Add-on oral corticosteroid of little benefit in persistent asthma

A short-term course of oral corticosteroid medication does not appear to improve disease control in patients with moderate to severe persistent asthma initiating treatment with inhaled corticosteroid-and-long-acting beta agonist (ICS-LABA).

Twenty-four patients with moderate to severe persistent asthma who were naïve to maintenance treatment were randomized to receive 2 weeks of either corticosteroid (n=13; mean age, 45.0 years; nine males) or placebo (n=11; mean age, 35.7 years; four males) at the beginning of ICS-LABA as initial treatment.

Peak expiratory flow (PEF) was measured daily, and patients were required to complete an asthma diary for 12 weeks. They also underwent spirometry testing at 4 and 12 weeks.

After 2 weeks of add-on short-course treatment, ACT, ACQ, AQLQ, FEV1, FEV1 percent significantly improved in both groups as compared with baseline data (p<0.05). However, the changes observed in all parameters did not differ significantly between the two groups (p>0.05).

At 4 weeks, three patients (30.8 percent) in the corticosteroid group and two (18.2 percent) in the placebo group achieved total asthma control. Seven patients in each group achieved partial control (61.5 percent vs 63.6 percent). There was no significant difference in control rates between the two groups (p=0.632).

Findings at 12 weeks followed a similar pattern.

The present data indicate that ICS-LABA as an initial therapy was adequate for achieving asthma control in majority of the patients, researchers said. Therefore, routine use of short course of oral corticosteroid is not necessary.