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Evaluating the effectiveness of systemic corticosteroids to mitigate relapse in children assessed and treated for

Scott W Kirkland1, Ben Vandermeer2, Sandy Campbell3

  • 1a Department of Emergency Medicine , University of Alberta , Edmonton , AB , Canada.

The Journal of Asthma : Official Journal of the Association for the Care of Asthma
|April 26, 2018
PubMed

Insights

Systemic corticosteroids (SCS) effectively reduce asthma relapse in children after hospital discharge. Specific regimens like intramuscular corticosteroids, short-course oral prednisone, and oral dexamethasone showed significant benefits compared to placebo.

Area of Science:

  • Pediatric Pulmonology
  • Pharmacology
  • Evidence-Based Medicine

Background:

  • Asthma relapse post-acute care is a significant concern in pediatric patients.
  • Systemic corticosteroids (SCS) are commonly used, but optimal regimens for relapse prevention require clarification.

Purpose of the Study:

  • To systematically review the effectiveness of various systemic corticosteroid (SCS) regimens in preventing asthma relapse in children discharged from acute care.

Main Methods:

  • Comprehensive literature search across multiple databases (Medline, EMBASE, etc.) and clinical trial registries.
  • Inclusion of randomized controlled trials without language, publication status, or year limitations.
  • Two independent reviewers assessed study eligibility and extracted data.

Main Results:

  • Fifteen studies were included in the analysis.
  • SCS significantly reduced asthma relapse compared to placebo (RR = 0.10; 95% CI: 0.01, 0.77).
  • Network analysis revealed significant relapse reduction with intramuscular corticosteroids, short-course oral prednisone, and oral dexamethasone versus placebo.

Conclusions:

  • Systemic corticosteroids demonstrate efficacy in reducing asthma relapse in children post-acute care.
  • Further research is needed to determine optimal SCS doses and treatment durations for relapse prevention.
Abstract

Keywords:
Dexamethasoneemergency departmentprednisonerandomized controlled trialssystematic review

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