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. 2017;5(1):e35.
Epub 2017 Jan 11.

Methyl prednisolone vs Dexamethasone in Management of COPD Exacerbation; a Randomized Clinical Trial

Mohammad Emami Ardestani  1 , Elham Kalantary  1 , Vajihe Samaiy  1 , Keramat Taherian  2
Affiliations

Methyl prednisolone vs Dexamethasone in Management of COPD Exacerbation; a Randomized Clinical Trial

Mohammad Emami Ardestani et al. Emerg (Tehran). 2017.

Abstract

Introduction: 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 O2 saturation, 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 7th day showed a significant difference between the 2 groups only regarding cough (p = 0.047), HCO3 (p < 0.001), and O2 saturation (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 7th and 14th day after treatment.

Conclusion: 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.

Keywords: Methylprednisolone; chronic obstructive; dexamethasone; pulmonary disease.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Failure rate of dexamethasone and prednisolone in treatment of sputum volume (A), sputum viscosity (B), dyspnea (C), and cough (D).
See this image and copyright information in PMC

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