Evaluation of Effectiveness of Dexamethasone versus Hydrocortisone in Reducing Hospital Length, Peak Expiratory Flow,Oxidative Stress Factors and Inflammatory Mediators in Chronic Obstructive Pulmonary Disease (COPD) Exacerbation Patients: A Randomized Controlled Trial

Background: Corticosteroids are routinely used in management of chronic obstructive pulmonary disease (COPD) exacerbation. The main goal of present study was to compare the efficacy of hydrocortisone(HCT) and dexamethasone (DXM). Methods: : Adult COPD patients entered the present randomized clinical trial.All patients received standard treatment on admission and then divided into 2 groups of intravenous HCT and sdyspnea, cough and general wellbeing on a 1-10 scale.Blood pressure and peripheral edema (as main corticosteroids side effects) measured and scaled 1-4 by researcher. Baseline parameters such as O 2 saturation, arterial blood gas parameters, white blood cell (WBC) count, malondialdehide (MDA) level, serum potassium level and c-reactive peptide (CRP) were compared on admission and discharge day using SPSS 22. Results: : 70 patients were randomly divided in 2 equal groups with 35 patients. The baseline characteristics of the two groups were similar (p < 0.05). Comparison of treatment outcomes showed a significant increase of edema in HCT group (p = 0.009). There was a significant improvement of Peak Expiratory Flow (P= 0.02, Mean 1.1 Lit/sec in DXM group vs 0.9 Lit/Sec in HCT group) and dyspnea (p = 0.01) in DXM group. There were no significant differences between the two medications regarding drug side effects on admission and discharge day after treatment. Conclusion: It seems that DXM is more effective than HCT andhave less side effects in treatment of COPD exacerbation. Trial registration: This study has been retrospectively registered in Iranian Registry of Clinical Trials at 2021-11-10, with registration reference: IRCT20200818048447N1. http://www.irct.ir/