Giving Asthmatics Intramuscular Steroids for Preventing Return to the Emergency Department: A Randomized Control Trial
Montefiore Medical Center
Summary
This study aims to compare the efficacy of a one-time IM dose of dexamethasone versus a 5-day course of prednisone in adult ED patients presenting with asthma exacerbations. This is a randomized, controlled, double-blind, non-inferiority trial conducted at two urban EDs within the Montefiore Health System.
Description
Asthma exacerbations are a leading cause of emergency department (ED) visits in the United States. In pediatric patients, a single dose of dexamethasone has been widely adopted as an effective and convenient alternative to multi-day oral steroid regimens. However, in adults, evidence regarding the efficacy of a single-dose steroid approach compared to a traditional 5-day course of oral prednisone is mixed. Despite the availability of oral corticosteroids like prednisone, medication adherence after ED discharge remains a significant challenge. Studies indicate that only about 30% of ED patients…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Adults ≥18 years old presenting to the ED with an asthma exacerbation * Diagnosed with asthma per International Classification of Diseases, 10th Revision (ICD-10) criteria or by the treating clinician * Discharged from the ED with a primary diagnosis of asthma exacerbation * Initiated systemic corticosteroids during the ED visit * Must be English or Spanish speaking Exclusion Criteria: * Current use of systemic corticosteroids, including Emergency Medical Services (EMS) administration before ED arrival * History of severe adverse reactions to corticosteroids * Heart fa…
Interventions
- DrugDexamethasone 16mg IM
Dexamethasone 16mg Intramuscular Administration Once
- DrugPrednisone 60mg PO
Prednisone 60mg PO for 5 Days
Location
- Montefiore Medical CenterThe Bronx, New York