{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T04:40:03Z","timestamp":1745469603356,"version":"3.40.4"},"reference-count":2,"publisher":"S. Karger AG","issue":"1-3","license":[{"start":{"date-parts":[[2001,1,1]],"date-time":"2001-01-01T00:00:00Z","timestamp":978307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2001,1,1]],"date-time":"2001-01-01T00:00:00Z","timestamp":978307200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Arch Allergy Immunol"],"published-print":{"date-parts":[[2001]]},"abstract":"<jats:p>&lt;i&gt;Background:&lt;\/i&gt; A step-down therapy may be more beneficial for the management of asthma than a step-up therapy. &lt;i&gt;Methods:&lt;\/i&gt; Eighty-two asthmatic patients with moderate persistent asthma were enrolled in the study and randomized into three groups. One group of patients received 400 \u00b5g\/day of beclomethasone dipropionate (BDP) for 4 weeks and then 800 \u00b5g\/day for another 4 weeks (step-up group). The other two groups of patients received 1,200 \u00b5g\/day of BDP for 4 weeks with or without short-term oral steroid (prednisolone, 0.5 mg\/day for 1 week) and then 800 \u00b5g\/day for another 4 weeks (step-down group). Severe exacerbation of asthma, asthma symptoms, respiratory function and rescue use of inhaled \u03b2&lt;sub&gt;2&lt;\/sub&gt;-agonists were monitored. If asthma was well controlled, the dose of BDP was decreased every 3 months and if asthma was exacerbated, the dose of BDP was increased until 8 months after the initial treatment. &lt;i&gt;Results:&lt;\/i&gt; Twenty-two patients during the run-in period, 4 patients in the step-up group, 2 patients in the step-down group treated with a high dose of BDP and no patients in the step-down group with oral steroids during first 4 weeks dropped out because of severe exacerbation of asthma. Although asthma symptoms and respiratory function significantly improved 8 weeks after the therapy in all groups, more significant and prompt improvements of these parameters were observed in patients of the step-down group than in patients of the step-up group after the first 2 weeks of treatment. Furthermore, step-down therapy with short-term oral steroid resulted in the lowest maintenance doses of BDP at 8 months of the three groups. &lt;i&gt;Conclusions:&lt;\/i&gt; These results suggest that step-down therapy starting with a high dose of inhaled steroid and short-term oral steroid is more effective in gaining prompt control of asthma and reducing the severe exacerbation of asthma and the maintenance dose of inhaled steroids than a step-up therapy starting with a low dose of inhaled steroids in patients with moderate persistent asthma.<\/jats:p>","DOI":"10.1159\/000053774","type":"journal-article","created":{"date-parts":[[2003,4,15]],"date-time":"2003-04-15T19:06:15Z","timestamp":1050433575000},"page":"414-416","source":"Crossref","is-referenced-by-count":5,"title":["Step-Down and Step-Up Therapy in Moderate Persistent Asthma"],"prefix":"10.1159","volume":"124","author":[{"given":"Mitsuru","family":"Adachi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasurou","family":"Kohno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Minoguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2012,1,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3003.2000.01522.x"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199711133372001"}],"container-title":["International Archives of Allergy and Immunology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/53774","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/53774","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T04:27:33Z","timestamp":1745468853000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000053774"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001]]},"references-count":2,"journal-issue":{"issue":"1-3","published-online":{"date-parts":[[2001,3,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000053774","archive":["Portico"],"relation":{},"ISSN":["1018-2438","1423-0097"],"issn-type":[{"type":"print","value":"1018-2438"},{"type":"electronic","value":"1423-0097"}],"subject":[],"published":{"date-parts":[[2001]]}}}