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Dexamethasone Prednisone Asthma

Scott W Kirkland, Ben Vandermeer, Sandy Campbell, Cristina Villa-Roel, Amanda Newton, Francine M Ducharme, Brian H Rowe
OBJECTIVE: The objective of this systematic review was to explore the effectiveness of various systemic corticosteroid (SCS) regimens to mitigate relapse in children with asthma discharged from an acute care setting. DATA SOURCES: Medline, EMBASE, Global Health, International Pharmaceutical Abstracts, EMB ALL, CINAHL, SCOPUS, Proquest Dissertations and Theses Global, and LILACS were searched using controlled vocabulary and key words. Additional citations were searched via clinical trial registries, Google Scholar, bibliographies, a SCOPUS forward search of a sentinel paper, and hand searching conference abstracts...
April 25, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Natalia Paniagua, Rebeca Lopez, Natalia Muñoz, Miriam Tames, Elisa Mojica, Eunate Arana-Arri, Santiago Mintegi, Javier Benito
OBJECTIVE: To determine whether 2 doses of dexamethasone is as effective as 5 days of prednisolone/prednisone therapy in improving symptoms and quality of life of children with asthma exacerbations admitted to the emergency department (ED). STUDY DESIGN: We conducted a randomized, noninferiority trial including patients aged 1-14 years who presented to the ED with acute asthma to compare the efficacy of 2 doses of dexamethasone (0.6 mg/kg/dose, experimental treatment) vs a 5-day course of prednisolone/prednisone (1...
December 2017: Journal of Pediatrics
Manali Mukherjee, David C Bulir, Katherine Radford, Melanie Kjarsgaard, Chynna Margaret Huang, Elizabeth A Jacobsen, Sergei I Ochkur, Ana Catuneanu, Hanah Lamothe-Kipnes, James Mahony, James J Lee, Paige Lacy, Parameswaran K Nair
BACKGROUND: The persistence of eosinophils in sputum despite high doses of corticosteroids indicates disease severity in asthmatic patients. Chronic inflamed airways can lose tolerance over time to immunogenic entities released on frequent eosinophil degranulation, which further contributes to disease severity and necessitates an increase in maintenance corticosteroids. OBJECTIVES: We sought to investigate the possibility of a polyclonal autoimmune event in the airways of asthmatic patients and to identify associated clinical and molecular characteristics...
July 24, 2017: Journal of Allergy and Clinical Immunology
Hans Bradshaw, Michael J Mitchell, Christopher J Edwards, Uwe Stolz, Oday Naser, Amanda Peck, Asad E Patanwala
OBJECTIVES: The objective of this study was to determine if physicians would alter their prescribing preferences after sampling liquid formulations of medications for common pediatric diagnoses. METHODS: This was a prospective interventional before/after study conducted at an academic medical center in the United States. The participants of interest included emergency, family medicine, and pediatric physicians. Participants initially completed a brief survey for their primary oral liquid medication of choice for the treatment of selected disease states...
November 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Matthew W Rehrer, Bella Liu, Marcela Rodriguez, Joseph Lam, Harrison J Alter
STUDY OBJECTIVE: Oral dexamethasone demonstrates bioavailability similar to that of oral prednisone but has a longer half-life. We evaluate whether a single dose of oral dexamethasone plus 4 days of placebo is not inferior to 5 days of oral prednisone in treatment of adults with mild to moderate asthma exacerbations to prevent relapse defined as an unscheduled return visit for additional treatment for persistent or worsening asthma within 14 days. METHODS: Adult emergency department patients (aged 18 to 55 years) were randomized to receive either a single dose of 12 mg of oral dexamethasone with 4 days of placebo or a 5-day course of oral prednisone 60 mg a day...
November 2016: Annals of Emergency Medicine
Kavita Parikh, Matt Hall, Vineeta Mittal, Amanda Montalbano, Jessica Gold, Sanjay Mahant, Karen M Wilson, Samir S Shah
OBJECTIVES: To study the comparative effectiveness of dexamethasone vs prednisone/prednisolone in children hospitalized with asthma exacerbation not requiring intensive care. STUDY DESIGN: This multicenter retrospective cohort study, using the Pediatric Health Information System, included children aged 4-17 years who were hospitalized with a principal diagnosis of asthma between January 1, 2007 and December 31, 2012. Children with chronic complex condition and/or initial intensive care unit (ICU) management were excluded...
