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Two-day course of dexamethasone effective for asthma flares

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Adult patients with asthma exacerbations do as well with 2 days of oral dexamethasone as with 5 days of oral prednisone, according to a report in the Annals of Emergency Medicine online February 18.

The authors point out that dexamethasone has the same bioavailability as prednisone but a longer half-life of up to 72 hours, so it may allow for a shorter duration of treatment.

To test this, Dr. Joel Kravitz, at the Community Medical Center of the St. Barnabas Health System in Toms River, New Jersey, and colleagues randomized 200 emergency room patients with acute asthma exacerbation to receive either 50 mg/d oral prednisone for 5 days or 16 mg/d oral dexamethasone for 2 days.

Significantly more subjects returned to normal activity within 3 days with dexamethasone (90%) compared with prednisone (80%; p=0.049), the investigators found.

Rates of relapse in the two groups were not significantly different at 11% among patients receiving dexamethasone versus 13% for those given prednisone, according to the report.