asthma, acute exacerbation
DISEASE INTERVENTION COMPARISON RESULTS
N Engl J Med. 2018 Mar 08;378(10):902-910 Randomized Controlled Trial, Multicenter Study
IN asthma, acute exacerbation The Use of
self-management plan including a temporary quadrupling of the dose of inhaled glucocorticoids when asthma control start to deteriorate
As Treatment, Acute
Is better Than
self-management plan without increase of inhaled corticosteroids
To reduce severe asthma exacerbations at 1 year: 45% with quadrupling VS 52% in the non-quadrupling. More local adverse events with quadrupling.
Am J Respir Crit Care Med. 2005 Jun 1;171(11):1231-6 Randomized Controlled Trial
IN asthma, acute exacerbation The Use of
corticosteroids, inhaled, fluticasone
As Treatment, Acute
Is better Than
parenteral IV corticosteroids
To improve PEF and FEV1 (30 to 46% more improvement with inhaled VS. IV corticosteroids) and reduce hospital admisions - all at 3 hours (very short term)
JAMA. 1999 Jun 9;281(22):2119-26 Randomized Controlled Trial
IN asthma, acute exacerbation The Use of
corticosteroids, inhaled, high dose, budesonide
As Treatment, Acute
Is better Than
placebo
To reducing symptoms and relapses, as unscheduled visits to physician, but not overall low rate of hospitalization. Improving quality of life.
BMJ. 1998 Oct 10;317:971-977 Meta-Analysis
IN asthma, acute exacerbation The Use of
inhaled anticholinergics added to inhaled beta-agonists
As Treatment, Acute
Is better Than
inhaled beta-agonists alone
To reduce the risk of hospital admission by 30% (RR 0.72, NNT 11) in children and adolescents with severe exacerbations
Am J Med. 1999 Oct;107:363-70 Meta-Analysis
IN asthma, acute exacerbation The Use of
inhaled anticholinergics added to inhaled beta-agonists
As Treatment, Acute
Is better Than
inhaled beta-agonists alone
To reducing hospitalization rate