THE EFFECT OF ORAL CORTICOSTEROIDS ON BRONCHODILATOR RESPONSES IN COPD

There have been suggestions that corticosteroid treatment might improv e bronchodilator responses in chronic obstructive pulmonary disease (C OPD). We have studied bronchodilator responses to salbutamol and to ox itropium bromide in 20 patients with stable moderate to severe COPD. D ose responses to the two bronchodilators were tested before and after 3 week courses of placebo and 30 mg prednisolone. Thirteen patients we re taking inhaled corticosteroids. There were no significant changes i n numbers of responses or maximum bronchodilator effects from either b ronchodilator, although there was a trend towards higher maximum level s after 3 weeks of prednisolone. Spirometry measured at home each morn ing before and after oxitropium bromide showed no difference between p rednisolone and placebo periods. This study provides no evidence for a significant effect on bronchodilator responses to beta-agonists or an ticholinergic agents from 3 weeks of oral prednisolone in moderately s evere COPD.