Is there a difference in the use of dexamethasone, hydrocortisone and prednisone for asthma?

Introduction

Asthma exacerbations are commonly treated with systemic corticosteroids to reduce inflammation and improve symptoms. Dexamethasone, hydrocortisone, and prednisone are among the corticosteroids used, but their efficacy and side effects may vary. This synthesis examines the comparative effectiveness and tolerability of dexamethasone, hydrocortisone, and prednisone in treating asthma, particularly focusing on dexamethasone and prednisone.

Key Insights

Efficacy and Relapse Rates
- Dexamethasone and prednisone show similar efficacy in reducing relapse rates and improving symptoms in both children and adults with acute asthma exacerbations .
Compliance and Side Effects
- Dexamethasone is associated with better compliance and fewer side effects, such as vomiting, compared to prednisone. This is attributed to its longer half-life and improved palatability .
Dosage and Administration
- A single or two-dose regimen of dexamethasone is as effective as a 5-day course of prednisone, making it a more convenient option for patients .
Hospitalization and Return Visits
- There is no significant difference in hospital admission rates or unscheduled return visits between patients treated with dexamethasone and those treated with prednisone .

Conclusion

Dexamethasone and prednisone are both effective in treating acute asthma exacerbations, with similar relapse rates and efficacy. However, dexamethasone offers advantages in terms of better patient compliance and fewer side effects, making it a viable alternative to prednisone. The convenience of a shorter dosing regimen with dexamethasone further supports its use in clinical practice.

Is there a difference in the use of dexamethasone, hydrocortisone and prednisone for asthma?

Summary

Introduction

Key Insights

Conclusion

Sources and full results

Comparative efficacy of oral dexamethasone versus oral prednisone in acute pediatric asthma.

Two doses of oral dexamethasone provide similar efficacy and improved compliance in children with acute asthma compared to five doses of prednisone.

A Randomized Trial of Single-Dose Oral Dexamethasone Versus Multidose Prednisolone for Acute Exacerbations of Asthma in Children Who Attend the Emergency Department.

A single dose of oral dexamethasone (0.3 mg/kg) is noninferior to a 3-day course of oral prednisolone (1 mg/kg per day) for treating acute asthma exacerbations in children, as measured by the mean PRAM score on day 4.

Dexamethasone Compared to Prednisone for the Treatment of Children With Acute Asthma Exacerbations.

Dexamethasone is an effective alternative to prednisone for treating acute asthma exacerbations in children, with no difference in emergency department visits and reduced emesis.

Oral Dexamethasone vs. Oral Prednisone for Children With Acute Asthma Exacerbations: A Systematic Review and Meta-Analysis

Both oral dexamethasone and prednisone have similar relapse rates for acute asthmatic exacerbations in children, but dexamethasone is associated with lower incidence of vomiting.

Dexamethasone for Acute Asthma Exacerbations in Children: A Meta-analysis

Dexamethasone is a viable alternative to prednisone/prednisolone for treating acute asthma exacerbations in children, with no difference in relapse risk or vomiting risk.

Dexamethasone versus prednisone/prednisolone in the management of pediatric patients with acute asthmatic exacerbations: a systematic review and meta-analysis

Dexamethasone is a safer and more effective treatment for pediatric patients with acute asthmatic exacerbations, reducing noncompliance and vomiting rates compared to prednisone/prednisolone.

A Randomized Controlled Noninferiority Trial of Single Dose of Oral Dexamethasone Versus 5 Days of Oral Prednisone in Acute Adult Asthma.

A single dose of oral dexamethasone showed a very small margin of noninferiority to prednisone for 5 days in treating adults with mild to moderate asthma exacerbations, potentially benefiting compliance and convenience.

Dexamethasone Versus Prednisone or Prednisolone for Acute Pediatric Asthma Exacerbations in the Emergency Department

Dexamethasone is a suitable alternative to prednisone/prednisolone for treating pediatric asthma exacerbations in the emergency department, with a lower risk of vomiting and similar improvement in asthma status assessment scores.

Is dexamethasone an effective alternative to oral prednisone in the treatment of pediatric asthma exacerbations?

Dexamethasone is an effective alternative to prednisone for treating mild to moderate asthma exacerbations in children, offering improved compliance, palatability, and cost benefits.

Two days of dexamethasone versus 5 days of prednisone in the treatment of acute asthma: a randomized controlled trial.

Two days of oral dexamethasone is as effective as 5 days of oral prednisone in returning patients to normal activity and preventing relapse in acute asthma exacerbations in adults.

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