Response to Oral Corticosteroid in Patients with Chronic Obstructive Pulmonary Disease

Abstract

We studied the effect of 30mg of prednisolone on 29 Japanese patients with chronic obstructive pulmonary disease (COPD). The mean value of the baseline forced expiratory volume in one second (FEV₁ ; mean±SEM) was 1.14±0.12l (46.9±3.9% pred) and the FEV₁ following the steroid trial was 1.30±0.12l (53.7±4.3% pred). Post-trial FEV₁-baseline FEV₁/predicted FEV₁ was 6.8±1.9%. Five patients (17%) had more than a 15% increase in FEV₁ as a percentage of predicted FEV₁. Post-trial FEV₁/baseline FEV₁ was 117.3±4.3%, and 12 patients (41%) had more than a 20% increase in FEV₁ after the trial. Acute bronchodilator response to β-agonist correlated positively with the response to corticosteroid. Baseline spirometries, blood eosinophil counts, serum IgE levels, sputum eosinophil counts, family history of asthma, and history of paroxysmal dyspnea did not vary across responders and non-responders. Patients with severe COPD should be treated to achieve the best possible pulmonary functions indicated by a steroid trial within the limit of acceptable levels of adverse effects.
(Internal Medicine 31 : 1179-1184, 1992)