What is the efficacy of a corticosteroid (steroid) injection in a clinical setting for an asthma exacerbation?

From the Guidelines

A steroid shot, typically methylprednisolone (Depo-Medrol) or triamcinolone (Kenalog), is a highly effective treatment for acute asthma flares when administered in a clinic setting, with the most recent and highest quality study 1 supporting its use. The typical adult dose ranges from 40-80mg as a single intramuscular injection, while children receive weight-based dosing (usually 1-2mg/kg) as stated in 1. This injection works rapidly to reduce airway inflammation, decrease mucus production, and relax bronchial smooth muscles, providing relief within hours that can last for several days to weeks. Some key points to consider when administering a steroid shot for an asthma flare include:

• The dose and frequency of administration, along with the frequency of patient monitoring, dependent on the severity of the exacerbation as mentioned in 1.
• The potential for temporary side effects, including increased appetite, mood changes, elevated blood sugar, fluid retention, or insomnia, as noted in 1.
• The importance of following up with regular asthma medications as prescribed and contacting a healthcare provider if symptoms worsen or don't improve within 24-48 hours.
• The possibility of a short oral steroid taper (like prednisone) being prescribed to follow the injection for continued symptom control, as suggested in 1. It's also important to note that there is no known advantage for higher doses of corticosteroids in severe asthma exacerbations, nor is there any advantage for intravenous administration over oral therapy provided gastrointestinal transit time or absorption is not impaired, as stated in 1.

From the Research

Steroid Shot in Clinic for Asthma Flare

• A steroid shot, also known as a corticosteroid injection, is a common treatment for asthma flare-ups 2, 3, 4, 5, 6.
• The goal of a steroid shot is to reduce inflammation and swelling in the airways, making it easier to breathe 2, 3, 4, 5, 6.
• There are different types of corticosteroids that can be used for asthma treatment, including prednisolone, dexamethasone, and methylprednisolone 3, 4, 5.
• The effectiveness of a steroid shot for asthma flare-ups can vary depending on the individual and the severity of their asthma 2, 3, 4, 5, 6.
• Some studies have compared the efficacy and safety of different corticosteroid regimens for acute asthma, including intravenous and oral administration 3, 4, 5.
• The use of inhaled corticosteroids (ICS) is also a common treatment for asthma, and some studies have investigated the effectiveness of increasing the dose of ICS during an exacerbation 2, 6.
• However, the evidence suggests that increasing the dose of ICS may not always be effective in reducing the need for oral steroids or improving other outcomes 6.

Types of Corticosteroids

• Prednisolone is a commonly used oral corticosteroid for asthma treatment 3, 4, 5.
• Dexamethasone is another type of oral corticosteroid that can be used for asthma treatment 4, 5.
• Methylprednisolone is an intravenous corticosteroid that can be used for acute asthma exacerbations 3, 5.
• Inhaled corticosteroids (ICS) are a type of corticosteroid that can be used for long-term asthma management 2, 6.

Administration and Dosage

• The dosage and administration of corticosteroids can vary depending on the individual and the severity of their asthma 2, 3, 4, 5, 6.
• Intravenous corticosteroids are typically administered in a clinic or hospital setting 3, 5.
• Oral corticosteroids can be taken at home, but the dosage and duration of treatment should be determined by a healthcare provider 3, 4, 5.
• Inhaled corticosteroids are typically administered using an inhaler, and the dosage and frequency of use should be determined by a healthcare provider 2, 6.