Related Experiment Video
Updated: Aug 6, 2025
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
Dexamethasone versus methylprednisolone for critical asthma: A single center, open-label, parallel-group clinical
Meghan R Roddy1, Austin R Sellers2, Kristina K Darville3
1Departments of Pharmacy, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA.
Insights
Dexamethasone is a safe alternative for treating pediatric critical asthma in the intensive care unit. Further research is needed to confirm its clinical benefits compared to methylprednisolone.
Area of Science:
- Pediatric Critical Care Medicine
- Pulmonology
- Pharmacology
Background:
- Limited evidence exists for dexamethasone use in pediatric critical asthma.
- This study compares dexamethasone to methylprednisolone in critically ill children with asthma.
Purpose of the Study:
- To compare the clinical efficacy and safety of dexamethasone versus methylprednisolone in children hospitalized in the pediatric intensive care unit (PICU) for critical asthma.
Main Methods:
- A prospective, nonrandomized trial included 92 children (5-17 years) with critical asthma.
- Participants received either intravenous dexamethasone (0.25 mg/kg every 6h for 48h) or methylprednisolone (1 mg/kg every 6h for 5 days).
- Efficacy endpoints included length of stay, albuterol duration, and adjunctive interventions; safety endpoints were corticosteroid-related adverse events.
Main Results:
- No significant differences were observed in hospital length of stay, continuous albuterol duration, or adverse events between the dexamethasone and methylprednisolone groups.
- Participants receiving methylprednisolone were more likely to be prescribed corticosteroids at discharge compared to those receiving dexamethasone (72% vs. 13%).
Conclusions:
- Dexamethasone demonstrates safety in pediatric critical asthma patients requiring intensive care.
- Further investigation is warranted to fully evaluate dexamethasone's clinical efficacy and potential advantages over methylprednisolone.
Background:
Evidence for the use of dexamethasone for pediatric critical asthma is limited. We sought to compare the clinical efficacy and safety of dexamethasone versus methylprednisolone among children hospitalized in the pediatric intensive care unit (PICU) for critical asthma.
Methods:
A prospective, single center, open-label, two-arm, parallel-group, nonrandomized trial among children ages 5-17 years hospitalized within the PICU from April 2019 to December 2021 for critical asthma consented to receive methylprednisolone (standard care) or dexamethasone (intervention) at a 2:1 allocation ratio, respectively. The intervention arm received intravenous dexamethasone 0.25 mg/kg/dose (max: 15 mg/dose) every 6 h for 48 h and the standard care arm intravenous methylprednisolone 1 mg/kg/dose every 6 h (max dose: 60 mg/dose) for 5 days. Study endpoints were clinical efficacy (i.e., length of stay [LOS], continuous albuterol duration, and a composite of adjunctive asthma interventions) and safety (i.e., corticosteroid-related adverse events).
Results:
Ninety-two participants were analyzed of whom 31 were allocated to the intervention arm and 61 the standard care arm. No differences in demographics, clinical characteristics, or acute/chronic asthma severity indices were observed. Regarding efficacy and safety endpoints, no differences in hospital LOS, continuous albuterol duration, adjunctive asthma intervention rates, or corticosteroid-related adverse events were noted. Compared to the intervention arm, participants in the standard care arm more frequently were prescribed corticosteroids at discharge (72% vs. 13%, p < 0.001).
Conclusions:
Among children hospitalized for critical asthma, dexamethasone appears safe and warrants further investigation to fully assess clinical efficacy and potential advantages over commonly applied agents such as methylprednisolone.
More Related Videos
08:25An Ex vivo Mast Cell Degranulation Assay using Crude Peritoneal Exudate Cells and Natural Antigen Stimulation
Published on: April 27, 2021
04:59Heat-sensitive Moxibustion as a Traditional Chinese Medicine Therapy for Chronic Obstructive Pulmonary Disease Combined with Insomnia
Published on: May 30, 2025
Related Concept Videos
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
01:24Antiasthma Drugs: Methylxanthines
Theophylline is thought to inhibit phosphodiesterase enzymes, increasing intracellular levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). This rise in cAMP and cGMP concentrations stimulates cardiac function,...
01:25Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:26COPD: Management Using Bronchodilators and Corticosteroids
01:25Antiasthma Drugs: β2-Adrenoceptor Agonists
One class of bronchodilators includes β2-adrenoceptor agonists. These agents target the β2-adrenoceptors located on bronchial smooth muscle cells. By stimulating these receptors, β2-agonists induce...