The effects of nebulized budesonide and oral prednisolone with placebo in the treatment of acute exacerbations of chronic obstructive pulmonary disease

Objective In this randomized, placebo-controlled trial, the effects of nebulized budesonide(BUD), oral prednisolone(PRED), and placebo(PLACEBO) was compared in 54 patients with acute exacerbations of COPD requiring hospitalization. Methods Eligible patients were randomly allocated to one of the three treatment groups, that is, BUD, PRED, or PLACEBO. The BUD group received BUD nebulized suspension. by exacerbation with 4mg every 12h. The PRED group was treated with 20 mg by mouth every 12 h and afer a week was treated with10 mg. The placebo was offered common treatment and not treated with adrenocortical hormones. All groups were observed for 24, 48 h, 7 d and 14 d. Results Both budesonide and prednisolone improved in FEV1, PaO2, PaCO2 and pH when compared with placebo(P0.05).The difference in FEV1, PaO2, PaCO2, pH between budesonide and prednisolone was not significant (P0.05). The occurrence of serious adverse events in the BUD group were lower than the PRED group(P0.05).Conclusions Both budesonide and prednisolone improved obstruent airflow in COPD patients. Nebulized budesonide may be an alternative to oral prednisolone in the treatment of nonacidotic exacerbations of COPD with lower adverse events.