Doubling the dose of inhaled corticosteroids during asthma deterioration did not improve asthma control
Year: 2004
Type: article
Abstract: Harrison TW, Oborne J, Newton S, et al. Doubling the dose of inhaled corticosteroid to prevent asthma exacerbations: randomised controlled trial. Lancet 2004;363:271–5. [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Q In patients with asthma, does doubling the dose of inhaled corticosteroid (ICS) reduce the need for prednisolone when control starts to deteriorate? Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★★☆ Allergy ★★★★★★☆ Respirology ★★★★★★☆ ### ![Graphic][5] Design: randomised, placebo controlled trial. ### ![Graphic][6] Allocation: concealed.* ### ![Graphic][7] Blinding: blinded (clinicians and patients).* ### ![Graphic][8] Follow-up period: 12 months. ### ![Graphic][9] Setting: a hospital in Nottingham, UK. ### ![Graphic][10] Patients: 390 patients who were ⩾16 years of age (mean age 49 y, 67% women) with a clinical diagnosis of asthma; were taking ICS, 100–2000 μg/d on a regular basis; and required oral corticosteroids or doubled their dose of ICS in the previous 12 months. Exclusion criteria: history of smoking >10 pack years or unstable asthma during a 2 week run in period. ### ![Graphic][11] Intervention: patients were stratified by entry ICS dose (low to moderate or high) and allocated to an active inhaler (n = 192) or a placebo inhaler (n = 198). Study inhalers were matched to patients’ regular ICS, … [1]: {openurl}?query=rft.jtitle%253DLancet%26rft.stitle%253DLancet%26rft.aulast%253DHarrison%26rft.auinit1%253DT.%2BW.%26rft.volume%253D363%26rft.issue%253D9405%26rft.spage%253D271%26rft.epage%253D275%26rft.atitle%253DDoubling%2Bthe%2Bdose%2Bof%2Binhaled%2Bcorticosteroid%2Bto%2Bprevent%2Basthma%2Bexacerbations%253A%2Brandomised%2Bcontrolled%2Btrial.%26rft_id%253Dinfo%253Adoi%252F10.1016%252FS0140-6736%252803%252915384-6%26rft_id%253Dinfo%253Apmid%252F14751699%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1016/S0140-6736(03)15384-6&link_type=DOI [3]: /lookup/external-ref?access_num=14751699&link_type=MED&atom=%2Febmed%2F9%2F5%2F140.atom [4]: /lookup/external-ref?access_num=000188361400008&link_type=ISI [5]: /embed/inline-graphic-1.gif [6]: /embed/inline-graphic-2.gif [7]: /embed/inline-graphic-3.gif [8]: /embed/inline-graphic-4.gif [9]: /embed/inline-graphic-5.gif [10]: /embed/inline-graphic-6.gif [11]: /embed/inline-graphic-7.gif
Source: BMJ Evidence-Based Medicine
DOI: 10.1136/ebm.9.5.140
Author: H. J Schunemann
Institution: University at Buffalo, State University of New York
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2072093666