Inhaled Steroids Helpful in Emergency Treatment of Asthma

Laurie Barclay, MD

July 22, 2002

July 23, 2002 -- Inhaled steroids benefit asthmatics who are treated and discharged from an emergency department (ED), according to results of an observational trial published in the July 22 issue of the Archives of Internal Medicine. Although those given inhaled steroids had 45% fewer return visits than those who did not, this trial showed no dose relationship. Determination of optimal dosing will await future randomized trials.

"Patients who visit the ED because of asthma frequently have a relapse," write Don D. Sin, MD, MPH, and S. F. Paul Man, MD, from the University of Alberta in Edmonton. "Inhaled corticosteroid therapy after ED discharge is associated with a significant reduction in the risk of subsequent ED visits."

Of 1,293 patients aged 5 to 60 years seen for asthma in an ED, 658 were prescribed inhaled steroids and 535 were not. Users of inhaled steroids after ED discharge had 45% fewer ED visits for relapse than did nonusers (adjusted risk ratio, 0.55; 95% confidence interval, 0.44-0.69). Reductions in risk of relapse were similar for low-, medium-, and high-dose inhaled steroids.

Although study limitations included observational design, the authors thought it unlikely that confounding by indication could explain the findings.

"Low-dose therapy appears to be as effective as high-dose therapy," the authors write. "However, further studies are needed to determine the optimal dosing regimen for inhaled corticosteroid therapy for asthma."

Arch Intern Med. 2002;162:1591-1595

Reviewed by Gary D. Vogin, MD


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: