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QUESTION: In patients discharged from the emergency department (ED) with acute asthma, does the addition of inhaled budesonide to a fixed dose of oral prednisone reduce relapses?
Design
Randomised (allocation concealed*), blinded (patients and outcome assessors),* placebo-controlled trial with 21-day follow-up.
Setting
A community hospital ED in Sudbury, Ontario, Canada.
Patients
191 patients 16–60 years of age who were treated in the ED for acute asthma and had a peak expiratory flow rate <80% predicted for sex, age, and height. Patients were excluded if they had received oral or inhaled corticosteroids during the previous week. Follow-up was 94%.
Intervention
All patients were given a non-tapering, 7-day course of oral prednisone, 50 mg/day, at discharge. 94 patients were allocated to an inhaled budesonide …