Title: R.E.D.U.C.E. trial: Is Less prednisone better?
题目： R.E.D.U.C.E.研究结果：激素越少越好吗？
Author作者: Haney Mallemat

COPD treatment guidelines (e.g., GOLD) recommend 10-14 days of steroid therapy following a COPD exacerbation to prevent recurrences; the supporting data is weak.
慢性阻塞性肺病（COPD）的治疗指南（如GOLD）建议在COPD恶化后使用类固醇治疗10-14天，可以防止复发，但支持这一观点的数据并不多。
A recent noninferiority trial compared patients with a severe COPD exacerbation who received either a 5-day course (n=156) or 14-day course (n=155) of prednisone 40mg.
最近的一项非劣效性试验对COPD恶化后使用每天强的松40mg，连续5天（n = 156）和14天（n = 155）的病人进行了比较。
The results were:
结果如下：
No significant reduction in time until the next exacerbation (primary end-point)
到下一次发作的时间无明显减少（主要结果）
No significant difference in mortality, incidence of mechanical ventilation, FEV1, or dyspnea scores (secondary end-points)
死亡率，机械通气使用率， FEV1 ，或呼吸困难评分（次要指标）无显著差异
What you need to know:
你需要知道：
This was a non-inferiority trial, which has limitations
这是一个非劣效性试验，具有它的局限性
All subjects received broad-spectrum antibiotics and an initial dose of IV steroid
所有实验者都接受了广谱抗生素和初始剂量的静脉类固醇
Surprisingly, there were no differences between groups with respect to steroid complications (e.g., hyperglycemia, hypertension, etc.)
令人惊讶的是，类固醇并发症方面在两组之间并无显着差异（例如，高血糖，高血压等）
Bottom-line: 5 days of prednisone may be as effective as 14-days for COPD exacerbations.
要点： 5天强的松可能对慢性阻塞性肺病急性发作与14天同样有效。
References 参考文献：
Leuppi, JD, 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):2223-2231