DORIGINAL ARTICLE å¡ Response to Oral Corticosteroid in Patients with Chronic Obstructive Pulmonary Disease

We studied the effect of 30mg of prednisolone on 29 Japanese patients with chronic ob structive pulmonary disease (COPD). The mean value of the baseline forced expiratory volume in one second (FEVi; mean±SEM) was 1.14±0.12/ (46.9±3.9% pred) and the FEVx following the steroid trial was 1.30 ± 0.12/ (53.7 ± 4.3% pred). Post-trial FEVx baseline FEVi/predicted FEV! was 6.8 ± 1.9%. Five patients (17%) had more than a 15% increase in FEVi as a percentage of predicted FEVi. Post-trial FEV^baseline FEV! was 117.3 ± 4.3% , and 12 patients (41%) had more than a 20% increase in FEVi after the trial. Acute bronchodilator response to j3-agonist correlated positively with the response to corticosteroid. Baseline spiro metries, blood eosinophil counts, serum IgE levels, sputum eosinophil counts, family history of asthma, and history of paroxysmal dyspnea did not vary across responders and non-responders. Patients with severe COPD should be treated to achieve the best possible pulmonary functions indicated by a steroid trial within the limit of acceptable levels of adverse effects. (Internal Medicine 31: 11791184, 1992)