Comparison of Dexamethasone and Hydrocortisone in Management of Exacerbated Chronic Obstructive Pulmonary Disease Patients; a Randomized Controlled Trial

Aims: Different corticosteroids with different characteristics, such as hydrocortisone and dexamethasone, have been used to treat exacerbated chronic obstructive pulmonary disease, but the drug of choice is unclear. The main goal of the present study was to compare the efficacy of hydrocortisone and dexamethasone on clinical symptoms, peak expiratory flow, oxidative stress factors, and inflammatory mediators in patients with exacerbation of chronic obstructive pulmonary disease. Materials Methods: In this single-blind randomized clinical trial study in 2021, 70 eligible patients with chronic obstructive pulmonary disease exacerbations were selected and randomly divided into two A (8mg of intravenous dexamethasone daily) and B (200mg of intravenous daily hydrocortisone) groups. Clinical symptoms and peak expiratory flow were measured before intervention (day 1), after intervention (day 2), and on discharge day. However, oxidative stress factors and inflammatory mediators were evaluated on day one and discharge day. Moreover, the probable complications of both drugs were measured and scaled 1-4 by the researcher. Findings: Between groups, comparisons showed significant differences in the patients’ clinical indicators for shortness of breath (p=0.02), sputum volume (p=0.01), and oxygen saturation of arterial blood (p=0.02). However, these differences were related to the first day, and no statistically significant differences were observed on the second or discharged days. The intragroup comparison revealed that the prescription of both dexamethasone and hydrocortisone led to significant improvement in the patient’s clinical symptoms. Conclusion: Dexamethasone and Hydrocortisone are the same in improving important clinical symptoms and have similar efficacy on inflammation and oxidative stress in patients with COPD exacerbation.