title: Prospective, placebo-controlled trial of 5 vs 10 days of oral prednisolone in acute adult asthma.
abstract: BACKGROUND
  The optimal duration of oral steroid treatment in the management of acute adult asthma is unclear. We prospectively studied the effect of 5 vs. 10 days of oral prednisolone in patients with acute asthma requiring hospital admission.
  
  
  METHODS
  Each patient received 40 mg of enteric-coated prednisolone daily for 5 days, followed by 5 days of 40 mg prednisolone daily (n=24) or placebo (n=20). All were given their usual inhaled asthma therapy including inhaled corticosteroids. Patients kept PEF and symptom diaries for 21 days.
  
  
  RESULTS
  For the 5-day treatment group mean (95% CI) early morning PEF was 6 (-47,+36) l/min lower to day 21 (P=0.78). There was no evidence of differences in other PEF measures (morning post-bronchodilator, evening or worst of day). One patient in each group had an exacerbation requiring further oral steroids during the 21-day observation period. Asthma symptom scores were worse in the 5-day group on days 6-21 but the significance of this finding was uncertain, as a difference had emerged by day 5 (prior to trial entry).
  
  
  CONCLUSIONS
  It may be possible to reduce the standard steroid course to 5 days in acute adult asthma, provided all patients receive inhaled steroids and a personal asthma management plan.
authors.affiliation: Department of Cardio-Respiratory Medicine, Hope Hospital, Salford, UK.
authors.forename: A M
authors.initials: AM
authors.lastname: Jones
authors.forename: M
authors.initials: M
authors.lastname: Munavvar
authors.forename: A
authors.initials: A
authors.lastname: Vail
authors.forename: R E
authors.initials: RE
authors.lastname: Aldridge
authors.forename: L
authors.initials: L
authors.lastname: Hopkinson
authors.forename: C
authors.initials: C
authors.lastname: Rayner
authors.forename: B R
authors.initials: BR
authors.lastname: O'Driscoll
mesh_terms: D000208:Acute Disease; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate; D011239:Prednisolone / Q000008:administration & dosage* / Q000627:therapeutic use; D011446:Prospective Studies
chemical_list: D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D011239:Prednisolone