How to Prevent Asthma Exacerbations: Is More ICS Better?

Veronica Hackethal, MD

Two studies look at the effect of increasing the dose of inhaled corticosteroids 4 and 5 times to abort asthma deterioration. The results may surprise you.  

What is the impact on asthma deterioration of temporarily increasing the dose of inhaled corticosteriods by as much as 5 times the maintenance dose? Two recent studies are highlighted in this short slide show; the results may surprise you.References 1. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention 2017. Accessed March 13 2018 at:2. Kew KM, Quinn M, Quon BS, et al. Increased versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and children. Cochrane Database Syst Rev. 2016;7:CD007524. doi: 10.1002/14651858.CD007524.pub4.3. McKeever T, Mortimer K, Wilson A, et al. Quadrupling inhaled glucocorticoid dose to abort asthma exacerbations. N Engl J Med. 2018;378:902-910. doi: 10.1056/NEJMoa1714257.4. Jackson DJ, Bacharier LB, Mauger DT, et al. Quintupling inhaled glucocorticoids to prevent childhood asthma exacerbations. N Engl J Med. 2018;3780):891-901. doi: 10.1056/NEJMoa1710988.