| Methods |
Randomisation: Patients were randomised using computer‐generated random numbers and randomised separately according to chronic steroid dependency.
Blinding: double blinded ‐ similar appearing
Number excluded:
Withdrawals: 2 (1 pneumonia: MP; 1 tachycardia: placebo)
Baseline characteristics: limited reporting; no adjusted analyses. |
| Participants |
Location: Montefiore Hospital in Pittsburgh, USA.
Participants: 56 adults, Dx of asthma, acute bronchospasm and dyspnea,
Asthma definition and severity: FEV‐1 < 70% predicted. No severity subgroups.
Exclusion criteria: TB, pregnancy, diabetes mellitus, pneumonia or congestive heart failure
Subgroups: Patients were considered non‐steroid dependent if they had used no steroid treatment within the past 14 days. |
| Interventions |
Intervention: methylprednisolone (MP: 30 mg/kg) infused over 30 min.
Control: saline placebo
Co‐interventions: Treatment begun with epinephrine, 0.3 ml sub‐Q in patients < 35 yrs or isoetharine 0.5 ml (updraft nebulization, followed by the inhalation of albuterol). If subsequent FEV‐1 showed improvement > 20%, the patient received beta‐agonist q 30 min until improvement ceased, or discharge criteria met. Patients failing to improve received IV aminophylline in addition to the beta‐agonists. |
| Outcomes |
Admission: hospitalized if failed to improve during initial or any subsequent 60 minute period of combined aminophylline maintenance infusion and beta‐agonist therapy. Discharged if clinical signs and symptoms of bronchospasm had cleared and the FEV‐1 =>70% of predicted or previous best.
Pulmonary functions: FEV‐1 and % predicted FEV‐1.
Adverse effects: none.
Vital signs: none.
Symptoms: none.
Lab: not reported.
Timing of assessment: entry, q 30 minutes
Follow‐up: Patients were considered treatment failures if they required hospitalization within 7 days after being successfully treated. Relapses were determined by chart audits as all patients were likely to return to the same hospital. |
| Notes |
Jadad score:
Dr. Schneider responded to correspondence, and was able to provide additional information including the data. |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Allocation concealment? |
Low risk |
Patients were randomised using computer‐generated random numbers and randomised separately according to chronic steroid dependency. |
