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Asthma patients who use low- or medium-dose inhaled corticosteroids have several therapeutic options when asthma control deteriorates. Although most people add a long-acting β-agonist in this situation, some physicians and patients first try to increase inhaled steroid doses.
In this randomized U.K. study, researchers examined the effect of doubling inhaled steroid doses in 390 asthma patients who were on long-term inhaled-steroid monotherapy (dosage range, 100-2000 μg beclomethasone equivalents daily). Patients monitored symptoms and morning peak flow. If peak flow fell by 15%, or symptom scores increased substantially, patients added study inhalers that contained either additional steroid (in an amount that doubled the baseline dose) or pl…