RT Journal Article SR Electronic T1 Short term glucocorticoid therapy in acute exacerbations of chronic obstructive pulmonary disease: “REDUCE*”, a non-inferiority multicenter trial. (*Reduction in the Use of Corticosteroids in Exacerbated COPD; ISRCTN19646069) JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 4293 VO 40 IS Suppl 56 A1 Jörg D. Leuppi A1 Philipp Schütz A1 Roland Bingisser A1 Matthias Briel A1 Tilman Drescher A1 Ursula Dürring A1 Christoph Henzen A1 Yolanda Leibbrandt A1 Sabrina Maier A1 David Miedinger A1 Beat Müller A1 Andreas Scherr A1 Christian Schindler A1 Rolf Stöckli A1 Sebastian Viatte A1 Christophe von Garnier A1 Michael Tamm A1 Jonas Rutishauser YR 2012 UL http://erj.ersjournals.com/content/40/Suppl_56/4293.abstract AB Background: The optimal dose and duration of systemic glucocorticoid therapy for acute exacerbations of COPD (AECOPD) is unknown. In this trial, we aimed to demonstrate non-inferiority of 5-days vs 14-days of systemic glucocorticoids with respect to COPD exacerbation.Methods: Patients admitted to hospital with AECOPD were randomized to receive 40mg of prednisone-equivalent daily for either 5 or 14 days in a placebo-controlled fashion. Follow-up was 180 days. The primary endpoint was time to next exacerbation.Results: Of 721 evaluated patients, 327 underwent randomization, and 304 completed the study. Mean age was 63.9 ±23.2 years; mean FEV1%predicted 31.5 ±14.3% and 60.8% were male. Exacerbations occurred in 36.8% and 38.4% of patients in the 5 day and 14 day treatment arms, respectively (p=0.81). Time to exacerbation did not differ between groups in the intention-to-treat and per-protocol analyses (hazard ratios for the short treatment arm, 0.92 [95%-CI, 0.64 to 1.34; p=0.67] and 0.91 [95%-CI, 0.63 to 1.32; p=0.62], respectively); nor did time to death or the combined endpoint of exacerbation and/or death, with both hazard ratios for the short treatment arm being <1 as well. With respect to the primary outcome, short treatment was not inferior to conventional treatment, since the 95%-confidence intervals did not include the predefined non-inferiority threshold of 1.515.Conclusion: In AECOPD, 5-day treatment with systemic glucocorticoids is non-inferior to 14-day treatment with regard to re-exacerbation during 6 months of follow-up.