A controlled trial of prednisone, in low dosage, in patients with chronic airways obstruction

Evans, J. A., Morrison, I. M., and Saunders, K. B. (1974).Thorax, 29, 401-406. A controlled trial of prednisone, in low dosage, in patients with chronic airways obstruction. Ten men with chronic airways obstruction took part in a double-blind controlled cross-over trial of 5 mg prednisone, daily for a week, versus placebo. All patients had breathlessness as their main complaint, and chronic cough with sputum for 2 to 30 years; five had evidence of emphysema on the chest radiograph. None had a personal or family history of asthma. For the group, mean forced expiratory volume in one second was 1·11 1., and mean forced vital capacity was 2·28 1. Six patients had abnormally high levels of arterial Pco₂ (46-52 mmHg). When the `placebo9 and `prednisone9 measurements were compared there was no significant change in forced expiratory volumes, bronchodilator effect on forced expiratory volumes, or blood gas tensions. Inspiratory airways resistance measured by body plethysmography was significantly higher, or `worse9, on prednisone (mean 4·2 cmH₂O per 1/sec) than on placebo (mean 3·2).