Navegando por Palavras-chave "Asma Brônquica"

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    Ensaio Clínico Randomizado Duplo Cego Comparando Ciclesonida Inaladae Hidrocortisona Injetável Para O Tratamento Da Asma Na Sala De Emergência
    (Universidade Federal de São Paulo (UNIFESP), 2017-12-20) Martins, Demetrius Tierno [UNIFESP]; Prado, Gilmar Fernandes Do [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: Current guidelines for management of acute asthma exacerbations advocate the administration of short-acting bronchodilators and systemic corticosteroids. The use of inhaled corticosteroids for management of asthma exacerbations has been tested since the 1990s, but the optimal agent, dose, and strategy have yet to be defined. Methods: This double-blind, randomized clinical trial enrolled 58 patients with a clinical diagnosis of bronchial asthma by GINA criteria who presented to the emergency department with peak flow <50% of predicted. Patients were randomized into two groups. Over the course of 4 hours, one group received 1440 mcg inhaled ciclesonide plus hydrocortisone-identical placebo (ciclesonide + placebo group), while the other received 500 mg intravenous hydrocortisone plus ciclesonide-identical placebo (hydrocortisone + placebo group). Both groups received short-acting bronchodilators (fenoterol hydrobromide and ipratropium bromide). Results: Overall, 31 patients received ciclesonide + placebo and 28 received hydrocortisone + placebo. Inhaled ciclesonide was as effective as intravenous hydrocortisone in improving clinical parameters (Borg-scored dyspnea, p=0.95; sternocleidomastoid muscle use, p=0.55; wheezing, p=0.55; respiratory effort, p=0.95) and spirometric parameters (forced vital capacity, p=0.50; forced expiratory volume in the first second, p=0.83; peak expiratory flow, p=0.51). Conclusions: Inhaled ciclesonide was non-inferior to systemic hydrocortisone for management of acute asthma exacerbations, improving both clinical and spirometry parameters.