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June 1984

Methylprednisolone in Status Asthmaticus-Reply

Author Affiliations

Torrance, Calif

Arch Intern Med. 1984;144(6):1305. doi:10.1001/archinte.1984.00350180255041

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In Reply.  —We appreciate Dr Rogol's comments regarding our study and agree that there is a paucity of well-controlled clinical trials using corticosteroid therapy for status asthmatThe group that received the lowest corticosteroid dosage (15 mg of methylprednisolone every six hours) did not improve as much as the two higher dosage groups did, mainly because three out of seven patients were "nonresponders." There were no nonresponders in the two higher dose groups; therefore, we agree that many patients may respond to lower doses of corticosteroids. However, we do not know of any clinical measures that identify these nonresponders prior to treatment. Hence, we believe it is preferable to "overtreat" some patients and adequately treat the rest rather than risk the potential morbidity or mortality resulting from inadequate initial treatment.In our patients and in the experience of most other investigators, the short course of high-dose corticosteroids is virtually without

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