Effectiveness of inhaled corticosteroids in the treatment of acute asthma in
children in the emergency department: a meta-analysis.
Author(s): Su XM(1), Yu N, Kong LF, Kang J.
Affiliation(s): Author information:
(1)Department of Respiratory Disease, The First Hospital of China Medical University
, Shenyang, 110001 , China.
Publication date & source: 2014, Ann Med. , 46(1):24-30
OBJECTIVES: This meta-analysis aimed to compare the treatment of an acute asthma
attack in children in the emergency department (ED) with inhaled corticosteroids
(ICS) versus placebo or oral systemic corticosteroids (SC) as assessed by the
hospital admission rates.
METHODS: After searching Medline, Cochrane, EMBASE, and Google Scholar, we
identified ten articles that described randomized controlled trials of ICS versus
placebo or oral SC for treating children with asthma attacks in the ED. Primary
outcome was the hospital admission rate as defined as inpatient admission or
admission into intensive care unit.
RESULTS: Across the studies, a range of drugs and doses were used. For ICS, six
studies administered budesonide (dose range: 0.4-2 mg), and three studies gave
fluticasone/flunisolide (dose range: 0.5-2 mg). Six studies administered oral
prednisone (dose range: 1-2 mg/kg/day), and four studies gave placebo. The rate
of hospital admissions in patients treated with ICS was not significantly higher
than those treated with oral SC. The rate of hospital admissions in patients
treated with ICS was significantly lower than those treated with placebo.
CONCLUSION: ICS treatment of children with acute asthma exacerbations showed a
similar rate of hospitalization as those treated by SC.
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