Effect of prednisolone on lung function and bronchodilator responses in stable COPD

Background : The effect of a short course of prednisolone on lung function and bronchodilator responsiveness in COPD is debatable. Methodology : After baseline spirometry and measurement of response to inhaled salbutamol, 31 patients with COPD were randomized to the steroid group (given 40 mg/day prednisolone for 7 days) while 29 patients were assigned to the control group. All the patients continued on their usual medication based on published management guidelines. The lung function and response to salbutamol were reassessed on day 8. Results : Both FEV 1 and FVC increased after salbutamol to the same extent in both the groups on the two test days. The proportions of FEV 1 and FVC responders were also similar in the two groups. The bronchodilator response was not reproducible and several responders of day I became non-responders on day 8 and vice versa in both the groups. At the end of 1 week, the prebronchodilator lung function showed similar improvement in FEV 1 and FVC in the two groups. A multiple logistic regression procedure failed to identify factors that could predict a steroid response. Conclusions : A short course of prednisolone does not favourably affect lung function and bronchodilator responsiveness in stable COPD