prednisolone (MP) and dexamethasone (DXM) for this purpose.
  
  
  METHODS
  Adult COPD patients entered the present clinical trial. All patients received standard treatment on admission and were then divided into 2 groups of intravenous MP and DXM. Patients were asked to rate their shortness of breath; sputum volume and viscosity; dyspnea; cough; and general wellbeing on a 0-5 scale. Baseline parameters such as O2saturation, arterial blood gas parameters, and white blood cell (WBC) count were compared on admission and day 7 and 14 of therapy using SPSS 22.
  
  
  RESULTS
  68 patients were randomly allocated to 2 groups of 34 (82.4% male). The baseline characteristics of the two groups were similar (p < 0.05). Comparison of treatment outcomes for the 7thday showed a significant difference between the 2 groups only regarding cough (p = 0.047), HCO3 (p < 0.001), and O2saturation (p = 0.042). On day 14 the 2 groups were different only regarding cough (p = 0.048) and sputum viscosity (p = 0.011). There was a significant difference between the two groups regarding trend of changes in dyspnea (p = 0.02; DXM >> MP) and cough (p = 0.035; MP >> DXM). There were no significant differences between the two medications regarding side effects on 7thand 14thday after treatment.
  
  
  CONCLUSIONS
  It seems that MP and DXM have similar efficacy and side effects in treatment of COPD exacerbation and selecting drug of choice would better be based on the most prominent symptoms of patients on admission.
authors.affiliation: Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Emami Ardestani
authors.affiliation: Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Kalantary
authors.affiliation: Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Vajihe
authors.initials: V
authors.lastname: Samaiy
authors.affiliation: Department of Emergency Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Keramat
authors.initials: K
authors.lastname: Taherian
keywords: Methylprednisolone; chronic obstructive; dexamethasone; pulmonary disease