Clinical Outcomes Of Using Nebulized Budesonide As The Initial Treatment For Acute Exacerbations Of Chronic Obstructive Pulmonary Disease: A Post-Hoc Analysis.

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  • Additional Information
    • Source:
      Publisher: DOVE Medical Press Country of Publication: New Zealand NLM ID: 101273481 Publication Model: eCollection Cited Medium: Internet ISSN: 1178-2005 (Electronic) Linking ISSN: 11769106 NLM ISO Abbreviation: Int J Chron Obstruct Pulmon Dis Subsets: MEDLINE
    • Publication Information:
      Original Publication: Auckland, N.Z. : DOVE Medical Press,
    • Subject Terms:
      Bronchodilator Agents/*administration & dosage ; Budesonide/*administration & dosage ; Glucocorticoids/*administration & dosage ; Lung/*drug effects ; Pulmonary Disease, Chronic Obstructive/*drug therapy; Administration, Inhalation ; Aged ; Aged, 80 and over ; Bronchodilator Agents/adverse effects ; Budesonide/adverse effects ; China ; Disease Progression ; Female ; Forced Expiratory Volume ; Glucocorticoids/adverse effects ; Humans ; Lung/physiopathology ; Male ; Middle Aged ; Nebulizers and Vaporizers ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/physiopathology ; Recovery of Function ; Retrospective Studies ; Time Factors ; Treatment Outcome
    • Abstract:
      Purpose: The current guidelines recommend the use of systemic corticosteroids (SCS) as the optimal treatment for acute exacerbations of chronic obstructive pulmonary disease (AECOPD). The aim of this real-world study was to evaluate whether nebulized budesonide (NBS) could also be used as an initial treatment for AECOPD.
      Patients and Methods: AECOPD patients initially treated with NBS or SCS (oral/intravenous) were enrolled. A large-scale, long-term multicenter cohort study of AECOPD patients was performed to analyze outcomes for each treatment (NCT02051166).
      Results: Initial NBS and SCS treatment resulted in similar outcomes in terms of improvements in FEV 1 , PaO 2 , SaO 2 , and PaCO 2 . Disease severity affected outcome similarly in both groups. When the groups were stratified according to whether the initial treatment was subsequently intensified or reduced, more intubation was seen in the groups in which initial treatment was intensified. NBS escalation and SCS reduction groups spent more days in the hospital. The NBS escalation group was associated with the highest medical expenditure and a relatively higher rate of new-onset pneumonia. The NBS maintenance/reduction group showed the lowest mortality rate between groups. Stratification according to initial PaCO 2 level showed more intubation in the groups with high initial PaCO 2 concentrations.
      Conclusion: These results indicate that NBS may be used as an initial treatment in certain AECOPD patients, and further studies are needed to better define those most likely to benefit.
      Competing Interests: The authors report no conflicts of interest in this work.
      (© 2019 Zheng et al.)
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    • Contributed Indexing:
      Keywords: AECOPD; chronic obstructive pulmonary disease; nebulized budesonide; systemic corticosteroids
    • Molecular Sequence:
      ClinicalTrials.gov NCT02051166
    • Accession Number:
      0 (Bronchodilator Agents)
      0 (Glucocorticoids)
      51333-22-3 (Budesonide)
    • Publication Date:
      Date Created: 20191211 Date Completed: 20200427 Latest Revision: 20200427
    • Publication Date:
      20231215
    • Accession Number:
      PMC6889964
    • Accession Number:
      10.2147/COPD.S196615
    • Accession Number:
      31819404