A Controlled Trial of the Effect of Steroids in Obstructive Airway Disease

Abstract

Because of the divergence of opinion about the efficacy of steroids in emphysema and because previous studies have shown conflicting results, it was decided to perform a double blind controlled study to assess their effect in this condition. Seven subjects with emphysema and 5 with asthma had their ventilatory function determined while on betamethasone and while on a placebo. Pulmonary function measurements were made at weekly intervals for a four week period prior to the patient receiving either the placebo or betamethasone. The change produced by the medications was then compared with the baseline measurements. After a suitable interval to allow the effects of the steroids to wear off, another baseline was established and the medications alternated so that those who had been initially on the placebo received the betamethasone and vice versa. Thus each patient acted as his own control and the mean change in pulmonary function obtained while on each medication was compared with the respective control periods. While the asthmatics showed a significant improvement in their mechanics of respiration, the emphysematous subjects remained either unchanged or showed a slight deterioration. Steroids are ineffective in emphysema and because of their distressing side-effects, they should be avoided in this type of obstructive airway disease.