A randomized clinical trial on inhaled ciclesonide for managing acute asthma in the emergency room
São Paulo med. j
; 140(3): 430-438, May-June 2022. tab, graf
Article
in En
| LILACS
| ID: biblio-1377394
Responsible library:
BR1.1
ABSTRACT
ABSTRACT BACKGROUND:
Use of inhaled corticosteroids for managing acute asthma exacerbations has been tested since the 1990s.OBJECTIVE:
To compare high doses of inhaled ciclesonide with systemic hydrocortisone for managing acute asthma exacerbations in the emergency department. DESIGN ANDSETTING:
Double-blind, randomized clinical trial in the public healthcare system of the city of São Paulo.METHODS:
Fifty-eight patients with moderate or severe asthma with peak flow < 50% of predicted were randomized into two groups. Over the course of four hours, one group received 1440 mcg of inhaled ciclesonide plus hydrocortisone-identical placebo (ciclesonide + placebo), while the other received 500 mg of intravenous hydrocortisone plus ciclesonide-identical placebo (hydrocortisone + placebo). Both groups received short-acting bronchodilators (fenoterol hydrobromide and ipratropium bromide). The research protocol included spirometry, clinical evaluation, vital signs and electrocardiogram monitoring. Data were obtained at 30 (baseline), 60, 90, 120, 180, and 240 minutes. We compared data from baseline to hour 4, between and within groups.RESULTS:
Overall, 31 patients received ciclesonide + placebo and 27 received hydrocortisone + placebo. Inhaled ciclesonide was as effective as intravenous hydrocortisone for improving clinical parameters (Borg-scored dyspnea, P = 0.95; sternocleidomastoid muscle use, P = 0.55; wheezing, P = 0.55; respiratory effort, P = 0.95); and spirometric parameters (forced vital capacity, P = 0.50; forced expiratory volume in the first second, P = 0.83; peak expiratory flow, P = 0.51).CONCLUSIONS:
Inhaled ciclesonide was not inferior to systemic hydrocortisone for managing acute asthma exacerbations, and it improved both clinical and spirometric parameters. TRIAL REGISTRATION RBR-6XWC26 - Registro Brasileiro de Ensaios Clínicos (http//www.ensaiosclinicos.gov.br/rg/RBR-6xwc26/).Key words
Full text:
1
Collection:
01-internacional
Database:
LILACS
Main subject:
Asthma
/
Hydrocortisone
Type of study:
Clinical_trials
/
Guideline
/
Prognostic_studies
Country/Region as subject:
America do sul
/
Brasil
Language:
En
Journal:
São Paulo med. j
Journal subject:
Cirurgia Geral
/
Cincia
/
Ginecologia
/
MEDICINA
/
Medicina Interna
/
Obstetr¡cia
/
Pediatria
/
Sa£de Mental
/
Sa£de P£blica
Year:
2022
Document type:
Article
Affiliation country:
Brazil
Country of publication:
Brazil