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Single-Dose Dexamethasone vs 5 Days of Prednisone in Acute Adult Asthma | PracticeUpdate

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  Lastly, our meta-analysis was not adequately powered to detect differences in relapse rates and hospital readmission rates, as out of the seven included trials, three studies 1 , 19 , 20 were of small sample size recruiting only 23—51 patients per group. All steroids come with the risk of side effects see Warnings section , and some can be very serious. Dexamethasone coupons. Pioglitazone Antidiabetic agents Yes Yes Carbamazepine.     ❾-50%}

 

Dexamethasone versus prednisone -

    Keeney et al. It is 6 times more potent strong than prednisone. Tablet, injection, oral solution, ophthalmic drops alone and in combination with other ingredients , ophthalmic ointments in combination with other ingredients Tablet, oral solution What is the standard dosage?

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Forgot your log in details? Register a new account? Forgot your user name or password? Search for this keyword. Schuler, MD. Carolyn M. Kercsmar, MD ; Carolyn M. Kercsmar, MD.

Katherine A. Auger, MD, MSc. Hosp Pediatr 12 3 : — Cite Icon Cite. Comments 0 Comments. Comments 0. View full article. Sign in Don't already have an account? Individual Login. Institutional Login. Sign in via OpenAthens. In comparison, while our updated review was able to include three more RCTs, we also conducted a power analysis to identify if the included studies and our meta-analysis was adequately powered to detect significant difference in outcome variables.

It is important to note that despite pooling of data from seven RCTs, our meta-analysis was underpowered to detect significant difference in relapse rates and hospital readmission rates between dexamethasone and prednisone. In a sub-group analysis, we also compared 1-day and a 2-days course of dexamethasone with 3—5 day therapy of prednisone.

However, with just one trial reporting a three-way comparison of 1-day and 2-days dexamethasone with prednisone 19 , combined with limited power of our meta-analysis, conclusion cannot be drawn till further studies are carried out to explore the differences between 1 and 2-days dexamethasone protocol. It is also important to note that relapse rates and hospital readmission rates may be influenced by factors like clinical decisions, hospital criteria for admission and accessibility to healthcare facilities The criteria for relapse rate are also broad varying from the visit of the child to a family doctor for continued wheezing and cough to a severe relapse requiring in-patient management Therefore, objective measures of reduction in asthma severity and assessment of persistent symptoms may better evaluate the differences in the two steroid treatment protocols.

Elkharwili et al. Paniagua et al. PRAM scores were measured at day 4 of treatment by Cronin et al. Altamimi et al. With a mean of 5. While individually all included studies reported dexamethasone to be as efficacious as prednisone, methodological heterogeneity of outcome measures precluded a meta-analysis of such variables in our study.

Despite intra-venous dexamethasone and prednisone demonstrating similar efficacy for preventing nausea and vomiting after chemotherapy 28 , the unpleasant taste of oral prednisone frequently results in vomiting especially in children While the difference of taste between dexamethasone and prednisone has reportedly not been a hindrance in treatment adherence 21 , vomiting may affect treatment compliance in pediatric patients Hames et al.

In our meta-analysis, vomiting at ED and home was found to be significantly higher with prednisone as compared to dexamethasone. Similar results have been reported in the meta-analysis of Keeney et al. The strengths and limitations of our study need to be elaborated.

Firstly, in our review three more RCTs were added since the last published meta-analysis, thereby providing an updated evidence. Secondly, a sensitivity analysis was carried out to assess influence of individual studies on the overall results. Lastly, power analysis was also carried out to provide a guide to readers on the validity of the calculated results. The results of our review, however, should be interpreted with caution due to the following limitations.

Additionally, lack of adequate randomization and allocation concealment, as well as attrition bias in some studies, could have influenced the overall results.

Secondly, there was considerable methodological heterogeneity amongst the seven trials especially concerning drug dose, duration of therapy, utilization of additional drugs, follow-up protocol, etc. Thirdly, inclusion criteria varied amongst studies, with the trial of Paniagua et al. Asthma is usually not diagnosed at such a young age due to the prevalence of bronchiolitis in this age-group Lastly, our meta-analysis was not adequately powered to detect differences in relapse rates and hospital readmission rates, as out of the seven included trials, three studies 1 , 19 , 20 were of small sample size recruiting only 23—51 patients per group.

In our power analysis, all included studies were found to be underpowered for detection of significant difference in the primary outcome variable. To conclude, despite our results indicating similar relapse rates and hospital re-admission rates with dexamethasone and prednisone when used for acute asthmatic exacerbations in children, strong conclusions cannot be drawn due to paucity of large scale RCTs and limited quality of evidence.

It is also not known if both drugs are equally efficacious in reducing asthma severity. Our results however indicate that, vomiting is significantly less with dexamethasone as compared to prednisone.

Further large-scale homogenous RCTs comparing the two drugs are warranted to establish guidelines for the use of oral steroid therapy in acute asthma exacerbations in children. JW and QC conceived and designed the study. JW was involved in the writing of the manuscript. All authors have read and approved the final manuscript.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Single-dose oral dexamethasone compared with three day course of oral prednisolone in children with moderate exacerbation of asthma-a pilot double-blinded randomised controlled trial.

