Inhaled corticosteroids in the emergency department treatment of acute asthma

Inhaled steroids given in the emergency department for acute asthma appear to reduce admission rates in patients who are not receiving systemic steroids.

A Cochrane review included data from 7 studies (4 adult, 3 paediatric) with a total of 376 subjects. Patients treated with inhaled corticosteroids were less likely to be admitted to hospital (OR 0.30, 95% CI 0.16 to 0.57). This benefit was only observed in patients not receiving concomitant systemic steroids (OR 0.21; 95% CI: 0.08, 0.53). Patients receiving inhaled corticosteroids also demonstrated small, significant improvements in peak expiratory flows (PEFR WMD: 8%; 95% CI 3 to 13 %) and forced expiratory volumes (FEV₁ WMD: 5%; 95% CI 0.4 to 10 %).

Comment: The quality of evidence is downgraded by sparse data but upgraded by large magnitude of effect.

Ədəbiyyat

1. Edmonds ML, Camargo CA Jr, Pollack CV Jr, Rowe BH. Early use of inhaled corticosteroids in the emergency department treatment of acute asthma. Cochrane Database Syst Rev 2003;(3):CD002308.