September 2015: Journal of Pediatrics
Heung-Woo Park, Bing Ge, Szeman Tse, Elin Grundberg, Tomi Pastinen, H William Kelly, Kelan G Tantisira
BACKGROUND: Long-term intermittent oral corticosteroid (OCS) use in children with asthma leads to significant decreases in bone mineral accretion (BMA). OBJECTIVE: We aimed to identify genetic factors influencing OCS dose effects on BMA in children with asthma. METHODS: We first performed a gene-by-OCS interaction genome-wide association study (GWAS) of BMA in 489 white participants in the Childhood Asthma Management Program trial who took short-term oral prednisone bursts when they experienced acute asthma exacerbations...
November 2015: Journal of Allergy and Clinical Immunology
Evan S Schwarz, Brian G Cohn
No abstract text is available yet for this article.
January 2015: Annals of Emergency Medicine
Annie L Andrews, Annie N Simpson
No abstract text is available yet for this article.
October 2014: Evidence-based Medicine
Jessica Sayre Meyer, Jeffrey Riese, Eric Biondi
BACKGROUND: A short course of systemic corticosteroids is an important therapy in the treatment of pediatric asthma exacerbations. Although a 5-day course of oral prednisone or prednisolone has become the most commonly used regimen, dexamethasone has also been used for a shorter duration (1-2 days) with potential for improvement in compliance and palatability. We reviewed the literature to determine if there is sufficient evidence that dexamethasone can be used as an effective alternative in the treatment of pediatric asthma exacerbations in the inpatient setting...
May 2014: Hospital Pediatrics
Grant E Keeney, Matthew P Gray, Andrea K Morrison, Michael N Levas, Elizabeth A Kessler, Garick D Hill, Marc H Gorelick, Jeffrey L Jackson
BACKGROUND AND OBJECTIVE: Dexamethasone has been proposed as an equivalent therapy to prednisone/prednisolone for acute asthma exacerbations in pediatric patients. Although multiple small trials exist, clear consensus data are lacking. This systematic review and meta-analysis aimed to determine whether intramuscular or oral dexamethasone is equivalent or superior to a 5-day course of oral prednisone or prednisolone. The primary outcome of interest was return visits or hospital readmissions...
March 2014: Pediatrics
Stefanie Wildi-Runge, Johnny Deladoëy, Carole Bélanger, Cheri L Deal, Guy Van Vliet, Nathalie Alos, Céline Huot
OBJECTIVES: To determine which biological or clinical variables may predict cortisol response to low-dose adrenocorticotropic hormone (ACTH) stimulation following supraphysiological doses of glucocorticoids in children. STUDY DESIGN: This retrospective study included all patients who underwent ACTH testing (1 μg) between October 2008 and June 2010 at the Sainte-Justine University Hospital Center, Montreal, after supraphysiological doses of glucocorticoids. RESULTS: Data from 103 patients (median age, 8...
August 2013: Journal of Pediatrics
Kelli W Williams, Annie L Andrews, Daniel Heine, W Scott Russell, M Olivia Titus
Asthma is the most common chronic condition affecting children and a prominent chief complaint in pediatric emergency departments (ED). We aimed to determine parental preference between short- and long-term courses of oral corticosteroids for use in children with mild to moderate asthma presenting to our pediatric ED with acute asthma exacerbations. We surveyed parents of asthmatic children who presented to our pediatric ED from August 2011 to April 2012. Questions characterized each patient's asthma severity, assessed parental preference among systemic steroid and inhaled medication delivery options for acute asthma management, and inquired about compliance, medication costs, and intention to follow up...
January 2013: Clinical Pediatrics
Annie Lintzenich Andrews, Kelli A Wong, Daniel Heine, W Scott Russell
OBJECTIVES: The objective was to evaluate the cost-effectiveness of dexamethasone versus prednisone for the treatment of pediatric asthma exacerbations in the emergency department (ED). METHODS: This was a cost-effectiveness analysis using a decision analysis model to compare two oral steroid options for pediatric asthma patients: 5 days of oral prednisone and 2 days of oral dexamethasone (with two dispensing possibilities: either a prescription for the second dose or the second dose dispensed at the time of ED discharge)...
