Double-blind evaluation of methylprednisolone versus placebo for acute asthma episodes

Twenty-eight children with persistent bronchospasm after outpatient therapy were treated for eight days with methylprednisolone or placebo in a prerandomized double-blind manner, in addition to treatment with optimal oral bronchodilators. At follow-up visits 1, 7, and 14 days after onset of therapy,...

Full description

Saved in:
Bibliographic Details
Published in:Pediatrics (Evanston) 1983-04, Vol.71 (4), p.510-514
Main Authors: Shapiro, G G, Furukawa, C T, Pierson, W E, Gardinier, R, Bierman, C W
Format: Article
Language:English
Subjects:
Adrenal Glands - drug effects
Asthma - drug therapy
Bronchial Spasm - drug therapy
Child
Child, Preschool
Double-Blind Method
Forced Expiratory Flow Rates
Forced Expiratory Volume
Humans
Isoproterenol - administration & dosage
Methylprednisolone - therapeutic use
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Twenty-eight children with persistent bronchospasm after outpatient therapy were treated for eight days with methylprednisolone or placebo in a prerandomized double-blind manner, in addition to treatment with optimal oral bronchodilators. At follow-up visits 1, 7, and 14 days after onset of therapy, a history was taken and physical examination and pulmonary function tests were performed. Initially and on the 14th day, patients underwent cosyntropin tests of adrenal function. Patients kept daily peak flow charts. Both groups improved with time. However, by 24 hours after starting methylprednisolone therapy, the placebo group continued to show reversibility after isoproterenol inhalation whereas the methylprednisolone group did not. By day 7 there were significantly more patients with normal 1-second forced expiratory volume (FEV1) and forced expiratory flow in the middle half of the forced vital capacity (FEF25-75%) in the methylprednisolone group and mean FEF25-75% was significantly higher for this group (P less than .02). By day 14, six days after finishing treatment with the study drugs, more patients in the placebo group had residual wheezing, but pulmonary function tests were now similar for the two groups. Although both groups showed a decline in cosyntropin responsiveness on day 14 compared with day 1, there was no difference between the steroid- and placebo-treated patients. This study proves that short-term corticosteroid therapy will accelerate resolution of moderately severe and severe-acute attacks of asthma without significant suppression of adrenal function.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.71.4.510