A double-blind, randomized clinical trial of methylprednisolone in status asthmaticus

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Abstract
Consecutive patients (25) admitted with status asthmaticus were blindly randomized to receive (i.v.) methylprednisolone every 6 h for 3 days at 1 of the following dosages: low, 15 mg; medium, 40 mg; or high, 125 mg. All other therapy, including i.v. and inhaled bronchodilators, was kept constant. Forced expiratory volume in 1 s (FEV1) was measured to quantitate response. The high-dose group improved significantly by the end of the 1st day, the medium-dose group improved by the middle of the 2nd day but the low-dose group did not improve significantly in 3 days. Together, the high- and medium-dose groups were significantly improved (FEV1 > 50% of predicted) compared with the low-dose group. No serious steroid side effects were encountered. The greater benefit of higher doses of steroids, such as 125 mg of methylprednisolone every 6 h, justifies their use in severe asthma.

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