Cargando…

Comparing the efficacy and safety of two regimens of sequential systemic corticosteroids in the treatment of acute exacerbation of bronchial asthma

BACKGROUND: Corticosteroids are commonly used in the management of acute asthma. However, studies comparing various steroids in the management of acute asthma are lacking. OBJECTIVE: To compare the efficacy and safety of two treatment regimens – intravenous (IV) methylprednisolone (MP) followed by o...

Descripción completa

Detalles Bibliográficos
Autores principales: Aggarwal, Praveen, Bhoi, Sanjeev
Formato: Texto
Lenguaje:English
Publicado: Medknow Publications 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2938487/
https://www.ncbi.nlm.nih.gov/pubmed/20930966
http://dx.doi.org/10.4103/0974-2700.66522
_version_ 1782186628195811328
author Aggarwal, Praveen
Bhoi, Sanjeev
author_facet Aggarwal, Praveen
Bhoi, Sanjeev
author_sort Aggarwal, Praveen
collection PubMed
description BACKGROUND: Corticosteroids are commonly used in the management of acute asthma. However, studies comparing various steroids in the management of acute asthma are lacking. OBJECTIVE: To compare the efficacy and safety of two treatment regimens – intravenous (IV) methylprednisolone (MP) followed by oral MP and IV hydrocortisone (HC) followed by oral prednisolone in acute bronchial asthma patients. MATERIALS AND METHODS: This was a randomized, prospective study performed in the emergency department (ED) of a tertiary care hospital in North India. A total of 94 patients with acute asthma were randomly allocated to either of the two treatment groups: Group A (n = 49) or Group B (n = 45). Patients in Group A were administered HC 200 mg IV 6-hourly until discharge from the ED, followed by oral prednisolone 0.75 mg/kg daily for 2 weeks. Patients in Group B were administered MP 125 mg IV bolus, followed by 40 mg MP IV 6-hourly until discharge, and then oral MP 0.6 mg/kg daily for 2 weeks. All clinical variables, peak expiratory flow (PEF) and forced expiratory volume in one second (FEV(1)) were assessed at baseline, at 1, 3 and 6 h and at every 6 h thereafter until discharge from the ED. The patients were followed-up after 2 weeks of discharge. The response to treatment was assessed by clinical and spirometric evaluation. Independent t-tests and chi-square tests were used to compare the two treatment regimens. RESULTS: The baseline characteristics were comparable in the two groups. There was a significant improvement in PEF and FEV(1) within the groups at 2 weeks of treatment when compared to the baseline. At 2 weeks of follow-up, Group B showed significant improvement over Group A in PEF (P < 0.0001), FEV(1) (P < 0.0001) and asthma score (P = 0.034). There was a significant increase in the blood sugar value at 2 weeks in both the groups. However, the increase was greater in Group A as compared to Group B (P < 0.0001). CONCLUSION: This study suggests that in acute asthma patients, IV MP followed by oral MP is a more efficacious and safer treatment regimen than IV HC followed by oral prednisolone.
format Text
id pubmed-2938487
institution National Center for Biotechnology Information
language English
publishDate 2010
publisher Medknow Publications
record_format MEDLINE/PubMed
spelling pubmed-29384872010-10-07 Comparing the efficacy and safety of two regimens of sequential systemic corticosteroids in the treatment of acute exacerbation of bronchial asthma Aggarwal, Praveen Bhoi, Sanjeev J Emerg Trauma Shock Original Article BACKGROUND: Corticosteroids are commonly used in the management of acute asthma. However, studies comparing various steroids in the management of acute asthma are lacking. OBJECTIVE: To compare the efficacy and safety of two treatment regimens – intravenous (IV) methylprednisolone (MP) followed by oral MP and IV hydrocortisone (HC) followed by oral prednisolone in acute bronchial asthma patients. MATERIALS AND METHODS: This was a randomized, prospective study performed in the emergency department (ED) of a tertiary care hospital in North India. A total of 94 patients with acute asthma were randomly allocated to either of the two treatment groups: Group A (n = 49) or Group B (n = 45). Patients in Group A were administered HC 200 mg IV 6-hourly until discharge from the ED, followed by oral prednisolone 0.75 mg/kg daily for 2 weeks. Patients in Group B were administered MP 125 mg IV bolus, followed by 40 mg MP IV 6-hourly until discharge, and then oral MP 0.6 mg/kg daily for 2 weeks. All clinical variables, peak expiratory flow (PEF) and forced expiratory volume in one second (FEV(1)) were assessed at baseline, at 1, 3 and 6 h and at every 6 h thereafter until discharge from the ED. The patients were followed-up after 2 weeks of discharge. The response to treatment was assessed by clinical and spirometric evaluation. Independent t-tests and chi-square tests were used to compare the two treatment regimens. RESULTS: The baseline characteristics were comparable in the two groups. There was a significant improvement in PEF and FEV(1) within the groups at 2 weeks of treatment when compared to the baseline. At 2 weeks of follow-up, Group B showed significant improvement over Group A in PEF (P < 0.0001), FEV(1) (P < 0.0001) and asthma score (P = 0.034). There was a significant increase in the blood sugar value at 2 weeks in both the groups. However, the increase was greater in Group A as compared to Group B (P < 0.0001). CONCLUSION: This study suggests that in acute asthma patients, IV MP followed by oral MP is a more efficacious and safer treatment regimen than IV HC followed by oral prednisolone. Medknow Publications 2010 /pmc/articles/PMC2938487/ /pubmed/20930966 http://dx.doi.org/10.4103/0974-2700.66522 Text en © Journal of Emergencies, Trauma, and Shock http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Aggarwal, Praveen
Bhoi, Sanjeev
Comparing the efficacy and safety of two regimens of sequential systemic corticosteroids in the treatment of acute exacerbation of bronchial asthma
title Comparing the efficacy and safety of two regimens of sequential systemic corticosteroids in the treatment of acute exacerbation of bronchial asthma
title_full Comparing the efficacy and safety of two regimens of sequential systemic corticosteroids in the treatment of acute exacerbation of bronchial asthma
title_fullStr Comparing the efficacy and safety of two regimens of sequential systemic corticosteroids in the treatment of acute exacerbation of bronchial asthma
title_full_unstemmed Comparing the efficacy and safety of two regimens of sequential systemic corticosteroids in the treatment of acute exacerbation of bronchial asthma
title_short Comparing the efficacy and safety of two regimens of sequential systemic corticosteroids in the treatment of acute exacerbation of bronchial asthma
title_sort comparing the efficacy and safety of two regimens of sequential systemic corticosteroids in the treatment of acute exacerbation of bronchial asthma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2938487/
https://www.ncbi.nlm.nih.gov/pubmed/20930966
http://dx.doi.org/10.4103/0974-2700.66522
work_keys_str_mv AT aggarwalpraveen comparingtheefficacyandsafetyoftworegimensofsequentialsystemiccorticosteroidsinthetreatmentofacuteexacerbationofbronchialasthma
AT bhoisanjeev comparingtheefficacyandsafetyoftworegimensofsequentialsystemiccorticosteroidsinthetreatmentofacuteexacerbationofbronchialasthma