Search research articles

ABOUT JoVE

Overview Leadership Blog JoVE Help Center

AUTHORS

Publishing Process Editorial Board Scope & Policies Peer Review FAQ Submit

LIBRARIANS

Testimonials Subscriptions Access Resources Library Advisory Board FAQ

RESEARCH

JoVE Journal Methods Collections JoVE Encyclopedia of Experiments Archive

EDUCATION

JoVE Core JoVE Business JoVE Science Education JoVE Lab Manual Faculty Resource Center Faculty Site

Terms & Conditions of Use

Search research articles

Related Experiment Videos

Step-down and step-up therapy in moderate persistent asthma.

M Adachi¹, Y Kohno, K Minoguchi

¹First Department of Internal Medicine, Showa University, Tokyo, Japan.

International Archives of Allergy and Immunology

|April 18, 2001

Summary

This summary is machine-generated.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by

Same author

Effect of tiotropium bromide on airway inflammation and remodelling in a mouse model of asthma.

Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology·2010

Same author

Inhibitory effects of suplatast tosilate on the differentiation and function of monocyte-derived dendritic cells from patients with asthma.

Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology·2007

Same author

Association between lipid peroxidation and inflammation in obstructive sleep apnoea.

The European respiratory journal·2006

Same author

Inhibitory effects of fluvastatin on cytokine and chemokine production by peripheral blood mononuclear cells in patients with allergic asthma.

Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology·2006

Same author

Suplatast tosilate inhibits thymus- and activation-regulated chemokine production by antigen-specific human Th2 cells.

Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology·2003

Same author

Cough receptor sensitivity to capsaicin does not change after allergen bronchoprovocation in allergic asthma.

Thorax·2003

Step-down therapy, starting with high-dose inhaled steroids and short-term oral steroids, offers better asthma control. This approach is more effective than step-up therapy for managing moderate persistent asthma and reducing exacerbations.

Area of Science:

Pulmonology
Clinical Pharmacology

Background:

Asthma management strategies often involve adjusting medication doses based on symptom control.
Step-up therapy increases medication as symptoms worsen, while step-down therapy reduces medication as symptoms improve.

Purpose of the Study:

To compare the efficacy of step-down versus step-up therapy for moderate persistent asthma.
To evaluate the impact on asthma control, exacerbations, and inhaled corticosteroid maintenance doses.

Main Methods:

Eighty-two patients with moderate persistent asthma were randomized into step-up and step-down treatment groups.
Step-up involved starting with 400 mcg/day beclomethasone dipropionate (BDP) and increasing to 800 mcg/day.
Step-down involved starting with 1200 mcg/day BDP (with or without oral steroids) and reducing to 800 mcg/day.

Related Experiment Videos

Main Results:

All groups showed significant improvement in asthma symptoms and respiratory function after 8 weeks.
Step-down therapy demonstrated more significant and prompt improvements within the first 2 weeks.
The step-down group with short-term oral steroids achieved the lowest maintenance BDP dose at 8 months.

Conclusions:

Step-down therapy, particularly with initial high-dose inhaled steroids and short-term oral steroids, is more effective for prompt asthma control.
This strategy effectively reduces severe asthma exacerbations and lowers the required maintenance dose of inhaled corticosteroids.
The findings support a step-down approach for managing moderate persistent asthma.