Duration of Systemic Corticosteroids in the Treatment of Asthma Exacerbation. A Randomized Study.

Hasegawa, Tsuyoshi; Ishihara, Kyosuke; Takakura, Shunji; Fujii, Hiroshi; Nishimura, Takashi; Okazaki, Miki; Katakami, Nobuyuki; Umeda, Bunichi

doi:10.2169/internalmedicine.39.794

Cited by 44 publications

(38 citation statements)

References 5 publications

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“…An oral glucocorticosteroid dose of 1 mg?kg -1 daily is adequate for treatment of exacerbations in children with mild persistent asthma [355]. A 7-day course in adults has been found to be as effective as a 14-day course [356], and a course of duration 3-5 days is usually considered appropriate in children (Evidence B). Current evidence suggests that there is no benefit in tapering the dose of oral glucocorticosteroids, either in the short term [357] or over several weeks (Evidence B) [358].…”

Section: Initial Assessmentmentioning

confidence: 99%

Global strategy for asthma management and prevention: GINA executive summary

Bateman

Ss²,

Barnes³

et al. 2008

European Respiratory Journal

2,641

2,301

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Asthma is a serious health problem throughout the world. During the past two decades, many scientific advances have improved our understanding of asthma and ability to manage and control it effectively. However, recommendations for asthma care need to be adapted to local conditions, resources and services. Since it was formed in 1993, the Global Initiative for Asthma, a network of individuals, organisations and public health officials, has played a leading role in disseminating information about the care of patients with asthma based on a process of continuous review of published scientific investigations. A comprehensive workshop report entitled ''A Global Strategy for Asthma Management and Prevention'', first published in 1995, has been widely adopted, translated and reproduced, and forms the basis for many national guidelines. The 2006 report contains important new themes. First, it asserts that ''it is reasonable to expect that in most patients with asthma, control of the disease can and should be achieved and maintained,'' and recommends a change in approach to asthma management, with asthma control, rather than asthma severity, being the focus of treatment decisions. The importance of the patient-care giver partnership and guided self-management, along with setting goals for treatment, are also emphasised.

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Section: Initial Assessmentmentioning

confidence: 99%

Global strategy for asthma management and prevention: GINA executive summary

Bateman

Ss²,

Barnes³

et al. 2008

European Respiratory Journal

2,641

2,301

View full text Add to dashboard Cite

show abstract

“…[28,29] • CS need to be continued for 7 -14 days. [30] • CS have been shown to be effective when administered by MDI or nebulisation in acute asthma, [31,32] but the inhaled route is not costeffective or as reliable as systemic administration in acute asthma. There is insufficient evidence that the inhaled route can replace systemic CS in acute asthma.…”

Section: Glucocorticosteroidsmentioning

confidence: 99%

Guideline for the management of acute asthma in adults: 2013 update

et al. 2012

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“…Two placebo-controlled studies have examined duration of OCS treatment in patients discharged from hospital or ED. HASEGAWA et al [9] found no difference between 1 and 2 weeks of oral prednisolone 0.5 mg?kg -1 , given after 3 days' i.v. corticosteroids, but JONES et al [10] found that symptoms were higher in patients treated with prednisolone (40 mg) for 5 days compared with 10 days.…”

Section: Duration Of Ocs Therapymentioning

confidence: 96%

Pharmacological strategies for self-management of asthma exacerbations

Reddel

Barnes²

2006

European Respiratory Journal

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Written action plans are effective within asthma self-management, but there are few guidelines about the specific medication adjustments which can be recommended for selftreatment of exacerbations.This review examines pharmacological strategies for self-management of asthma exacerbations in adults, including those for inhaled corticosteroid/long-acting b 2 -agonist (ICS/LABA) users.Oral corticosteroids are well-established in clinical practice and clinical trials for the treatment of severe exacerbations, including during combination therapy. Evidence supports 7-10 days treatment, with no need to taper except to reduce side-effects. Doubling the dose of ICS is not effective. Several studies have shown benefit from high-dose ICS (2,400-4,000 mg beclomethasone equivalent) for 1-2 weeks. This may be achieved by adding a high-dose ICS inhaler to maintenance ICS or ICS/LABA therapy. There is inconclusive evidence about acutely increasing the dose of maintenance budesonide/formoterol for exacerbations, and no studies of this approach with fluticasone/salmeterol. For patients taking maintenance budesonide/formoterol, use of the same medication as-needed reduces exacerbations. Short-acting b 2 -agonists are still effective in producing bronchodilation during combination therapy; however, a higher dose may be required.There is a need for further studies to clarify remaining issues about self-management of asthma exacerbations, particularly with regard to side-effects of treatment and patient acceptability.

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Duration of Systemic Corticosteroids in the Treatment of Asthma Exacerbation. A Randomized Study.

Abstract: Objective To determine an appropriate duration for a short course of oral steroids in cases of asthmaexacerbations.

Cited by 44 publications

References 5 publications

Global strategy for asthma management and prevention: GINA executive summary

Global strategy for asthma management and prevention: GINA executive summary

Guideline for the management of acute asthma in adults: 2013 update

Pharmacological strategies for self-management of asthma exacerbations

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