Oke Viska, Faisal Yunus, Wiwien Heru Wiyono
Departemen Pulmonologi dan Ilmu Kedokteran Respirasi, Fakultas Kedokteran Universitas Indonesia, RS Persahabatan, Jakarta, Indonesia
Background: Efforts to reduce the recurrence of asthma exacerbations is optimal handling. Steroid has a role in reducing exacerbations, but another problem arises due to uneffective oral dose after the patient is discharged. This study aimed to determine whether 2 weeks therapy of 36 mg/day dose of oral prednisolone is more effective than 12 mg/day in moderate persistent asthma treatment following acute asthma exacerbations. Methods: This study was a randomized open-controlled trial at asthma clinic Persahabatan Hospital between January-August 2008 of which 98 subjects with acute asthma exacerbation moderate to severe were enrolled and randomly divided into two groups. A total of 79 subjects
were able to qualify for inclusion. All patients were given 2 weeks therapy with oral prednisolone and were followed for 4 weeks. Results: No differences were found in either relapse rate in 2 weeks (10.2% vs 22.5% p> 0.05) or 6 weeks (25.6% vs 35.0% p> 0.05) between the two groups. During the first 2 weeks after discharge, patients who received 36 mg of prednisolone reported average significantly higher daily scores for symptoms of shortness of breath (9.95 ± 1.95 vs 9.02 ± 2.09, p<0.05), but no significant difference after 2 weeks. No significant differences in the use of β2-agonists and peak expiratory flow rate (PEFR) between the two groups. Conclusion: Thirty six mg/day oral prednisolone provide a lower recurrence rate, symptoms improvement compare with 12 mg/day in moderate persistent asthma after acute exacerbation, but no significant association in β2-agonist consumption and PEFR compare with 12mg/day. (J Respir Indo. 2014; 34: 139-48)
Keywords: asthma, oral prednisolone, relapse.