Effectiveness of inhaled corticosteroids in the treatment of acute asthma in children in the emergency department: A meta-analysis

Abstract

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.

Key words::

• Asthma
• children
• emergency department
• inhaled corticosteroids
• meta-analysis

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.