Prospective, placebo-controlled trial of 5 vs 10 days of oral prednisolone in acute adult asthma

Respir Med. 2002 Nov;96(11):950-4. doi: 10.1053/rmed.2002.1369.


Background: The optimal duration of oral steroid treatment in the management of acute adult asthma is unclear. We prospectively studied the effect of 5 vs. 10 days of oral prednisolone in patients with acute asthma requiring hospital admission.

Methods: Each patient received 40 mg of enteric-coated prednisolone daily for 5 days, followed by 5 days of 40 mg prednisolone daily (n=24) or placebo (n=20). All were given their usual inhaled asthma therapy including inhaled corticosteroids. Patients kept PEF and symptom diaries for 21 days.

Results: For the 5-day treatment group mean (95% CI) early morning PEF was 6 (-47,+36) l/min lower to day 21 (P=0.78). There was no evidence of differences in other PEF measures (morning post-bronchodilator, evening or worst of day). One patient in each group had an exacerbation requiring further oral steroids during the 21-day observation period. Asthma symptom scores were worse in the 5-day group on days 6-21 but the significance of this finding was uncertain, as a difference had emerged by day 5 (prior to trial entry).

Conclusions: It may be possible to reduce the standard steroid course to 5 days in acute adult asthma, provided all patients receive inhaled steroids and a personal asthma management plan.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acute Disease
  • Administration, Oral
  • Adolescent
  • Adult
  • Anti-Asthmatic Agents / therapeutic use*
  • Anti-Inflammatory Agents / therapeutic use*
  • Asthma / drug therapy*
  • Asthma / physiopathology
  • Drug Administration Schedule
  • Female
  • Humans
  • Male
  • Middle Aged
  • Peak Expiratory Flow Rate
  • Prednisolone / administration & dosage*
  • Prednisolone / therapeutic use
  • Prospective Studies


  • Anti-Asthmatic Agents
  • Anti-Inflammatory Agents
  • Prednisolone