Cochrane · systematic review · CD001288
Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease
Walters, JAE, Tan, DJ, White, CJ, et al. · Cochrane Database of Systematic Reviews · 2014 · Cochrane Library
AirwaysAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
13
current version
GRADE rated
13
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 3 · 23.1%Moderate 6 · 46.2%High 4 · 30.8%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Systemic corticosteroid compared with placebo for acute exacerbations of COPD
Population: acute exacerbations COPD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure Need to intensify therapy/ED or hospital admission Systemic corticosteroid vs placebo | OR 0.48 [0.35, 0.67] | 9 studies · 917 participants | High |
Relapse Treatment for AE of COPD or hospital re‐admission Systemic corticosteroid vs placebo | OR 0.77 [0.51, 1.17] | 5 studies · 596 participants | Moderate Downgraded: imprecision |
Improvement in lung function ‐ early effect FEV1 (L) as absolute or change Systemic corticosteroid vs placebo | no estimate extracted | 7 studies · 649 participants | High |
Decreased breathlessness ‐ early effect Borg scale or VAS Systemic corticosteroid vs placebo | no estimate extracted | 3 studies · 178 participants | Moderate Downgraded: imprecision |
Adverse drug effect Systemic corticosteroid vs placebo | OR 2.33 [1.59, 3.43] | 8 studies · 736 participants | High |
Hyperglycaemia Systemic corticosteroid vs placebo | OR 2.79 [1.86, 4.19] | 6 studies · 804 participants | High |
Treatment route: intravenous corticosteroid compared with oral corticosteroid for acute exacerbations of COPD
Population: acute exacerbations of COPD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure Need to intensify therapy Treatment route: intravenous corticosteroid vs oral corticosteroid | OR 0.67 [0.34, 1.3] | 3 studies · 298 participants | Moderate Downgraded: imprecision |
Relapse Hospital readmission for COPD Treatment route: intravenous corticosteroid vs oral corticosteroid | OR 0.95 [0.5, 1.8] | 3 studies · 298 participants | Moderate Downgraded: imprecision |
Breathlessness ‐ early effect VAS 0‐10. Scale from: 0 to 10. Treatment route: intravenous corticosteroid vs oral corticosteroid | no estimate extracted | 2 studies · 75 participants | Low Downgraded: risk of bias, imprecision |
Mortality after discharge (1‐3 months) Treatment route: intravenous corticosteroid vs oral corticosteroid | OR 1.4 [0.44, 4.51] | 3 studies · 298 participants | Moderate Downgraded: risk of bias, imprecision |
Duration of hospitalisation Days Treatment route: intravenous corticosteroid vs oral corticosteroid | no estimate extracted | 3 studies · 298 participants | Low Downgraded: risk of bias, imprecision |
Adverse drug effect ‐ hyperglycaemia Treatment route: intravenous corticosteroid vs oral corticosteroid | OR 4.89 [1.2, 19.94] | 1 study · 40 participants | Moderate Downgraded: indirectness |
PaO2 mmHg Treatment route: intravenous corticosteroid vs oral corticosteroid | no estimate extracted | 1 study · 38 participants | Low Downgraded: risk of bias, imprecision, indirectness |