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Clinical Trial
. 2004 Jul;59(7):550-6.
doi: 10.1136/thx.2003.014936.

Doubling the dose of budesonide versus maintenance treatment in asthma exacerbations

J M FitzGerald  1 , A Becker, M R Sears, S Mink, K Chung, J Lee; Canadian Asthma Exacerbation Study Group
Affiliations
Clinical Trial

Doubling the dose of budesonide versus maintenance treatment in asthma exacerbations

J M FitzGerald et al. Thorax. 2004 Jul.

Abstract

Background: Previous guidelines recommend doubling the daily dose of maintenance inhaled corticosteroid to treat or prevent progression of exacerbations of asthma.

Methods: Over a 6 month period a cohort of patients were evaluated prospectively and randomised in a double blind controlled trial to treatment with either a continued maintenance dose (MD) of inhaled corticosteroid or doubling the dose (DD) at the time of an exacerbation.

Results: A total of 290 patients were randomised (33% male) and 98 (DD, n = 46) experienced evaluable asthma exacerbations during the study period. Mean (SD) baseline characteristics at randomisation (age 33.5 (14.0) years; forced expiratory volume in 1 second (FEV(1)) 2.8 (0.7) l; peak expiratory flow (PEF) 422.9 (110.5) l/min) were similar in both groups. In the DD group 41% of patients were considered treatment failures because they either required systemic steroids (n = 12), had an unscheduled visit to a physician (n = 1), or their asthma did not return to baseline (n = 6). This did not differ from the MD group in which 40% were treatment failures (n = 9, 0, and 12, respectively; p = 0.94).

Conclusions: In patients who regularly take an inhaled corticosteroid, doubling the maintenance dose may not affect the pattern of the exacerbation.

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Comment in

  • Management of asthma exacerbations.
    Busse WW, Lemanske RF Jr. Busse WW, et al. Thorax. 2004 Jul;59(7):545-6. doi: 10.1136/thx.2004.023481. Thorax. 2004. PMID: 15223855 Free PMC article. No abstract available.

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