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Increasing inhaled glucocorticoid doses to prevent asthma exacerbations


In children with moderate to severe persistent asthma, quintupling the inhaled corticosteroid (ICS) dose at early signs of loss of asthma control did not reduce the rate of severe asthma exacerbations; however, in adolescents and adults, quadrupling the ICS dose when asthma control started to deteriorate did result in fewer severe exacerbations in a small group of patients, according to two studies published in the New England Journal of Medicine.


Jackson DJ, et al. Quintupling inhaled glucocorticoids to prevent childhood asthma exacerbations. N Engl J Med. 2018;378(10):891–901.

McKeever T, et al. Quadrupling inhaled glucocorticoids to abort asthma exacerbations. N Engl J Med. 2018;378(10):902–10.

Bardin PG. Escalating inhaled glucocorticoids to prevent asthma exacerbations. N Engl J Med. 2018;378(10):950–2.

Global Initiative for Asthma. Global strategy for asthma management and prevention, 2018. Accessed April 25, 2018.