Impact of Corticosteroids on Adrenal Function in COPD Patients
Author Information
Author(s): Philipp Schuetz, Mirjam Christ-Crain, Ursula Schild, Erika Süess, Michael Facompre, Florent Baty, Charly Nusbaumer, Martin Brutsche, Beat Müller
Primary Institution: University Hospital Basel
Hypothesis
The study investigates the effect of a 14-day course of systemic corticosteroids on the hypothalamic-pituitary-adrenal axis in patients with acute exacerbation of chronic obstructive pulmonary disease.
Conclusion
Short-term systemic steroid treatment for acute exacerbation of COPD can lead to immediate and prolonged suppression of the HPA axis.
Supporting Evidence
- 78% of patients had a blunted cortisol response on the first day of steroid treatment.
- 89% of patients had a blunted cortisol response after 14 days of steroid treatment.
- Basal cortisol levels were predictive of an impaired function of the HPA axis.
Takeaway
Giving steroids to people with breathing problems can make their body less able to respond to stress for a while, even if they feel fine.
Methodology
Nine patients were assessed before, during, and after a 14-day steroid treatment using clinical and laboratory measures, including ACTH stimulation tests.
Potential Biases
The population varied in respect to the use of inhaled corticosteroids, which is a known risk factor for adrenal insufficiency.
Limitations
The study included a small number of patients and did not directly assess free cortisol levels.
Participant Demographics
Nine steroid-naive patients (3 women, 6 men) with a median age of 72 years.
Statistical Information
P-Value
p = 0.008
Confidence Interval
95%CI 627–771
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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