Inhaled Steroids for Asthma: The Effect of Dose

Charles P. Vega, MD


April 16, 2018

Hello. I'm Dr Charles Vega, and I am a clinical professor of family medicine at the University of California at Irvine. Welcome to Medscape Morning Report, our 1-minute news story for primary care.

According to a new study, a personalized asthma self-management plan that includes temporary quadrupling of the dose of inhaled glucocorticoids can decrease the incidence of severe asthma exacerbations by 19%.

An unblinded, randomized trial,[1]involving about 1900 adults with a mean age of 56 and at least one asthma exacerbation in the past 12 months, was conducted over a year.

The number of participants who had a severe asthma exacerbation in the year after randomization was unexpectedly high, at 45% in the group that received the quadrupled dose as compared with 52% in the non-quadrupling placebo group. Fewer patients in the quadruple group required hospitalization because of an exacerbation, and fewer required systemic corticosteroids.

Because this was an open-label study, the results should be approached with caution. More studies are needed but the findings are encouraging. The quadruple-dose strategy has the potential to reduce severe asthma exacerbations and thereby save lives.


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