Steroid shot suitable after ER visit for asthma

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After an ER visit for asthma, a single steroid shot is just as good as an 8-day course of steroid pills at preventing a disease relapse, new research suggests. The authors believe that the shot might be particularly useful for patients who have difficulty taking the pills as prescribed.

As reported in the medical journal Chest, Dr. E. John Gallagher, from Montefiore Medical Center in New York, and colleagues assessed the relapse rates of 180 adults who received the steroid methylprednisolone given as a single injection or in pill form when they were discharged from the ER.

The subjects who received the pills were instructed to decrease or “taper” the drug dose over an 8-day period.

To make the study stronger, the researchers “blinded” the subjects to the actual treatment received. This means the subjects treated with the steroid shot were also given inactive “placebo” pills, whereas subjects treated with the steroid pills were also given a placebo shot.

The relapse rate for the shot group was 14.1 percent, nearly the same as the 13.6 percent rate in the pill group, the investigators note.

In general, side effects were uncommon and occurred with similar frequency in each group. However, pain and bruising at the injection site was more common in the group that received the steroid shots.

A shot of “methylprednisolone to adult asthmatic patients at ER discharge appears to be a viable therapeutic alternative to a course” of methylprednisolone pills, the researchers write.

SOURCE: Chest, August 2004.

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