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    DOACs associated with reduced risk of major bleeding compared to warfarin

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    Women of childbearing potential must be on Pregnancy Prevention Programme if taking valproate

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Umesh Modi is a chartered accountant, and Pamini Jatheeskumar is a chartered certified accountant at Silver Levene...
  Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead...
Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
More inWhite Papers  

a lady using inhaler imageMarch 26 2018

A new study has suggested that shorter doses of systemic corticosteroids may be as beneficial as standard longer courses in chronic obstructive pulmonary disease (COPD).

Cochrane researchers reviewed recent research to compare oral or injected corticosteroid treatment given for seven or fewer days compared to people given steroids longer than a week for COPD exacerbations.

Data was assessed from eight studies relating to 582 people with COPD admitted to hospital because of a COPD flare-up.

“No differences were observed between shorter and longer courses of treatment. People treated for seven or fewer days did not have a higher rate of treatment failure or longer time to their next exacerbation; the number of people who avoided treatment failure ranged from 51 fewer to 34 more per 1,000 treated (average 22 fewer people per 1,000),” the researchers found.

The data also indicated that the time spent in hospital and lung function at the end of treatment were no different in the short and long-term treatment cohorts. Nor were there any differences in side effects or death rates.

The researchers said that a new large study included in their analysis had “increased our confidence that five days of oral corticosteroids is likely to be sufficient for treatment of adults with acute exacerbations of COPD.” Their analysis also indicated that shorter courses of around five days lead to no worse outcomes than longer course of 10-14 days.

They point out that the studies reviewed in the analysis did not include people with mild to moderate COPD.

Links:
Cochrane announcement         
JAE Walters et al. ‘Different durations of corticosteroid therapy for exacerbations of chronic obstructive pulmonary disease’. Cochrane Database of Systematic Reviews 2018, Issue 3. Art. No.: CD006897. DOI: 10.1002/14651858.CD006897.pub4.    

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