Early administration of corticosteroids in emergency room treatment of acute asthma

Article Abstract:

Corticosteroids have been used for their anti-inflammatory effects to treat bronchial asthma for the past 40 years. Although these anti-inflammatory agents are effective in treating asthma that does not respond to conventional therapies, their effects on acute or sudden asthma attacks have not been clearly demonstrated. In addition, the onset of steroid action in treating asthma and the effects of corticosteroid treatment on rate of hospital admission after an acute asthma attack have not been thoroughly investigated. The effectiveness of early administration of corticosteroids in decreasing the duration of emergency room treatment and the rate of hospital admission was assessed in 81 patients, 18 to 45 years of age, with acute or sudden bronchial asthma. A dose of 125 milligrams of the corticosteroid methylprednisolone was given to one group of patients, whereas the remaining patients (control group) were not treated with the anti-inflammatory steroids. All patients were also given anti-asthmatic agents that dilate the bronchi (airways), including metaproterenol and theophylline. If emergency room treatment of the acute asthma attack lasted more than 12 hours, the patient was hospitalized. The duration of emergency room treatment, the necessity of hospitalization, and the frequency of return visits two days following emergency room discharge were similar for the corticosteroid-treated and control groups. The results show that the early administration of corticosteroids did not provide additional benefits to patients with acute asthma. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Hospitals, Hospital emergency services

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Slowing the deterioration of asthma and chronic obstructive pulmonary disease observed during bronchodilator therapy by adding inhaled corticosteroids: a 4-year prospective study

Article Abstract:

The addition of an inhaled corticosteroid may slow the progression of asthma or chronic obstructive pulmonary disease (COPD) during bronchodilator therapy. Continuous treatment with a bronchodilator can increase the incidence of complications and death among asthma and COPD patients. Among 48 patients with an annual decline in forced expiratory volume per second (FEV1), 26 had asthma and 22 had COPD. A drop in FEV1 indicates worsening lung function. The patients were treated only with a bronchodilator during the first two years of treatment. During the second two years of treatment, they were also treated with 400 micrograms of the inhaled corticosteroid beclomethasone dipropionate two times a day. The patients had a smaller annual drop in FEV1 after the addition of beclomethasone to their treatment regimen. Other measures of lung function improved during treatment with beclomethasone in the asthma patients but not in the COPD patients.

Complications and side effects, Bronchodilator agents

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Periodic treatment regimens with inhaled steroids in asthma or chronic obstructive pulmonary disease: is it possible?

Article Abstract:

Inhaled corticosteroids may be stopped in patients with mild and stable asthma or chronic obstructive pulmonary disease (COPD), without a worsening of lung function. Researchers studied 48 patients with asthma or COPD who had experienced a decline in forced expiratory volume in 1 second (FEV1). They were treated with inhaled steroids for two years. Treatment was then stopped in 14 patients, who volunteered to discontinue beclomethasone. They experienced no decline in lung function from the two-year period they were receiving beclomethasone. Periodic treatment with corticosteroids in certain patients may prove to be a good option because side effects can be reduced and patients will be more likely to cooperate with the shorter term steroid therapy.

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