Five-day COPD treatment quells flare-ups, reduces side effects, researchers find

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Patients with chronic obstructive pulmonary disease flare-ups do better with a shorter round of prednisone, researchers have found.

A team from various Swiss research centers and hospitals conducted a study of more than 300 patients hospitalized with acute exacerbations of COPD. Patients who took the corticosteroid prednisone for five days had equally good outcomes after six months as those who took prednisone for the recommended 14 days, the researchers discovered. Those in the five-day group also experienced fewer adverse side effects and were released from the hospital sooner.

The findings suggest that shortening the standard prednisone treatment period could reduce the hyperglycemia, weight gain and insomnia that are short-term side effects of the medication, as well as toxicity, diabetes, fractures and other long-term complications associated with ongoing steroid exposure.

“The clinical implications of this study are clear,” according to a Journal of the American Medical Association editorial accompanying the study. “Most patients with acute COPD exacerbations can be treated with a five-day course of prednisone or equivalent (40 mg daily). Furthermore, this regimen can be applied across all GOLD (Global Initiative for Chronic Obstructive Lung Disease) categories of disease severity.”

The findings were published Tuesday in the online version of JAMA.

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