ORAL VERSUS REPOSITORY CORTICOSTEROID-THERAPY AFTER HOSPITALIZATION FOR TREATMENT OF ASTHMA

Tapering regimens of oral steroids may be difficult or confusing for s ome patients. Repository steroids have been shown to be as effective a s tapering oral doses in preventing relapse after emergency treatment. This study was undertaken to determine whether repository steroids ar e as effective as tapering oral steroids in preventing relapse after h ospitalization for treatment of asthma. Twenty-six patients with acute exacerbations of asthma requiring treatment for 24 to 72 hours with p arenteral steroids were randomized into two groups. Both groups receiv ed oral prednisone, 60 mg daily, when parenteral steroids were discont inued. At discharge, one group received intramuscular placebo and oral prednisone tapered over 8 days, and the other received 80 mg intramus cular methylprednisolone sodium acetate and oral placebo. At discharge and 2-week follow-up, patients were interviewed and examined, and spi rometry results were obtained. There was little difference between gro ups in ratings of symptoms at discharge or follow-up. Both groups had less wheezing at follow-up than at discharge, through the improvement was significant only in the respiratory steroid group (p < 0.05). Mean forced expiratory volume in 1 second, forced vital capacity, peak exp iratory flow rate improved at follow-up in both groups. No significant differences in outcome were found between the oral and repository ste roid groups.