A comparative study to evaluate the role of inhaled steroid versus low-dose oral steroid in patients of chronic obstructive pulmonary disease -

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death and disability worldwide. Its prevalence is increasing globally, especially in countries with high frequencies of smoking combined with significant environmental exposures to pollutants and biomass smoke. Currently COPD is the third leading cause of death worldwide, after ischemic heart disease and stroke. Efforts have been made to design a standard protocol for treatment of the disease, and these efforts are still in the process. Methods: The study was done on 100 subjects to assess whether steroid (inhaled or oral) actually have any role in decreasing the decline in forced expiratory volume in 1 sec and to compare the effect of both to find out which one is superior. Patients were divided into two arms, inhaled steroids group (according to GOLD guidelines), and the other group was oral prednisolone 10 mg in addition to standard treatment except inhaled steroid. The effects were studied with appropriate statistical tests. Results: Our study data showed that oral steroids are more effective on symptom control as compared to inhaled steroids. Symptoms such as cough (64% vs. 82%) and breathlessness (76% vs. 94%) significantly improved in the oral corticosteroids group. The rate of exacerbation also improved (22% vs. 12%) in the test group. Conclusion: The use of steroids has ever been a subject of divergence of views ever since its role in the treatment of COPD was first described. Although, overall steroid in any form is beneficial in symptomatic/subjective and objective improvements in COPD, oral steroids stand a better chance as compared to inhaled steroids.