Effect of a short course of prednisone in the prevention of early relapse after the emergency room treatment of acute asthma

Visits to the hospital emergency room are not rare among patients with asthma, and from 25 to 30 percent of all patients visiting an emergency room for treatment of an acute exacerbation of asthma will have a relapse following treatment. Some clinicians have recommended that a short course of oral corticosteroids be given after emergency treatment, but until now the value of this practice had not been objectively established. Ninety-three emergency room patients were recruited into a controlled study of oral steroids; 48 patients took prednisone for eight days after their emergency room visit, and 45 took a placebo which was indistinguishable in appearance and taste from the real drug. The patients took eight 5 milligram tablets of prednisone or eight tablets of placebo the first day, and each day the dose was tapered by a single tablet. Follow-up revealed that only 3 of the patients taking prednisone relapsed within the first 10 days, in contrast with 11 of the patients taking placebo. From days 11 through 21, 5 patients in the treatment group and 6 in the placebo group suffered relapses, indicating that the beneficial effect seen in the treatment group was limited to the interval during which prednisone was taken daily. In addition to freedom from relapses requiring medical attention, the group treated with prednisone experienced significantly fewer episodes of shortness of breath and used inhaled bronchodilators significantly less often. The results demonstrate that a short course of oral steroid treatment after an emergency room visit for acute asthma does indeed reduce the risk of relapse. (Consumer Summary produced by Reliance Medical Information, Inc.)