Route of Administration of Corticosteroids and Asthma Relapse after Acute Care; Appraisal of Evidence on Effectiveness and Safety

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DOI: 10.21522/TIJPH.2013.09.03.Art021

Authors : Sogunle PT, Sogunle E.O

Abstract:

Patients managed for acute exacerbation of asthma in acute settings respond to standard management protocol involving systemic and oral steroids. However, relapses are common due to poor adherence to tapering doses of oral steroids. Intramuscular (IM) administration of corticosteroids has been shown to be equipotent to oral steroids with the added advantage of convenient dosing and improved adherence. However, the role of the route of administration of corticosteroids related to relapse of asthma attacks after acute care has not been fully explored. To find and appraise up-to-date evidence in the literature that compares the effectiveness and safety of IM corticosteroids o a short-course oral corticosteroid in the treatment of asthma patients in acute care settings. The principles of evidence-based medicine (EBM) were used. Suitable articles were identified using MEDLINE, Cochrane library, and Google scholar. Titles and summary texts were reviewed. The full article of the relevant article was downloaded for critical appraisal of methodological quality using a measurement tool to assess systematic review 2 (AMSTAR 2). In applying AMSTAR 2 to the selected systematic review article, it was noted that the investigators followed most of the requirements. However, adequate investigation of publication bias and discussion of its likely impact on the review’s result was not done by the researchers. No significant differences in effectiveness and safety were observed between IM corticosteroids and oral corticosteroids among this category of patients. Additional studies are required to compare different IM and oral corticosteroid preparations.
Keywords: Acute exacerbation of Asthma, AMSTER 2, Evidence-based medicine, Route of administration of corticosteroids.

References:

[1] Croisant S. 2014 Epidemiology of Asthma: Prevalence and Burden of Disease. In: Brasier A. (eds) Heterogeneity in Asthma. Advances in Experimental Medicine and Biology, vol 795:17-29 Humana Press, Boston, MA. https://doi.org/10.1007/978-1-4614-8603-9_2.

[2] Rowe BH, Kirkland SW, Vandermeer B, et al. 2017. Prioritizing Systemic Corticosteroid Treatments to Mitigate Relapse in Adults With Acute Asthma: A Systematic Review and Network Meta-analysis. Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine. Mar;24(3):371-381. DOI: 10.1111/acem.13107. PMID: 27664401.

[3] Services UD of H and H. National asthma education program: executive summary. Guidelines for the diagnosis and management of asthma Publication NO. 1991.

[4] Topal E, Gücenmez OA, Harmancı K, Arga M, Derinoz O, Turktas I, 2014. Potential predictors of relapse after treatment of asthma exacerbations in children, Annals of Allergy, Asthma & Immunology, Volume 112 (4), 361-364, ISSN 1081-1206, https://doi.org/10.1016/j.anai.2014.01.025.

[5] Ducharme FM, Zemek RL, Chalut D, McGillivray D, Noya FJ, Resendes S, Khomenko L, Rouleau R, Zhang X. 2011. Written action plan in pediatric emergency room improves asthma prescribing, adherence, and control. Am J Respir Crit Care Med. 15;183(2):195-203. DOI: 10.1164/rccm.201001-0115OC. Epub 2010 Aug 27. PMID: 20802165.

[6] McNamara RM, Rubin JM. 1993. Intramuscular methylprednisolone acetate for the prevention of relapse in acute asthma. Ann Emerg Med. 22(12):1829-35. DOI: 10.1016/s0196-0644(05)80409-3. PMID: 8239103.

[7] Hoffman IB, Fiel SB. 1988. Oral vs. repository corticosteroid therapy in acute asthma. Chest. 93(1):11-3. DOI: 10.1378/chest.93.1.11. PMID: 3275525.

[8] Lee CH, Lee CJ, Lan RS, Tsai YH, Chiang YC, Wang WJ, Tsao TC. 1993. Repository dexamethasone in the treatment of acute bronchial asthma. Changgeng Yi Xue Za Zhi. 16(1):25-9. PMID: 8490772.

[9] Schuckman H, DeJulius DP, Blanda M, Gerson LW, DeJulius AJ, Rajaratnam M. 1998. Comparison of intramuscular triamcinolone and oral prednisone in the outpatient treatment of acute asthma: a randomized controlled trial. Ann Emerg Med. 31(3):333-338. DOI: 10.1016/s0196-0644(98)70343-9. Erratum in: Ann Emerg Med 1998 Jun;31(6):795. PMID: 9506490.

