Initial starting dose of inhaled corticosteroids in adults with asthma: a systematic review
Open Access
- 1 December 2004
- Vol. 59 (12) , 1041-1045
- https://doi.org/10.1136/thx.2004.023754
Abstract
Background: Asthma guidelines vary in their recommendations for the initial dose of inhaled corticosteroid (ICS) in asthma. A systematic review of the literature was conducted to establish the optimal starting dose of ICS for asthma in adults. Methods: Randomised controlled trials comparing two doses of the same ICS in adults with asthma and no concomitant inhaled or oral corticosteroid were assessed. Included trials were analysed according to the following ICS dose comparisons: high (⩾800 μg/day beclomethasone (BDP)) versus moderate (400Conclusions: For patients with asthma who require ICS, starting with a moderate dose is equivalent to starting with a high dose and stepping down. The small non-significant benefits of starting with a high ICS dose are not of sufficient clinical benefit to warrant its use. Initial moderate ICS doses appear to be more effective than an initial low ICS dose.Keywords
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