Efficacy of Nebulised Budesonide versus Oral Prednisolone in Acute Severe Asthma

Arulparithi, Cuddalore Subramanian; Babu, Thirunavukkarasu Arun; Ravichandran, Caitlin; Santhanam, Indumathy; Sathyamurthi, B; S, Parivathini; Hemachitra, J.

doi:10.1007/s12098-014-1498-0

Cited by 13 publications

(10 citation statements)

References 16 publications

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“…; NIH 2020[35], 2 RS[60,61] and 6 RCT[62][63][64][65][66][67].Scientific evidences on these topics are very heterogeneous for all PICO elements: 1. Population: age (adults/ children); asthma step (step 2/not specified); severity of asthma attack (mild, moderate, severe); 2.…”

mentioning

confidence: 99%

Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases

Duse¹,

Santamaria²,

Verga³

et al. 2021

Ital J Pediatr

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Background In 2019, a multidisciplinary panel of experts from eight Italian scientific paediatric societies developed a consensus document for the use of inhaled corticosteroids in the management and prevention of the most common paediatric airways disorders. The aim is to provide healthcare providers with a multidisciplinary document including indications useful in the clinical practice. The consensus document was intended to be addressed to paediatricians who work in the Paediatric Divisions, the Primary Care Services and the Emergency Departments, as well as to Residents or PhD students, paediatric nurses and specialists or consultants in paediatric pulmonology, allergy, infectious diseases, and ear, nose, and throat medicine. Methods Clinical questions identifying Population, Intervention(s), Comparison and Outcome(s) were addressed by methodologists and a general agreement on the topics and the strength of the recommendations (according to the GRADE system) was obtained following the Delphi method. The literature selection included secondary sources such as evidence-based guidelines and systematic reviews and was integrated with primary studies subsequently published. Results The expert panel provided a number of recommendations on the use of inhaled corticosteroids in preschool wheezing, bronchial asthma, allergic and non-allergic rhinitis, acute and chronic rhinosinusitis, adenoid hypertrophy, laryngitis and laryngospasm. Conclusions We provided a multidisciplinary update on the current recommendations for the management and prevention of the most common paediatric airways disorders requiring inhaled corticosteroids, in order to share useful indications, identify gaps in knowledge and drive future research.

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mentioning

confidence: 99%

Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases

Duse¹,

Santamaria²,

Verga³

et al. 2021

Ital J Pediatr

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“…Two randomized clinical trials compared the effectiveness of high-dose of ICS vs, SS [ 42 , 43 ], the results showed that ICS and SS have the same efficacy to improve clinical symptoms. However, one study [ 38 ] showed that in the group treated with high doses of budesonide (800 μg/ 20 min) there was an increase in the percentage of children discharged from hospital after 2 h compared to the group treated with prednisolone (2 mg/kg).…”

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confidence: 99%

Guideline on management of the acute asthma attack in children by Italian Society of Pediatrics

2018

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BackgroundAcute asthma attack is a frequent condition in children. It is one of the most common reasons for emergency department (ED) visit and hospitalization. Appropriate care is fundamental, considering both the high prevalence of asthma in children, and its life-threatening risks.Italian Society of Pediatrics recently issued a guideline on the management of acute asthma attack in children over age 2, in ambulatory and emergency department settings.MethodsThe Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was adopted. A literature search was performed using the Cochrane Library and Medline/PubMed databases, retrieving studies in English or Italian and including children over age 2 year.ResultsInhaled ß2 agonists are the first line drugs for acute asthma attack in children. Ipratropium bromide should be added in moderate/severe attacks. Early use of systemic steroids is associated with reduced risk of ED visits and hospitalization. High doses of inhaled steroids should not replace systemic steroids. Aminophylline use should be avoided in mild/moderate attacks. Weak evidence supports its use in life-threatening attacks. Epinephrine should not be used in the treatment of acute asthma for its lower cost / benefit ratio, compared to β2 agonists. Intravenous magnesium solphate could be used in children with severe attacks and/or forced expiratory volume1 (FEV1) lower than 60% predicted, unresponsive to initial inhaled therapy. Heliox could be administered in life-threatening attacks. Leukotriene receptor antagonists are not recommended.ConclusionsThis Guideline is expected to be a useful resource in managing acute asthma attacks in children over age 2.

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“…There were 7 studies remaining for the analysis; comprised of three meta-analysis and four added studies. [ 12 13 14 15 16 17 18 ] The three meta-analysis included Edmonds et al ., in 2012; Su et al ., in 2014; and Beckhaus et al ., in 2014. [ 12 13 14 ] The other four RCT studies were added and shown in Table 1 .…”

Section: R Esultsmentioning

confidence: 99%

“…In total, there were 19 studies included in the final analysis. [ 8 9 10 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 ] These 19 studies had 20 comparisons between ICS and other treatments; Milani 2004 study had two comparisons; ICS versus placebo and ICS versus SC. The 20 comparisons categorized as ICS versus placebo (5 comparisons), ICS versus SC (11 comparisons), and ICS plus SC versus SC (4 comparisons).…”

Section: R Esultsmentioning

confidence: 99%

Role of inhaled corticosteroids for asthma exacerbation in children: An updated meta-analysis

Sawanyawisuth

Chattakul

Khamsai

et al. 2020

J Emerg Trauma Shock

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Background: Several studies showed that inhaled corticosteroids (ICS) may be a potential treatment in acute asthma exacerbation in children. This study was an update meta-analysis on the roles of ICS in the management of acute asthma exacerbation in children presenting to the hospital. Materials and Methods: Published articles with key words of ICS for asthma exacerbation, asthma attacks, and acute asthma in children aged under 18 years in the hospital setting with outcome of hospital admission between 2009 and 2018 were enrolled. The databases used in this study were Medline, Scopus, and Web of Science. Odds ratio of comparison between ICS and other treatments on hospital admissions was calculated. Results: There were 311 eligible studies met the searching criteria; seven eligible studies for the analysis; comprised of three meta-analysis and four added studies. The ICS had a significant reduction in hospital admission compared with placebo in overall with odds ratio of 0.63 (95% confidence interval [CI]: 0.41–0.96) and in moderate-to-severe group with odds ratio of 0.17 (95% CI: 0.05–0.51). Comparing with systemic corticosteroid (SC), ICS had significantly lower hospital admissions overall and in mild-to-moderate group with odds ratios of 0.63 and 0.26, respectively. The combination of ICS and SC had odds ratio of 0.75 (95% CI: 0.57–0.99) over SC in moderate-to-severe asthma exacerbation. Conclusions: ICS significantly reduced hospital admission in asthma exacerbation in children. It may be used alone for mild-to-moderate asthma exacerbation and combination with SC for moderate-to-severe asthma exacerbation.

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Efficacy of Nebulised Budesonide versus Oral Prednisolone in Acute Severe Asthma

Abstract: Nebulised budesonide significantly improves PEFR levels and fitness for discharge at 2 h when compared to oral prednisolone in children between 5 and 12 y with acute severe asthma.

Cited by 13 publications

References 16 publications

Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases

Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases

Guideline on management of the acute asthma attack in children by Italian Society of Pediatrics

Role of inhaled corticosteroids for asthma exacerbation in children: An updated meta-analysis

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