Prioritizing Systemic Corticosteroid Treatments to Mitigate Relapse in Adults With Acute Asthma: A Systematic Review and Network Meta‐analysis

Rowe, Brian H.; Kirkland, Scott W.; Vandermeer, Ben; Campbell, Sandy; Newton, Amanda S; Ducharme, Francine M; Villa‐Roel, Cristina

doi:10.1111/acem.13107

Cited by 6 publications

(4 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the heterogeneity of the trials, subsequent systematic reviews have concurred that there is no convincing difference in clinical outcomes between higher or lower doses of prednisolone, nor duration of use of prednisolone, nor whether a tapering of dose was used. [42][43][44] A study comparing 2 days of dexamethasone with 5 days of prednisone showed similar rates of relapse and time to return to normal activity suggesting the former strategy may be an option. 45 Caution is required in anyone taking dexamethasone for more than 2 days given its potent metabolic (diabetogenic) effects.…”

Section: What Dose Of Ocs?mentioning

confidence: 99%

Oral corticosteroids stewardship for asthma in adults and adolescents: A position paper from the Thoracic Society of Australia and New Zealand

et al. 2021

View full text Add to dashboard Cite

Oral corticosteroids (OCS) are frequently used for asthma treatment. This medication is highly effective for both acute and chronic diseases, but evidence indicates that indiscriminate OCS use is common, posing a risk of serious side effects and irreversible harm. There is now an urgent need to introduce OCS stewardship approaches, akin to successful initiatives that optimized appropriate antibiotic usage. The aim of this TSANZ (Thoracic Society of Australia and New Zealand) position paper is to review current knowledge pertaining to OCS use in asthma and then delineate principles of OCS stewardship. Recent evidence indicates overuse and over-reliance on OCS for asthma and that doses >1000 mg prednisolone-equivalent cumulatively are likely to have serious side effects and adverse outcomes. Patient perspectives emphasize the detrimental impacts of OCS-related side effects such as weight gain, insomnia, mood disturbances and skin changes. Improvements in Laurence Ruane and John Gornall are consumer representatives.

show abstract

Section: What Dose Of Ocs?mentioning

confidence: 99%

Oral corticosteroids stewardship for asthma in adults and adolescents: A position paper from the Thoracic Society of Australia and New Zealand

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Similarly, in adults, systemic steroids reduced acute relapse rates, though the course of prednisone needed to be at least 7-10 days in duration, with shorter courses being ineffective (65). Treatment with ICS cannot be used in place of OCS (66), but may prevent the need to use OCS in acute asthma.…”

Section: Adjusting Ics/ocsmentioning

confidence: 99%

Mechanisms and Management of Asthma Exacerbations

Ramsahai

Hansbro

Wark

2019

Am J Respir Crit Care Med

104

View full text Add to dashboard Cite

Acute asthma remains an important medical emergency, the most frequent cause of acute admissions in children and a major source of morbidity for adults with asthma. In all ages with asthma the presence of exacerbations is an important defining characteristic of asthma severity. In this review we will assess the epidemiology of acute asthma, the triggers of acute exacerbations and the mechanisms that underlie these exacerbations. We will also assess current treatments that prevent exacerbations, with an emphasis on the role of type 2 airway inflammation in the context of acute exacerbations and the novel treatments that effectively target this. Finally we will review current management strategies of the exacerbations themselves.

show abstract

“…The clinical features of asthma resulting from reversible airway inflammation include chest tightness, worsening cough, shortness of breath, and wheezing [1]. In our context, most patients managed for acute exacerbation of asthma respond favourably to treatment with standard management protocol [2]. Systemic and oral steroids are administered, followed by gradual resolution of symptoms.…”

Section: Introductionmentioning

confidence: 99%

Route of Administration of Corticosteroids and Asthma Relapse after Acute Care; Appraisal of Evidence on Effectiveness and Safety

Sogunle¹

2021

TIJPH

View full text Add to dashboard Cite

Patients managed for acute exacerbation of asthma in acute settings respond to standard management protocol involving systemic and oral steroids. However, relapses are common due to poor adherence to tapering doses of oral steroids. Intramuscular (IM) administration of corticosteroids has been shown to be equipotent to oral steroids with the added advantage of convenient dosing and improved adherence. However, the role of the route of administration of corticosteroids related to relapse of asthma attacks after acute care has not been fully explored. To find and appraise up-to-date evidence in the literature that compares the effectiveness and safety of IM corticosteroids o a short-course oral corticosteroid in the treatment of asthma patients in acute care settings. The principles of evidence-based medicine (EBM) were used. Suitable articles were identified using MEDLINE, Cochrane library, and Google scholar. Titles and summary texts were reviewed. The full article of the relevant article was downloaded for critical appraisal of methodological quality using a measurement tool to assess systematic review 2 (AMSTAR 2). In applying AMSTAR 2 to the selected systematic review article, it was noted that the investigators followed most of the requirements. However, adequate investigation of publication bias and discussion of its likely impact on the review’s result was not done by the researchers. No significant differences in effectiveness and safety were observed between IM corticosteroids and oral corticosteroids among this category of patients. Additional studies are required to compare different IM and oral corticosteroid preparations. Keywords: Acute exacerbation of Asthma, AMSTER 2, Evidence-based medicine, Route of administration of corticosteroids.

show abstract

Prioritizing Systemic Corticosteroid Treatments to Mitigate Relapse in Adults With Acute Asthma: A Systematic Review and Network Meta‐analysis

Cited by 6 publications

References 23 publications

Oral corticosteroids stewardship for asthma in adults and adolescents: A position paper from the Thoracic Society of Australia and New Zealand

Oral corticosteroids stewardship for asthma in adults and adolescents: A position paper from the Thoracic Society of Australia and New Zealand

Mechanisms and Management of Asthma Exacerbations

Route of Administration of Corticosteroids and Asthma Relapse after Acute Care; Appraisal of Evidence on Effectiveness and Safety

Contact Info

Product

Resources

About