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Table 1 Patients characteristics and steroid regimen in the studies included in the meta-analysis

From: Systemic corticosteroids in acute exacerbation of COPD: a meta-analysis of controlled studies with emphasis on ICU patients

Study and publication year Setting Exacerbation criteria Mean age (SD) Patient number Intervention Duration (days) Endpoint and success criteria Jadad score
Systemic corticosteroids (n/N) Controls (n/N)
Albert 1980 [29] Pulmonology ward Clinical and pulmonary function 61.5 ± 9.5 22/44 22/44 Methylprednisolone IV 0.5 mg/kg/6 h ± 72 h 3 Improvement in lung function 5
Emerman 1989 [28] ED Clinical and pulmonary function 64.0 ± 7.8 52/96 44/96 Methylprednisolone IV 100 mg single injection 1 Improvement in lung function; no need for hospitalization 5
Bullard 1996 [30] ED/pulmonology ward Clinical and pulmonary function 66.0 ± 10.9 60/113 53/113 Hydrocortisone IV 100 mg/4 h ± 4 days or until discharge, then prednisolone PO 40 mg/day ± 4 days 8 Improvement in FEV1 at 6 h; no relapse or ED visit 4
Thompson 1996 [31] Ambulatory Clinical 67.8 ± 8.6 13/27 14/27 Prednisone PO 60 mg/day ± 3 days followed by 40 mg/day ± 3 days, then 20 mg/day ± 3 days 9 Improvement in FEV1 at days 1, 3, and 10; improved blood gases and clinical symptoms 5
Wood-Baker 1997 [32] Pulmonology ward Clinical 72 ± 6.3 12/38 13/38 (1) Prednisolone PO 2.5 mg/kg/day ± 3 days, then placebo ± 11 days 3 Improvement in lung function, 6-min walk test, hospitalization duration, improvement in clinical symptoms 5
13/38 (2) Prednisolone PO 0.6 mg/kg/day ± 7 days, then 0.3 mg/kg/day ± 7 days 14 FEV1 at day 1 and at 6 weeks, hospitalization duration, clinical improvement
Davies 1999 [33] Pulmonology ward Clinical and pulmonary function. Exacerbation without acidosis 67.3 ± 8.4 29/56 27/56 Prednisone PO 30 mg/day ± 14 days 14 Elapsed time until treatment failure, improvement in FEV1, hospitalization duration 5
Niewoehner 1999 [23] Pulmonology ward Clinical and pulmonary function 67.7 ± 9.3 80/271 111/271 (1) Methylprednisolone IV 125 mg/6 h ± 72 h followed by prednisone PO 60 mg/day with slow tapering for 54 days 57 Improvement in FEV1 and blood gases at day 3, clinical improvement, hospitalization duration 5
80/271 (2) Methylprednisolone IV 125 mg/6 h ± 72 h followed by prednisone PO 60 mg/day with slow tapering for 12 days 15 Lack of relapse or rehospitalization, improvement in FEV1, clinical improvement and improvement in life quality at day 10
Maltais 2002 [34] Pulmonology ward Clinical and pulmonary function 70.4 ± 8.3 62/128 66/128 Prednisone PO 30 mg/12 h ± 3 days, then 40 mg/day ± 7 days 10 Improvement in lung function, blood gases, and reduction in hospitalization duration 4
Aaron 2003 [35] Ambulatory Clinical 69.4 ± 10.8 74/147 73/147 Prednisone PO 40 mg/day ± 10 days 10 I: no relapse or readmission, II: improvement in FEV1, clinical status, and quality of life at day 10 5
Chen 2008 [36] Pulmonology ward Clinical 71.6 ± 7.3 44/130 43/130 (1) Prednisone PO 30 mg/day ± 7 days 7 Improvement in FEV1, blood gases, hospitalization duration 5
43/130 (2) Prednisone PO 30 mg/day ± 10 days, then 15 mg/day ± 4 days 14
Alia 2011 [37] ICU Clinical 68.4 ± 10.2 43/83 40/83 Methylprednisolone IV 0.5 mg/kg/6 h ± 3 days, then 0.5/kg/12 h ± 3 days followed by 0.5 mg/kg/day ± 4 days 10 Mechanical ventilation duration, ICU stay, and intubation rate 5
Abroug 2014 [38] ICU Clinical 69.0 ± 6 111/217 106/217 Prednisone 1 mg/kg/day ± 10 days maximum or until discharge 10 Non-invasive ventilation success, ICU mortality in intubated patients 3
  1. R, randomization; B, blindness; L, lost to follow-up; SD, standard deviation; n, patients in the study arm; N, total sample size.