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Asthma guidelines recommend stepping up doses of inhaled corticosteroids (ICS) from low to medium to high if the disease is uncontrolled (see ), but the benefits of high-dose ICS are unclear. Two new reports shed some light.
In the first report, researchers used U.S. medical claims data to evaluate whether stepping up ICS after an acute exacerbation reduced the risk of subsequent exacerbations. At 1.5 years of follow-up:
Stepping up from low-dose to high-dose ICS was no more beneficial than stepping up to medium-dose ICS.
Stepping up from a medium dose to a high dose was associated with an increased risk of exacerbation compared with remaining on a medium dose.
The second report was a meta-analysis of 12 randomized tr…