Systemic Corticotherapy for Acute Exacerbation of Chronic Obstructive Pulmonary Disease: What is New? / What is Important?

Acute exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD), the most relevant event affecting COPD mortality, is catastrophic event during clinical course of the disease.Whereas its pharmacological management relies mostly on three families of drugs: inhaled bronchodilators, antibiotics and systemic corticosteroids, this review is limited to systemic corticotherapy only.The review aims to update current indications to systemic corticotherapy in the management of AECOPD, including choice of drug, dosage and duration of therapy.Systemic corticotherapy, undoubtedly, has a significant role in the management of AECOPD as it alleviates clinical symptoms, improves pulmonary function, shortens hospitalization(s) and decreases relapse rate.There is compelling evidence that such patients should be treated with the lowest possible dose of corticosteroids for the minimum duration possible.It has been shown that short -course therapy of 40 mg prednisone equivalent, with or after food, per day for 5 days is sufficient for successful management of AECOPD and is non-inferior to, previously employed, duration of 10-21 days.Moreover, it is no longer necessary to taper the dose, which further simplifies the treatment and improves compliance.