High-dose corticosteroids

The good news is that not all exacerbations require treatment. Mild sensory changes (numbness, pins-and-needle sensations) or bursts of fatigue that don’t significantly impact a person’s activities can generally be left to get better on their own.

For severe exacerbations (involving loss of vision, severe weakness or poor balance, for example) which interfere with a person’s mobility, safety or overall ability to function, most neurologists recommend a short course of high-dose corticosteroids to reduce the inflammation and bring the relapse to an end more quickly. The most common treatment regimen is a three-to-five-day course of intravenous (Solu-Medrol® - methylprednisolone) or oral (Deltasone® - prednisone) corticosteroids. Corticosteroids are not believed to have any long-term benefit on the disease.

Disclaimer: Every effort has been made to ensure that this monograph was accurate and up-to-date at the time of writing, however it cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes of the measures recommended. The final decision regarding which treatment is used for an individual patient remains the clinical responsibility of the prescriber. This material may be freely reproduced for education and not for profit purposes within the UK National Health Service, however no linking to this website or reproduction by or for commercial organisations is permitted without the express written permission of this service. This document is regularly reviewed and updated. Only use UKTIS monographs downloaded directly from or to ensure you are using the most up-to-date version.

Results   The analyses included 16 randomized clinical trials (N = 22 748 patients), 15 of which evaluated SMART as a combination therapy with budesonide and formoterol in a dry-powder inhaler. Among patients aged 12 years or older (n = 22 524; mean age, 42 years; 14 634 [65%] were female), SMART was associated with a reduced risk of asthma exacerbations compared with the same dose of inhaled corticosteroids and LABA as the controller therapy (RR, [95% CI, to ]; RD, −% [95% CI, −% to −%]) and a higher dose of inhaled corticosteroids and LABA as the controller therapy (RR, [95% CI, to ]; RD, −% [95% CI, −% to −%]). Similar results were seen when SMART was compared with inhaled corticosteroids alone as the controller therapy. Among patients aged 4 to 11 years (n = 341; median age, 8 [range, 4-11] years; 69 [31%] were female), SMART was associated with a reduced risk of asthma exacerbations compared with a higher dose of inhaled corticosteroids as the controller therapy (RR, [95% CI, to ]; RD, −% [95% CI, −% to −%]) or the same dose of inhaled corticosteroids and LABA as the controller therapy (RR, [95% CI, to ]; RD, −% [95% CI, −% to −%]).

High-dose corticosteroids

high-dose corticosteroids

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