Doubling of inhaled corticosteroid dose during asthma exacerbations

• over a 6 month period a cohort of patients were evaluated prospectively and randomised in a double blind controlled trial to treatment with either a continued maintenance dose (MD) of inhaled corticosteroid or doubling the dose (DD) at the time of an exacerbation.
• this study involved 290 patients and 98 (DD, n = 46) experienced evaluable asthma exacerbations during the study period
• study results revealed that in the DD group 41% of patients were considered treatment failures because they either required systemic steroids This did not differ from the MD group in which 40% were treatment failures
• the study authors concluded that, in patients who regularly take an inhaled corticosteroid, doubling the maintenance dose may not affect the pattern of the exacerbation

Reference:

1. Fitzgerald JM et al (2004). Doubling the dose of budesonide versus maintenance treatment in asthma exacerbations. Thorax;59:550-6.