Dose response of patients to oral corticosteroid treatment during exacerbations of asthma.

Ten patients with asthma were treated with different doses of oral corticosteroids during three separate exacerbations. Prednisolone was given in doses of 0.2, 0.4, and 0.6 mg/kg body weight daily for two weeks in a double blind randomised order (equivalent to 14, 28, and 42 mg of prednisolone daily in a person weighing 70 kg). Patients developing an exacerbation recorded peak expiratory flow rate twice daily for two days before starting and two weeks during treatment. A dose response was shown that was significant for the difference between the peak flows, low dose less than medium dose (p less than 0.005), medium dose less than high dose (p less than 0.001) at the end of treatment. These results confirm the value of treatment with oral corticosteroids in exacerbations of asthma not requiring admission to hospital and indicate that a short high dose course of corticosteroids should consist of a minimum dose of 0.6 ng prednisolone/kg body weight for a period up to two weeks.