Do inhaled or oral glucocorticoids more effectively control feline asthma?

Abstract

PICO question
 In cats with chronic bronchospasm and airway hypersensitivity (asthma) do oral glucocorticoids or inhaled glucocorticoids more effectively control the clinical signs?
 
 Clinical bottom line
 Category of research question
 Treatment
 The number and type of study designs reviewed
 Three prospective randomised clinical trials were appraised. Two of the studies followed a crossover design and had a control group, whilst the third study described an interrupted time series
 Strength of evidence
 Weak
 Outcomes reported
 The available studies deemed a reduction in eosinophilia on bronchoalveolar lavage fluid analysis, and a reduction in airway resistance as markers of treatment efficacy
 Conclusion
 There is weak evidence to suggest equal treatment efficacy of oral and inhaled glucocorticoid therapy for management of feline asthma. Higher powered studies would be required before a definitive recommendation can be made
 
 How to apply this evidence in practice
 The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
 Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.