Can a 2-week course of oral steroids predict the future effect of an inhaled corticosteroid?
A 2-week course of prednisolone has been widely used in an attempt to detect corticosteroid responders, i.e. patients who improve significantly (>15%) in airway function (FEV1 or PEF) or benefit in terms of reduced symptoms or improved health related quality of life. However, there is mounting evidence that far from all patients who respond to long-term treatment with an inhaled corticosteroid do not respond during a 2-week course of oral steroids (1-3). Also, patients who respond to oral steroid short term may not benefit from long-term treatment with inhaled steroids. The best approach for evaluation of benefits of an inhaled corticosteroid is to give patients with COPD a trial with Pulmicort for 3-6 months and thereafter evaluate whether treatment should continue or not. Distribution of changes in post-bronchodilator FEV1 following prednisolone Distribution of changes in post-bronchodilator FEV1 following prednisolone. There was no correlation between this response and the subsequen
