Chronic obstructive pulmonary disease patients and steroids: benefit or harm

Background: Corticosteroids are being widely used in conditions related to allergy and inflammation. There are great species differences in the responses to glucocorticoids that mean a “steroid resistant” species. Steroids have profound effect on inflammatory response by way of vasoconstriction, decreased chemotaxis and interference with macrophages. There still are enormous gaps in our knowledge of the action of glucocorticosteroids in patients of chronic obstructive lung disease (COPD).Methods: This study was done in the department of general medicine at SKIMS, Srinagar from December 2017 to December 2018 on patients of chronic obstructive pulmonary disease. A total number of 100 patients were enrolled for the study but 20 patients, 10 from each group lost their follow up. To see the effect of steroids on pulmonary function tests, patients were divided into case and control group. Patients in case group were given prednisolone 30 mg orally for two week (tapering dose). Patients in control group were given placebo for the same duration of two weeks. Steroid response was defined as 15% improvement in baseline forced expiratory volume (FEV).Results: Steroid response was defined as 15% increase in forced expiratory volume in one second/forced vital capacity (FEV1/FVC) after receiving tapering dose of prednisone 30 mg for 2 weeks, no patients in case group showed increase in FEV1/FVC of 15%. The change in pulmonary function tests was comparable in each group (p>0.5).Conclusions: The change in pulmonary function tests were comparable in each group (p>0.5). So, steroids in stable patients of COPD are best to be avoided.