Duration and dosing of systemic corticosteroids for acute exacerbation of COPD, protocol for a systematic review with meta-analysis of randomized trials and cohort studies

<h4>Purpose</h4> Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a leading cause of deterioration in patients with otherwise stably controlled COPD. Treatments of AECOPD often require the use of corticosteroid therapy in conjunction with bronchodilators and antibi...

Full description

Bibliographic Details
Main Authors: Raymond Yin, Yiyang Wang, Yue Ying, Mutian Ding, Yunqing Ouyang, Emily Yuan, Daniel Ye, Shirley Yuan, Guanying Li, Winston Hou
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10470871/?tool=EBI
_version_ 1797690775608229888
author Raymond Yin
Yiyang Wang
Yue Ying
Mutian Ding
Yunqing Ouyang
Emily Yuan
Daniel Ye
Shirley Yuan
Guanying Li
Winston Hou
author_facet Raymond Yin
Yiyang Wang
Yue Ying
Mutian Ding
Yunqing Ouyang
Emily Yuan
Daniel Ye
Shirley Yuan
Guanying Li
Winston Hou
author_sort Raymond Yin
collection DOAJ
description <h4>Purpose</h4> Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a leading cause of deterioration in patients with otherwise stably controlled COPD. Treatments of AECOPD often require the use of corticosteroid therapy in conjunction with bronchodilators and antibiotics. However, the duration and dosage of corticosteroids still remain unclear. We propose to perform this systematic review and meta-analysis of all available randomized control trials (RCTs) and observational cohort studies to comprehensively assess the efficacy and safety of different corticosteroid duration and dosing regimen in the current body of evidence. <h4>Methods</h4> We will search MEDLINE, EMBASE, CENTRAL via Ovid as well as CINAHL and Web of Science for available literature comparing different corticosteroid duration and dosage in the treatment of AECOPD. We will perform title and full text screening in duplicate, then extract relevant data using a pre-piloted extraction form. We will define short duration as less than 14-day duration of treatment and long duration as greater than 14-day treatment. We will report mortality difference as our primary outcome, with additional comparisons in incidence of re-exacerbation, hospital length of stay, lung function, incidence of hyperglycemia and infection. We will perform risk of bias assessment using the ROB2.0 and ROBINS-I tool, as well as the GRADE assessment to assess the quality of evidence. <h4>Results</h4> We will publish the full results of our systematic review and meta-analysis in a peer-reviewed journal. <h4>Discussions</h4> To our knowledge, this represents an updated and most comprehensive review of the literature comparing different duration and dosing regimen of corticosteroid treatments in AECOPD, as we will include both RCTs and observational studies without date or language restrictions. We aim to validate prior meta-analyses and study findings on the efficacy of short duration corticosteroid therapy over longer treatments and to inform future research directions in dosing regimens.
first_indexed 2024-03-12T02:04:02Z
format Article
id doaj.art-2f543154dc184ae0bdd519b8b43129c4
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-03-12T02:04:02Z
publishDate 2023-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-2f543154dc184ae0bdd519b8b43129c42023-09-07T05:32:00ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01188Duration and dosing of systemic corticosteroids for acute exacerbation of COPD, protocol for a systematic review with meta-analysis of randomized trials and cohort studiesRaymond YinYiyang WangYue YingMutian DingYunqing OuyangEmily YuanDaniel YeShirley YuanGuanying LiWinston Hou<h4>Purpose</h4> Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a leading cause of deterioration in patients with otherwise stably controlled COPD. Treatments of AECOPD often require the use of corticosteroid therapy in conjunction with bronchodilators and antibiotics. However, the duration and dosage of corticosteroids still remain unclear. We propose to perform this systematic review and meta-analysis of all available randomized control trials (RCTs) and observational cohort studies to comprehensively assess the efficacy and safety of different corticosteroid duration and dosing regimen in the current body of evidence. <h4>Methods</h4> We will search MEDLINE, EMBASE, CENTRAL via Ovid as well as CINAHL and Web of Science for available literature