The purpose of this study is to evaluate the dose response relationship for either a tapering dose of oral steroids or an inhaled metered dose regimen of steroids and specific stimuli in asthmatic subjects. Over the past few years, effective protocols and care paths have been developed for inpatients admitted with asthma. More recently, attention has been focused on the short and long-term follow-up of such patients discharged from the hospital and directly from the emergency room as well. Specifically, attention has turned to the high rates of relapse and return admissions with all the attendant costs in terms of added morbidity and utilization of heathcare resources. Guidelines for caring for these patients have looked to the notion that asthma represents a chronic inflammatory state in the airways and that treatment of inflammation with glucocorticoids is an essential component of management, especially after discharge. Of particular interest is the belief that a tapered dose of oral steroids or an inhaled metered-dose regimen of steroids begun upon discharge will protect the patient against future encounters with allergen or other stimuli. Although this belief is widely held by many physicians, well controlled studies adressing this issue are lacking.
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