NTRODUCTION: Oral use of glucocorticoids is a well-described therapy in the treatment of acute exacerbations of chronic obstructive pulmonary disease (COPD). Patients with COPD occasionally report subjective benefits of glucocorticoids in terms of fewer symptoms and better exercise performance, even when they do not experience exacerbation. This study investigated whether a single high therapeutic dose of oral glucocorticoid improves short-term exercise tolerance in patients with moderate-to-very severe COPD.

METHODS: In a double-blinded crossover design, patients were randomised to either 100 mg of prednisolone or placebo. The study consisted of a baseline visit and two study visits, each seven days apart. The primary endpoint was time to exhaustion (TTE) on an ergometer bike using a submaximal exercise test on 70% of the maximal workload. On every study visit, spirometry, the COPD Assessment Test, maximal inspiratory/expiratory pressure and maximal voluntary contraction of the quadriceps muscle were measured. A total of 14 male patients with grade C/D COPD were randomised.

RESULTS: The mean TTE was significantly longer at the prednisolone visit (p = 0.019), whereas no differences were seen on other parameters such as lung function, respiratory symptoms or muscle strength.

CONCLUSION: Our finding suggests that COPD patients experience improvements in exercise tolerance from a single high dose of glucocorticoid even in the stable phase of their disease.