Please use this identifier to cite or link to this item: http://hdl.handle.net/1959.13/925321
- An umbrella review: corticosteroid therapy for adults with acute asthma
Krishnan, Jerry A.;
Davis, Steven Q.;
Naureckas, Edward T.;
Rowe, Brian H.
- The University of Newcastle. Faculty of Health, School of Medicine and Public Health
- The objective of this “umbrella” review is to synthesize the evidence and provide clinicians a single report that summarizes the state of knowledge regarding the use of corticosteroids in adults with acute asthma. Systematic reviews in the Cochrane Library and additional clinical trials published in English from 1966 to 2007 in MEDLINE, EMBASE, CINAHL, and Cochrane CENTRAL, and references from bibliographies of pertinent articles were reviewed. Results indicate that the evidence base is frequently limited to small, single-center studies. Findings suggest that therapy with systemic corticosteroids accelerates the resolution of acute asthma and reduces the risk of relapse. There is no evidence that corticosteroid doses greater than standard doses (prednisone 50-100 mg equivalent) are beneficial. Oral and intravenous corticosteroids, as well as intramuscular and oral corticosteroid regimens, seem to be similarly effective. A nontapered 5- to 10-day course of corticosteroid therapy seems to be sufficient for most discharged patients. Combinations of oral and inhaled corticosteroids on emergency department/hospital discharge might minimize the risk of relapse.
- American Journal of Medicine Vol. 122, Issue 11, p. 977-991
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- journal article