of Steroids Before Severe Asthma Attacks Proves Ineffective
to double inhaled steroids at the start of asthma attacks are
challenged by research findings in issue 24, January 2004 edition
of The Lancet.
Doubling the dose of inhaled corticosteroid when asthma control
deteriorates is widely advocated but is of unproven value. Tim
Harrison from the department of respiratory medicine, Nottingham
City Hospital, UK, and colleagues studied 390 asthma patients,
deemed to be at risk of an asthma exacerbation. Patients monitored
their asthma for up to one year and were instructed to add an
extra inhaler (either steroid or placebo) for two weeks when
their asthma control deteriorated.
There was no statistically significant difference in the proportion
of people requiring oral steroids (the main study outcome) between
the active and placebo groups (around 12% of patients in both
findings provide little support for the recommendation that
patients taking an inhaled corticosteroid
should double the dose when asthma control is deteriorating.
Whether a larger increase in inhaled corticosteroid dose would
be effective needs to be established. Until more data are available
patients should continue to take a short course of oral steroids
for asthma exacerbations."
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