Glucocorticoids in Exacerbations of Chronic Obstructive Pulmonary Disease

Abstract This chapter appraises the REDUCE trial, which compares the effectiveness of a 5-day glucocorticoid treatment to the conventional 14-day course for acute chronic obstructive pulmonary disease (COPD) exacerbations. The researchers conducted the study across five teaching hospitals in Switzerland, recruiting 314 patients who receive either a 5-day or 14-day systemic corticosteroid treatment along with other therapies. The study showed that the 5-day regimen was noninferior to the 14-day course in terms of re-exacerbation rates over 6 months, while significantly reducing glucocorticoid exposure. Both groups showed similar improvements in clinical measures, such as forced expiratory volume in first 1 second, and in patient-reported outcomes. Finally, the chapter considers the potential for shorter glucocorticoid courses to maintain efficacy while reducing treatment duration.