Corticosteroid Management in Acute Asthma Exacerbations
Summary
In acute exacerbations of asthma, corticosteroids remain the mainstay of anti‐inflammatory therapy. Systemic agents such as prednisolone or methylprednisolone are introduced promptly—often intravenously in severe cases or orally on discharge—to quell eosinophil‐ and T-cell-driven airway inflammation. Early administration reduces hospital admissions, decreases relapse rates and accelerates recovery of lung function as assessed by peak expiratory flow. Concurrently, high-dose inhaled corticosteroids such as budesonide and ciclesonide have been explored as adjuncts or substitutes for systemic steroids, aiming to maintain therapeutic efficacy while limiting systemic exposure. Current efforts focus on optimising dose regimens, routes of delivery and duration of therapy to enhance patient adherence and minimise adverse effects in diverse healthcare settings worldwide.
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Corticosteroid Management in Acute Asthma Exacerbations publication trend
The graph below shows the total number of articles in corticosteroid management in acute asthma exacerbations across all publications each year (not limited to Nature Index journals).
Technical terms
Systemic corticosteroid: An orally or intravenously administered glucocorticoid that suppresses widespread airway inflammation and immune activation during an acute asthma attack.
Inhaled corticosteroid (ICS): A locally delivered anti-inflammatory agent, typically via nebuliser or metered-dose inhaler, designed to target airway mucosa with minimal systemic absorption.
Peak expiratory flow (PEF): The maximum speed of exhalation measured by a peak flow meter, used to assess severity of airway obstruction and monitor treatment response.
Glucocorticoid receptor (GR): A cytosolic receptor that binds corticosteroids and translocates to the nucleus to modulate expression of inflammatory genes.
References
- A Randomised Controlled Trial of High Dose, Inhaled Budesonide Versus Oral Prednisone in Patients Discharged from the Emergency Department following an Acute Asthma Exacerbation. Canadian Respiratory Journal (2000).
- Nebulized budesonide combined with systemic corticosteroid vs systemic corticosteroid alone in acute severe asthma managed in the emergency department: a randomized controlled trial. BMC Emergency Medicine (2022).
- A randomized clinical trial on inhaled ciclesonide for managing acute asthma in the emergency room. Sao Paulo Medical Journal (2022).
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