[10] Chan JS, Cowie RL, Lazarenko GC, Little C, Scott S, Ford GT. 2001. Comparison of intramuscular betamethasone and oral prednisone in the prevention of relapse of acute asthma. Can Respir J. 8(3):147-52. DOI: 10.1155/2001/613426. PMID: 11420590.

[11] Saunders CE. 1987. Patient compliance in filling prescriptions after discharge from the emergency department. Am J Emerg Med.;5(4):283-6. DOI: 10.1016/0735-6757(87)90351-2. PMID: 3297080.

[12] Thomas EJ, Burstin HR, O’Neil AC, Orav EJ, Brennan TA. 1996. Patient noncompliance with medical advice after the emergency department visit. Ann Emerg Med. 27(1):49-55. DOI: 10.1016/s0196-0644(96)70296-2. PMID: 8572448.

[13] Titler M. Developing an evidence-based practice. 2006.

[14] Sackett DL. Evidence-based medicine: how to practice and teach. EBM. 2000.

[15] Sackett DL, Rosenberg WM, Gray JM, Haynes RB, Richardson WS. 1996. Evidence-based medicine. BMJ: British Medical Journal. 313: 170. DOI: https://doi.org/10.1136/bmj.312.7023.71.

[16] Akobeng AK. Principles of evidence-based medicine. Arch Dis Child. 2005 Aug;90(8):837-40. DOI: 10.1136/adc.2005.071761. PMID: 16040884; PMCID: PMC1720507.

[17] Antman EM, Lau J, Kupelnick B, Mosteller F, Chalmers TC. 1992. A comparison of results of meta-analyses of randomized control trials and recommendations of clinical experts. Treatments for myocardial infarction. JAMA. 1992 8;268(2):240-8. PMID: 1535110.

[18] Oxman AD, Guyatt GH. The science of reviewing research. Ann N Y Acad Sci. 1993 Dec 31;703:125-33; discussion 133-4. DOI: 10.1111/j.1749-6632.1993.tb26342.x. PMID: 8192290.

[19] Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. 2009. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. ;62(10):e1-34. DOI: 10.1016/j.jclinepi.PMID: 19631507.

[20] Akobeng AK. 2005. Understanding randomised controlled trials. Arch Dis Child. 90(8):840-4. DOI: 10.1136/adc.2004.058222. PMID: 16040885; PMCID: PMC1720509.

[21] Kang H. 2016. How to understand and conduct evidence-based medicine. Korean J Anesthesiol. 2016 Oct;69(5):435-445. DOI: 10.4097/kjae.2016.69.5.435. Epub 2016 Sep 8. PMID: 27703623; PMCID: PMC5047978.

[22] Kirkland S, Cross E, Campbell S, Villa‐Roel C, Rowe B. 2018. Intramuscular versus oral corticosteroids to reduce relapses following discharge from the emergency department for acute asthma. Cochrane Database of Systematic Reviews.. doi:10.1002/14651858.CD012629.pub2.

[23] Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358: j4008. doi:10.1136/bmj.j4008.

[24] Shea BJ, Grimshaw JM, Wells GA, Boers M, Andersson N, Hamel C, et al. Development of
AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Medical Research Methodology. 2007;7: 10. doi:10.1186/1471-2288-7-10.

[25] Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339: b2535. doi:10.1136/bmj.b2535.

[26] Shea BJ, Hamel C, Wells GA, Bouter LM, Kristjansson E, Grimshaw J, et al. AMSTAR is a reliable and valid measurement tool to assess the methodological quality of systematic reviews. Journal of Clinical Epidemiology. 2009;62: 1013–1020. doi:10.1016/j.jclinepi.2008.10.009.

[27] Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of Observational Studies in EpidemiologyA Proposal for Reporting. JAMA. 2000;283: 2008–2012. doi:10.1001/jama.283.15.2008.

[28] Higgins J, Altman D, Sterne J. Chapter 12: Assessing the risk of bias in included studies. In: Cochrane Handbook for Systematic Reviews of Interventions: The Cochrane Collaboration. 2011. Available: http://handbook.cochrane.org.

[29] Higgins J, Altman D, Sterne J. Chapter 8: Assessing the risk of bias in included studies. In: Cochrane Handbook for Systematic Reviews of Interventions: The Cochrane Collaboration. 2011. Available: http://handbook.cochrane.org.