comparing different corticosteroid duration and dosage in the treatment of AECOPD. We will perform title and full text screening in duplicate, then extract relevant data using a pre-piloted extraction form. We will define short duration as less than 14-day duration of treatment and long duration as greater than 14-day treatment. We will report mortality difference as our primary outcome, with additional comparisons in incidence of re-exacerbation, hospital length of stay, lung function, incidence of hyperglycemia and infection. We will perform risk of bias assessment using the ROB2.0 and ROBINS-I tool, as well as the GRADE assessment to assess the quality of evidence. <h4>Results</h4> We will publish the full results of our systematic review and meta-analysis in a peer-reviewed journal. <h4>Discussions</h4> To our knowledge, this represents an updated and most comprehensive review of the literature comparing different duration and dosing regimen of corticosteroid treatments in AECOPD, as we will include both RCTs and observational studies without date or language restrictions. We aim to validate prior meta-analyses and study findings on the efficacy of short duration corticosteroid therapy over longer treatments and to inform future research directions in dosing regimens.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10470871/?tool=EBI
spellingShingle Raymond Yin
Yiyang Wang
Yue Ying
Mutian Ding
Yunqing Ouyang
Emily Yuan
Daniel Ye
Shirley Yuan
Guanying Li
Winston Hou
Duration and dosing of systemic corticosteroids for acute exacerbation of COPD, protocol for a systematic review with meta-analysis of randomized trials and cohort studies
PLoS ONE
title Duration and dosing of systemic corticosteroids for acute exacerbation of COPD, protocol for a systematic review with meta-analysis of randomized trials and cohort studies
title_full Duration and dosing of systemic corticosteroids for acute exacerbation of COPD, protocol for a systematic review with meta-analysis of randomized trials and cohort studies
title_fullStr Duration and dosing of systemic corticosteroids for acute exacerbation of COPD, protocol for a systematic review with meta-analysis of randomized trials and cohort studies
title_full_unstemmed Duration and dosing of systemic corticosteroids for acute exacerbation of COPD, protocol for a systematic review with meta-analysis of randomized trials and cohort studies
title_short Duration and dosing of systemic corticosteroids for acute exacerbation of COPD, protocol for a systematic review with meta-analysis of randomized trials and cohort studies
title_sort duration and dosing of systemic corticosteroids for acute exacerbation of copd protocol for a systematic review with meta analysis of randomized trials and cohort studies
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10470871/?tool=EBI
work_keys_str_mv AT raymondyin durationanddosingofsystemiccorticosteroidsforacuteexacerbationofcopdprotocolforasystematicreviewwithmetaanalysisofrandomizedtrialsandcohortstudies
AT yiyangwang durationanddosingofsystemiccorticosteroidsforacuteexacerbationofcopdprotocolforasystematicreviewwithmetaanalysisofrandomizedtrialsandcohortstudies
AT yueying durationanddosingofsystemiccorticosteroidsforacuteexacerbationofcopdprotocolforasystematicreviewwithmetaanalysisofrandomizedtrialsandcohortstudies
AT mutianding durationanddosingofsystemiccorticosteroidsforacuteexacerbationofcopdprotocolforasystematicreviewwithmetaanalysisofrandomizedtrialsandcohortstudies
AT yunqingouyang durationanddosingofsystemiccorticosteroidsforacuteexacerbationofcopdprotocolforasystematicreviewwithmetaanalysisofrandomizedtrialsandcohortstudies
AT emilyyuan durationanddosingofsystemiccorticosteroidsforacuteexacerbationofcopdprotocolforasystematicreviewwithmetaanalysisofrandomizedtrialsandcohortstudies
AT danielye durationanddosingofsystemiccorticosteroidsforacuteexacerbationofcopdprotocolforasystematicreviewwithmetaanalysisofrandomizedtrialsandcohortstudies
AT shirleyyuan durationanddosingofsystemiccorticosteroidsforacuteexacerbationofcopdprotocolforasystematicreviewwithmetaanalysisofrandomizedtrialsandcohortstudies
AT guanyingli durationanddosingofsystemiccorticosteroidsforacuteexacerbationofcopdprotocolforasystematicreviewwithmetaanalysisofrandomizedtrialsandcohortstudies
AT winstonhou durationanddosingofsystemiccorticosteroidsforacuteexacerbationofcopdprotocolforasystematicreviewwithmetaanalysisofrandomizedtrialsandcohortstudies