In patients presenting to the emergency department with acute exacerbations of Chronic Obstructive Pulmonary Disease (COPD), 5-day treatment with systemic glucocorticoids was noninferior to 14-day treatment with regard to reexacerbation within 6 months of follow-up but significantly reduced glucocorticoid exposure.

These findings support the use of a 5-day glucocorticoid treatment in acute exacerbations of COPD.

Of 314 randomized patients, 289 (92%) of whom were admitted to the hospital, 311 were included in the intention-to-treat analysis and 296 in the per-protocol analysis.

Hazard ratios for the short-term vs conventional treatment group were 0.95 in the intention-to-treat analysis and 0.93 in the per-protocol analysis, meeting our non-inferiority criterion.

In the short-term group, 56 patients (35.9%) reached the primary end point; 57 (36.8%) in the conventional group.

Treatment with 40 mg of prednisone daily for either 5 or 14 days in a placebo-controlled, double-blind fashion.

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