|
SELECTED ARTICLES FROM THE RECENT LITERATURE 2007
September 6, 2007
Comparison of inhaled fluticasone and oral prednisone treatments in acute asthma exacerbations
Summary
Background - Some studies have suggested that high doses of inhaled corticosteroids (ICS) are effective in treating moderate acute asthma exacerbations (AAE), thus avoiding the need for systemic corticosteroid (CS) therapy. How does such ICS treatment compare with oral CS therapy in AAE?
Findings - Belda et al of the Universital Autonoma in Barcelona, Spain compared the effects of inhaled fluticasone (F), 4,000 microg/day and prednisone (P) 30 mg/day in a randomized, double blind, placebo-controlled study in adults with moderate AAE. They found that there were significant reductions in symptoms and improved FEV-1/PEF by 24 hours in both F and P treated patients with no significant differences between the 2 groups. Eosinophil frequency in the sputum decreased in both groups, but faster during F treatment. Plasma protein levels in the sputum and blood eosinophilia decreased in both groups with no significant difference between the 2 groups.
Reference
Eur Respir J 2007; Aug 9, Epub
Editor's Comments
These findings suggest that high dosage inhaled F can be as effective as oral CS in treating moderate AAE. However, the daily dose of F used here (4000 microg) is higher than used in other studies of ICS treatment in AAE. Also, the dose of prednisone (30 mg/day) is lower than usually given to adults in AAE. Thus, one cannot say with certainty that an ICS is as effective as oral CS in treating AAE. However, the inhaled F treatment certainly had strong anti-inflammatory effects in these patients.
|