Intramuscular versus oral methylprednisolone in asthma
2004; Elsevier BV; Volume: 364; Issue: 9450 Linguagem: Inglês
10.1016/s0140-6736(04)17526-0
ISSN1474-547X
AutoresFrancine M. Ducharme, Brian H. Rowe,
Tópico(s)Inhalation and Respiratory Drug Delivery
ResumoRecently, Michael Lahn and colleagues 1 Lahn M Bijur P Gallagher EJ Randomized clinical trial of intramuscular vs oral methylprednisolone in the treatment of asthma exacerbations following discharge from an emergency department. Chest. 2004; 126: 362-368 Crossref PubMed Scopus (38) Google Scholar published a well designed parallel-group, randomised trial evaluating two routes of administration (oral vs intramuscular) of the same cumulative dose (160 mg) of dexamethasone for asthma. The primary outcome was relapse, determined by phone contact at 10 days; secondary outcomes included relapse at 21 days and side-effects at the intramuscular injection site. The study was powered for detection of a massive (70%) difference in relapse rate at 10 days, from 19% to 5%. The observed relapse rate at 10 days was 14·1% with the intramuscular injection and 13·6% with the oral preparation. While acknowledging that the power of the study was insufficient to prove equivalence, the authors concluded that intramuscular dexamethasone might serve as a substitute for an 8-day oral course of dexamethasone when poor compliance is a consideration. We must consider several important methodological issues before we adopt this strategy for patients with asthma. Department of ErrorDucharme FM, Rowe BH. Intramuscular versus oral methylprednisolone in asthma. Lancet 2004; 364: 2000–01—In this Comment (Dec 4) all four mentions of dexamethasone in the text should read methylprednisolone. Full-Text PDF
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