Randomized clinical trial of intramuscular vs oral methylprednisolone in the treatment of asthma exacerbations following discharge from an emergency department

Michael Lahn, Polly Bijur, E. John Gallagher

Research output: Contribution to journalArticlepeer-review

40 Scopus citations

Abstract

Objective: To compare the efficacy of long-acting IM methylprednisolone to tapering oral methylprednisolone in adult asthmatic patients discharged from the emergency department (ED). Methods: Randomized, double-blind, placebo-controlled trial of a single IM dose of 160 mg depot methylprednisolone vs 8-day tapering of a total dose of 160 mg oral methylprednisolone in adult asthmatic patients (age range, 18 to 45 years) who were discharged from the ED following standardized treatment for an acute exacerbation. The primary end point was relapse, which was defined as the need to seek unscheduled care at a doctor's office, clinic, or ED for symptoms of persistent or worsening asthma within 10 days of ED discharge. Results: Of 190 patients enrolled into the study, 180 completed the study and the folow-up at 10 days (96%). The relapse rate was nearly identical for the two treatment groups (IM administration, 14.1% [13 of 92 patients]; oral administration, 13.6% [12 of 88 patients]; difference, 0.5% [95% confidence interval, - 9.6 to 10.6%]). Conclusions: Single-dose IM methylprednisolone administered to adult asthmatic patients at ED discharge appears to be a viable therapeutic alternative to a course of oral methylprednisolone. Clinicians may choose to base the route of administration of corticosteroids on concerns about nonadherence to therapy or on the ability of a patient to afford a prescription for outpatient medication.

Original languageEnglish (US)
Pages (from-to)362-368
Number of pages7
JournalChest
Volume126
Issue number2
DOIs
StatePublished - Aug 2004

Keywords

  • Bronchial asthma
  • Corticosteroids
  • Emergency therapy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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