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...
Autores principales: | , |
---|---|
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 |