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Inhaled flunisolide for acute severe asthma

G Rodrigo¹, C Rodrigo

¹Departamento de Emergencia, Hospital Central de las FF.AA., Montevideo, Uruguay.

American Journal of Respiratory and Critical Care Medicine

|March 28, 1998

Summary

High-dose inhaled flunisolide combined with salbutamol significantly improved lung function in emergency room patients with acute asthma. This combination therapy proved especially effective for patients with prolonged asthma attack symptoms.

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Area of Science:

Pulmonology
Emergency Medicine
Pharmacology

Background:

Acute asthma exacerbations require effective emergency room (ER) treatment.
Optimizing bronchodilator and anti-inflammatory therapy in the ER is crucial for patient outcomes.

Purpose of the Study:

To evaluate the efficacy of high-dose, cumulative inhaled flunisolide added to salbutamol for acute asthma in the ER.
To assess the impact of symptom duration prior to ER presentation on treatment effectiveness.

Main Methods:

A randomized, double-blind trial involving 94 acute asthma patients in the ER.
Patients received either salbutamol plus placebo or salbutamol plus flunisolide via metered-dose inhaler and spacer every 10 minutes for 3 hours.
Lung function (FEV1, PEFR) was measured at intervals up to 180 minutes.

Main Results:

Both treatment groups showed significant improvement in FEV1 and PEFR from baseline.
The flunisolide group demonstrated significantly better lung function compared to placebo at multiple time points (90-180 minutes).
Patients with asthma attacks lasting 24 hours or longer showed significantly lower FEV1 in the placebo group compared to others.

Conclusions:

High-dose, cumulative inhaled flunisolide administered with salbutamol is an effective therapy for acute asthma in the ER.
This combination therapy is particularly beneficial for patients presenting with prolonged asthma symptoms.
Metered-dose inhaler with spacer is a viable delivery method for this intensive treatment regimen.

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