Comparison of oral-steroid sparing by high-dose and low-dose inhaled steroid in maintenance treatment of severe asthma

摘要: Abstract It is not clear whether high doses of inhaled steroids have a greater sparing effect than low on the requirement for systemic steroids. In randomised, double-blind, multicentre study, we compared effects high-dose (1500 μg/day) and low-dose (300 beclomethasone diproprionate (BDP) in patients with severe asthma requiring daily oral prednisolone dose 10-40 mg. During 3-month run-in period, tried to achieve optimum control by means steroid BDP 300 μg/day. The were then allocated (n=71) or (n = 72) treatment an independent observer who took into account various prognostic factors. was administered aerosol inhaler spacer device. reduced as much possible during 6-month study period while keeping peak expiratory flow (PEF) constant clinically stable. There no difference between groups mean reduction achieved end (5·2 [SD 7·9] vs 5·0 [9·4] mg/day). maximum response seen, however, only after several months' therapy both groups. differences use on-demand β-agonist inhalations symptoms, PEF values throughout study. Both well tolerated. High offer further benefit over maintenance steroid-dependent when