Intramuscular methylprednisolone acetate for the prevention of relapse in acute asthma

Abstract

Study objective: To examine the hypothesis that an IM long-acting steroid injection will decrease the relapse rate of asthma patients.

Design: A randomized, single-blind, placebo-controlled trial.

Setting: The emergency department of an urban academic medical center.

Type of participants: Acute asthma patients aged 18 to 45 years who were treated successfully in the ED.

Interventions: Participants received either IM saline placebo or 240 mg methylprednisolone acetate suspension at the time of discharge. MEASUREMENTS AND MAIN OUTCOME: Relapse, defined as the need to seek nonroutine medical care for asthma within seven days of discharge, was the main outcome measure. Of 70 patients entered, 56 (80%) completed follow-up, including 30 in the steroid group and 26 in the placebo group. The groups had similar characteristics and peak expiratory flow values on arrival and at discharge. Relapse occurred in two steroid patients (6.7%) and eight placebo recipients (30.8%) (P < .05). There was one death in the placebo group. Reported side effects were similar.

Conclusion: IM long-acting steroids reduced the rate of relapse in patients with acute asthma.