Previous asthma management plans suggest doubling the dose of inhaled corticosteroids when asthma controls fail. In a recent study conducted in UK, a four fold increase in dosage showed that it prevented any exacerbations from occuring.
The study employed asthma patients wherein management plans include increasing their maintenance dose of beclomethasone inhaler or its equivalent. From the usual 200 μg, dose was increased to 1000 μg when the peak respiratory flow deteriorates.
According to the authors of the study, this resulted in a significant reduction in the series of exacerbations needing oral corticosteroids. As much as fifty percent reduction was seen in patients who received the new management plan than those who received placebo inhalers.
However, the results did not prove to be statistically significant since some patients in the control group did not follow the management plan of quadrupling the dose, according to the researchers in the American Journal of Respiratory and Clinical Care Medicine.
They further suggested that the relationship between inhaled corticosteroid dose and a reduction in exacerbation is non – linear, thereby, significant effects in doubling the dose could not be established.
They concluded that further studies are needed to establish relationships between variables, but in the meantime, their findings suggest the best approach in preventing asthma exacerbations.
From 6 minutes:
In a studyinvolving 400 asthma patients, management plans were adopted that advised a quadrupling of the usual dose of 200 to 1000 µg of beclomethasone inhaler (or equivalent) when the peak expiratory flow fell by 15% on two consecutive days or by 30% on one day.This led to a marked reduction in the number of exacerbations needing oral corticosteroids (21% v 50%) in patients who used the active rather than placebo inhalers, the study authors say.
However, the overall reduction in exacerbations was not statistically significant because some patients did not adopt the quadrupling dose advice, say the researchers in the American Journal of Respiratory and Clinical Care Medicine (online 9 July).
