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October 6, 1989

Immunotherapy and Asthma

JAMA. 1989;262(13):1772. doi:10.1001/jama.1989.03430130046021

To the Editor.—  I note with interest the recent article1 regarding the role of intravenous corticosteroids in status asthmaticus. The article makes a useful contribution in elucidating the appropriate dose and mode of administration of corticosteroids in acute asthma. Despite this, I think it would be appropriate for the authors to comment on the fact that at the time of entry to the study, 21% of the patients in the oral group as against 11% of the patients in the intravenous group were taking steroids (Table 1 of the article). I think this could introduce a bias in the study, as patients who had started therapy before randomization might have had a significant effect on outcome. In addition, the authors fail to mention a previous study that supports their hypothesis.2