Comparison of the Effect of Short Course of Oral Prednisone in Patients with Acute Asthma

Background: Although corticosteroids are considered essential treatment for acute asthma and widely prescribed, we studied the value of oral corticosteroids in moderate persistent asthma (MPA) and severe persistent asthma (SPA), and comparison of those effects. Methods: One hundred-one patients with acute asthma (48 with MPA, 53 with SPA) were studied to determine the efficacy of oral corticosteroids. All patients received other bronchodilator treatment. The patients were divided into two groups depending on initial FEV1 (less than 60% predicted as SPA and FEV1 between 60 to 80% predicted as MPA), and treated with oral prednisone 40 mg daily for 7 days. Spirometric variable and percentage of change to baseline FVC, FEV1 and FEF 25-75% after treatment was calculated. Results: After 7 days of treatment, the increase in FVC, FEV1 and FEF 25-75% predicted values in both group of patients with MPA and SPA was significant (P<0.001). The percentage of FVC, FEV1 and FEF 25-75% improvement in patients with MPA and SPA was 19.3 ± 11.2% vs 61.6± 45.5%; 29.5 ± 14.2% vs 85.3 ±93.2% and 53±36.4% vs 128.7±108% respectively. Conclusion: Short course of oral prednisone administered in moderate and severe persistent asthma induces in spirometric measurements, that these changes together with percentage improvement of FVC, FEV1, and FEF 25-75% in SPA was higher than those with MPA.