J Clin Diag Res. Scarfone RJ, Friedlaender E. Corticosteroids in acute asthma: past, present, and future. Pediatr Emerg Care. Different oral corticosteroid regimens for acute asthma. Cochrane Database Syst Rev. Dexamethasone for acute asthma exacerbations in children: a meta-analysis. Is dexamethasone as effective as prednisone or prednisolone in the management of pediatric asthma exacerbations? Ann Emerg Med. British Guideline on the Management of Asthma.

PubMed Abstract Google Scholar. Comparative efficacy of oral dexamethasone versus oral prednisone in acute pediatric asthma.

Outcomes including relapse were assessed by a follow-up telephone interview at 2 weeks. One hundred seventy-three dexamethasone and prednisone subjects completed the study regimen and telephone follow-up. Subjects in the 2 groups had similar rates of hospitalization for their relapse visit dexamethasone 3.

Adverse effect rates were generally the same in the 2 groups. A single dose of oral dexamethasone did not demonstrate noninferiority to prednisone for 5 days by a very small margin for treatment of adults with mild to moderate asthma exacerbations.

Enhanced compliance and convenience may support the use of dexamethasone regardless. Property Value Status. We have detected that you are using an Ad Blocker. PracticeUpdate is free to end users but we rely on advertising to fund our site.

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Introduction Asthma is one of the most prevalent chronic respiratory diseases, which often leads to an emergency department visit. Prednisolone is the most commonly used corticosteroid in treatment of asthma exacerbation.

Oral dexamethasone demonstrates bioavailability similar to that of oral prednisolone but has a longer half-life. Objective To evaluate in adouble-blind,randomised clinical trial the efficacy of different doses of dexamethasone versus prednisolone in controlling asthma exacerbations in children. Methods We recruited 60 patients with asthma exacerbation, aged 2—11 years. Participants were randomly divided into three groups 20 patients each. Group I received a single dose of oral dexamethasone 0.

Vomiting, gastrointestinal tract cramps, ATAQ and relapse rate showed a non-statistically significant difference. You will be able to get a quick price and instant permission to reuse the content in many different ways. Skip to main content. Log in via OpenAthens. Log in using your username and password For personal accounts OR managers of institutional accounts. Forgot your log in details? Register a new account? Forgot your user name or password?

Search for this keyword. Advanced search. Latest content Current issue Archive Authors About. Log in via Institution. You are here Home Archive Volume 27, Issue 3 Two regimens of dexamethasone versus prednisolone for acute exacerbations in asthmatic Egyptian children. Email alerts.

Article Text. Article menu. Original research. Two regimens of dexamethasone versus prednisolone for acute exacerbations in asthmatic Egyptian children. Abstract Introduction Asthma is one of the most prevalent chronic respiratory diseases, which often leads to an emergency department visit.

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localhost › GoodRx Health › Drug Classes › Corticosteroids. Dexamethasone is long-acting medication and is considered to be a potent, or strong, steroid. It is 6 times more potent (strong) than prednisone. Can prednisone. The duration of action of dexamethasone is three times as long as that of prednisone and lasts up to 72 hours; 5 mg of prednisone are equal to. Dexamethasone's favorable side effect profile and pharmacokinetics compared with prednisone may mitigate poor adherence to longer steroid. Dexamethasone, a long-acting corticosteroid, has been studied as an alternative to prednisone to allow a shorter course of treatment in. Generic medications are more often covered by insurance, including Medicare and Medicaid. Short-term; varies Short-term; varies Who typically uses the medication? Avoid grapefruit and grapefruit juice while taking dexamethasone. Adv Emerg Nurs J. Adults presenting to the emergency department with a mild or moderate exacerbation of asthma were randomized to receive a single dose of dexamethasone with 4 days of placebo or 5 days of oral prednisone. Attrition bias was found to be high in two studies 19 Figure 2.

Disclaimer » Advertising. Erik R. Hoefgen, Bin Huang, Christine L. Schuler, Carolyn M. Hosp Pediatr March ; 12 3 : — Dexamethasone is increasingly used for the management of children hospitalized with asthma in place of prednisone, yet data regarding the effectiveness of dexamethasone in children with asthma exacerbation severe enough to require hospitalization are limited.

Our objective is to compare the effectiveness of dexamethasone versus prednisone in children hospitalized with an asthma exacerbation on day reutilization.

A covariate-balanced propensity score was derived to account for physician discretion in steroid selection. A generalized linear model, including inverse probability treatment weighting, was used to detect differences in day return utilization unplanned readmission or emergency department visit between children whose first dose of corticosteroid was dexamethasone versus prednisone.

The total cohort had a mean age of 8. The covariate-balanced cohort had no significant differences in demographic characteristics or illness severity between groups.

The dexamethasone group had a return utilization of 3. The propensity score-adjusted analysis revealed the steroid treatment was not found to significantly affect the day reutilization adjusted odds ratio [aOR] 1. The initial steroid choice dexamethasone versus prednisone was not associated with day reutilization after hospitalization for an asthma exacerbation.

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Close mobile search navigation Article navigation. Volume 12, Issue 3. Previous Article Next Article. Article Navigation. Research Articles February 07 Hoefgen, MD, MS. Louis, Missouri. Louis, MO This Site. Google Scholar. Christine L. Schuler, MD ; Christine L. Schuler, MD. Carolyn M. Kercsmar, MD ; Carolyn M. Kercsmar, MD. Katherine A. Auger, MD, MSc. Hosp Pediatr 12 3 : — Cite Icon Cite. Comments 0 Comments.

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