Do non enteric coated prednisolone tablets provide faster improvements in peak expiratory flow rates than enteric coated prednisolone tablets in patients with acute exacerbations of asthma?

Report By: Brett Rocos - ST1 Trauma and Orthopaedics
Institution: University Hospitals Bristol NHS Foundation Trust
Date Submitted: 14th July 2008
Last Modified: 16th August 2008
Status: Blue (submitted but not checked)

Three Part Question

In [patients with acute exacerbations of asthma] do [enteric coated prednisolone tablets rather than non enteric coated prednisolone tablets] improve [peak expiratory flow rates] more quickly

Clinical Scenario

A 30 year old female with no other medical co-morbidities presents to an acute medical take and is diagnosed with an acute exacerbation of pre existing asthma. Would she achieve a faster improvement in her peak expiratory flow rate if she was treated with enteric coated steroid tablets in preference to non enteric coated steroid tablets?

Search Strategy

OVID MEDLINE (R interface on the world wide web. 1950 to August Week 1 2008
(exp Delayed-Action Preparations/) AND (exp Steroid) AND (exp Asthma/ OR exp Peak Expiratory Flow Rate/)

Search Outcome

2 papers found of which both are irrelevant

Comment(s)

There is no published clinical evidence to support the use of enteric in preference to non enteric coated steroids in this situation.

Editor Comment

There are some pharmacological studies carried out in the 1970s showing no difference in the effective serum concentration of steroid when using either enteric or non enteric coated tablets.

Clinical Bottom Line

There is no benefit to using enteric coated steroids over using non enteric coated steroids in improving peak expiratory flow rates in patients with exacerbations of asthma.

Level of Evidence

Level 3 - Small numbers of small studies or great heterogeneity or very different population.