Loading...
Asthma guidelines recommend stepwise increases in inhaled corticosteroid (ICS) doses, based on severity and control. However, higher doses of ICS are associated with adverse effects, and whether they actually improve asthma outcomes is unclear.
In a historical U.K. cohort study that involved 70,000 adolescents and adults with asthma, researchers examined the effect of stepping up from medium- to high-dose ICS. In an analysis adjusted for asthma severity, time to first exacerbation actually was significantly shorter in patients who stepped up to high-dose ICS than in those who remained on medium-dose ICS (2.0 vs. 2.7 years). Overall exacerbations and need for antibiotic courses occurred significantly more frequently in the step-up group; thes…