Role of steroids in stable patients of chronic obstructive pulmonary disease

Background: Corticosteroids are widely used in the treatment of allergic and inflammatory conditions. It is important to recognize that there are great species differences in the responses to glucocorticoids and that means a "Steroid resistant" species. Steroids affect metabolism and distribution of T and B lymphocytes, but do not significantly affect antibody production in humans. Steroids profoundly affect the inflammatory response by way of vasoconstriction, decreased chemotaxis and interference with macrophages. There are still enormous gaps in our knowledge of the action of glucocorticosteroids in stable patients of chronic obstructive lung disease (COPD).
Aim: To find out the effect of steroids on pulmonary function and arterial blood gases in stable patients of chronic obstructive pulmonary disease and to know the clinical improvement in such patients by giving steroids.
Material and Methods: This study was done in the department of General Medicine (SKIMS) from August 2017 to January 2019 on patients of stable chronic obstrucImonarydisense. 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 and Arterial blood gases, patients were divided into case and control group.Patients in case group were gives 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 FEV.
Results and Conclusion: Steroid response was defined as 15% increase in FEV1/FVC after receiving tapering dose of prednisone 30 mg for 2 weeks. None of patients in case group showed increase in FEV1/FVC of 15%. The change in pulmonary function tests and arterial blood gases were comparable in each group (p>.0.5). So steroids in stable patients of COPD, are best to be avoided.