6/29/23, 1:09 AM REDUCE (COPD) Pathway Feedback Search Clinical Topics Home Studies REDUCE COPD REDUCE COPD Disease Chronic obstructive pulmonary Trial question Is short-term systemic corticosteroid therapy noninferior to conventional corticosteroid therapy in patients with acute exacerbation of COPD? Study design Multi-center Double blinded RCT Population Characteristics of study participants 39.4% female N = 314 60.6% male 314 patients (123 female, 188 male) Inclusion criteria: patients presenting to the emergency department with acute COPD exacerbation Key exclusion criteria: history of asthma, ratio of FEV in 1 second to FVC > 70% as evaluated by bedside postbronchodilator spirometry, radiological diagnosis of pneumonia, estimated survival < 6 months due to severe comorbidity, pregnancy or lactation Interventions N=156 short-term treatment (40 mg of prednisone daily for 5 days) N=155 conventional treatment (40 mg of prednisone daily for 14 days) https://web.pathway.md/studies/recXMiVhWbfjPnUJn 1/2 6/29/23, 1:09 AM REDUCE (COPD) Pathway Primary outcome Recurrent chronic obstructive pulmonary disease exacerbation at 6 months 36.8 % 36.8 35.9 27.6 % 18.4 % Difference not exceeding nonferiority margin 9.2 % 0.0 % Short-term treatment Conventional treatment Difference not exceeding nonferiority margin in recurrent COPD exacerbation at 6 months (35.9% vs. 36.8%; HR 0.95, 95% CI 0.7 to 1.29) Secondary outcomes No significant difference in need for mechanical ventilation (11% vs. 13.6%; OR 0.78, 95% CI 0.37 to 1.63) Significant increase in hospital stay (8 vs. 9; HR 1.25, 95% CI 0.99 to 1.59) Safety outcomes No significant differences in treatment-associated adverse reactions, including hyperglycemia and hypertension. Significant differences in mean cumulative prednisone dose (379 vs. 793 mg, p < 0.001). Conclusion In patients presenting to the emergency department with acute COPD exacerbation, short-term treatment was noninferior to conventional treatment with respect to recurrent COPD exacerbation at 6 months. Reference Leuppi JD, Schuetz P, Bingisser R et al. Short-term vs conventional glucocorticoid therapy in acute exacerbations of chronic obstructive pulmonary disease: the REDUCE randomized clinical trial. JAMA. 2013 Jun 5;309(21):2223-31. Open reference URL https://web.pathway.md/studies/recXMiVhWbfjPnUJn 2/2