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Structured abstracts of sentinel articles: Picket
Quadrupling or quintupling inhaled corticosteroid doses to prevent asthma exacerbations: the jury’s still out
  1. Amanda Jane Friend1,2
  1. 1 Department of Paediatrics, Leeds General Infirmary, Leeds, UK
  2. 2 School of Medicine, University of Leeds, Leeds, UK
  1. Correspondence to Dr Amanda Jane Friend, Department of Paediatrics, Leeds General Infirmary, Leeds, LS1 3EX, UK; amanda.friend{at}nhs.net

https://doi.org/10.1136/archdischild-2018-315608

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    Study 1

    Study design

    Double blind, randomised controlled trial.

    Study question

    Setting: UK.

    Patients: 1871 adults and adolescents (mean age 57 years) who had a diagnosis of asthma, were being treated with inhaled corticosteroid (ICS) and had had at least one exacerbation requiring systemic glucocorticoid treatment in the preceding 12 months.

    Intervention: Quadrupling dose of ICS at the early loss of asthma control (vs usual dose of ICS; both groups increased bronchodilator as required).

    Outcomes: Rates of asthma exacerbation requiring treatment with systemic glucocorticoids or an unscheduled healthcare visit.

    Main results

    The study’s main results are summarised in table 1.

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    Table 1

    Summary of asthma exacerbations in patients treated with quadrupled dose of ICS vs usual-dose ICS during the 12-month trial period

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    Conclusion

    Temporary quadrupling of ICS dose at the early signs of loss of asthma control results in a lower rate of severe asthma …

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    Footnotes

    • Provenance and peer review Not commissioned; internally peer reviewed.