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Review: inhaled corticosteroids alone appear to be as effective as oral corticosteroids after emergency department discharge for acute asthma

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 QUESTION: Are inhaled corticosteroids (ICSs) alone or combined with oral corticosteroids (OCSs) as effective as OCSs alone after discharge from the emergency department (ED) for acute asthma?

Data sources

Published and unpublished trials were identified by searching the Cochrane Airways Review Group “Asthma and wheeze” randomised controlled trial register (to April 1999), which is based on searches of EMBASE/Excerpta Medica, Medline, CINAHL, and the Cochrane Clinical Trials Register; handsearching 20 respiratory care journals, abstracts from 3 respiratory societies, and meeting abstracts from the American Thoracic Society; reviewing bibliographies of retrieved studies; and contacting experts and pharmaceutical companies.

Study selection

Randomised or quasirandomised controlled trials published in any language were selected if they included patients who were discharged from an ED after treatment for acute asthma and if patients were allocated to ICS treatment (ie, any corticosteroid agent administered by metered-dose inhaler, other inhaler, or nebuliser) in addition to or as a substitute for OCS …

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  • Source of funding: National Institutes of Health.

  • For correspondence: Dr M Edmonds, Division of Emergency Medicine, University of Alberta, 1G1 Walter Mackenzie Centre, 8440-112 Street, Edmonton, Alberta T6G 2B7, Canada. Fax +1 780 407 3314.