August 2012: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Elena Goleva, Leisa P Jackson, Melanie Gleason, Donald Y M Leung
BACKGROUND: Blood tests are needed to identify steroid-resistant (SR) asthmatic patients early so that they can be managed with alternative anti-inflammatory therapy. OBJECTIVE: We sought to assess the usefulness of peripheral blood to predict steroid response in asthmatic patients. METHODS: Nineteen asthmatic patients with FEV(1) of less than 80% of predicted value were classified as SR or steroid sensitive (SS) based on change in lung FEV(1) percentage after 7 days of oral prednisone...
March 2012: Journal of Allergy and Clinical Immunology
Keith P Cross, Ronald I Paul, Ran D Goldman
QUESTION: I prescribe oral steroids for children in my community when they suffer asthma exacerbation. How many doses of steroids are recommended? Do all children need to take steroids for 5 days? ANSWER: Traditionally, mild-to-moderate pediatric asthma exacerbations have been treated with a short course of oral steroids-often 5 days of prednisone or prednisolone. However, recent evidence suggests a similar outcome can be acheived with a single dose of dexamethasone, which has a longer half-life and powerful anti-inflammatory effects, along with easier administration and compliance...
October 2011: Canadian Family Physician Médecin de Famille Canadien
Joel Kravitz, Paul Dominici, Jacob Ufberg, Jonathan Fisher, Patricia Giraldo
STUDY OBJECTIVE: Dexamethasone has a longer half-life than prednisone and is well tolerated orally. We compare the time needed to return to normal activity and the frequency of relapse after acute exacerbation in adults receiving either 5 days of prednisone or 2 days of dexamethasone. METHODS: We randomized adult emergency department patients (aged 18 to 45 years) with acute exacerbations of asthma (peak expiratory flow rate less than 80% of ideal) to receive either 50 mg of daily oral prednisone for 5 days or 16 mg of daily oral dexamethasone for 2 days...
August 2011: Annals of Emergency Medicine
Riten Kumar, Shahina Qureshi, Prita Mohanty, Sreedhar P Rao, Scott T Miller
BACKGROUND: A short course of dexamethasone therapy may attenuate the course of acute chest syndrome (ACS) of sickle cell disease, but it also increases the risk of early readmission after discharge. Over several years at our institution, an "asthma regimen" of prednisone [2 mg/kg/d (max 80 mg) in 2 divided doses for 5 days] has increasingly been used to treat moderate-to-severe ACS. METHODS: Review of medical records identified 63 patients hospitalized 78 times with ACS over a 2-year period...
April 2010: Journal of Pediatric Hematology/oncology
Allan E Shefrin, Ran D Goldman
QUESTION: Children frequently present to my rural emergency department with asthma exacerbations. Should I prescribe systemic corticosteroids? If so, which systemic corticosteroid should I prescribe? ANSWER: A short course of steroids is indicated in the treatment of asthma exacerbations. Both prednisone (1 to 2 mg/kg daily for 5 days) and dexamethasone (0.3 to 0.6 mg/kg daily for 1 to 5 days) are effective in reducing hospital admissions and unscheduled return to care, with minimal side effects...
July 2009: Canadian Family Physician Médecin de Famille Canadien
Elena Goleva, Pia J Hauk, Clifton F Hall, Andrew H Liu, David W H Riches, Richard J Martin, Donald Y M Leung
BACKGROUND: The cause of corticosteroid-resistant (CR) asthma is unknown. OBJECTIVE: We sought to perform gene microarray analyses by using bronchoalveolar lavage (BAL) cells from well-characterized subjects with CR asthma and subject with corticosteroid-sensitive (CS) asthma to elucidate the differential expression of genes that contribute to the development of corticosteroid resistance. METHODS: The patients were characterized as having CR or CS asthma based on FEV(1) percent predicted improvement after a 1-week course of oral prednisone...
September 2008: Journal of Allergy and Clinical Immunology
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