Corticosteroids in Acute Asthma: Past, Present, and Future

Scarfone, Richard J.; Friedlaender, Eron

doi:10.1097/01.pec.0000092585.40174.f6

Cited by 25 publications

(19 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Accepted for publication Dec 4, 2013 Asthma affects .6 million children in the United States, making it the most common chronic disease of childhood. 1,2 As such, asthma accounts for 2% of all ambulatory care and emergency department (ED) visits by patients ,18 years of age. 3 Asthma is a chronic inflammatory disease characterized by airway edema, bronchoconstriction and airway hyperresponsiveness.…”

Section: Methodsmentioning

confidence: 99%

“…They systemically reduce inflammation, decrease mucus production, and enhance the effects of b-agonists. 2 National and international guidelines advise early administration of systemic corticosteroids for moderate or severe exacerbations and for mild exacerbations that do not immediately and completely respond to short-acting b-agonists. 1,4 Current treatment regimens consist of oral prednisone or prednisolone taken onceor twicedaily for 5days.Oral (PO)or intramuscular (IM) dexamethasone has been proposed as an equivalent therapy.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Dexamethasone for Acute Asthma Exacerbations in Children: A Meta-analysis

et al. 2014

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVE: Dexamethasone has been proposed as an equivalent therapy to prednisone/prednisolone for acute asthma exacerbations in pediatric patients. Although multiple small trials exist, clear consensus data are lacking. This systematic review and meta-analysis aimed to determine whether intramuscular or oral dexamethasone is equivalent or superior to a 5-day course of oral prednisone or prednisolone. The primary outcome of interest was return visits or hospital readmissions.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Dexamethasone for Acute Asthma Exacerbations in Children: A Meta-analysis

et al. 2014

View full text Add to dashboard Cite

show abstract

“…(17,(25)(26) However, in the literature, there are no objective criteria based on baseline clinical score, baseline SpO 2 or baseline PEF for the indication of corticosteroid use to treat acute asthma. Some authors have found that, after nebulizations with salbutamol, an SpO 2 cutoff value of 91% had higher sensitivity, specificity and positive predictive value for the indication of intravenous treatment in children with acute asthma.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown that a delay in initiating corticosteroid use may result in a greater number of admissions and alter the prognosis of the course of acute asthma. (25)(26) Some studies have demonstrated that SpO 2 is a better predictor of the course of acute asthma than is PEF. (5)(6)23) In addition, SpO 2 and PEF were found to be predictors, to some extent, of the need for hospitalization, but only SpO 2 was predictive of recurrence.…”

Section: Discussionmentioning

confidence: 99%

Fatores preditivos da evolução da asma aguda em crianças

Paro

Rodrigues

2005

J. bras. pneumol.

View full text Add to dashboard Cite

Objective: To use clinical and functional characteristics observed upon admission to an emergency room to identify factors predictive of the occurrence and course of acute asthma attacks in children. Methods: We prospectively studied 130 asthmatic children, from 1 to 13 years of age, who were treated for acute asthma attacks in an emergency room, evaluating status determined at admission and over the course of the crisis. Clinical scores were determined and arterial oxygen saturation by pulse oximetry was measured, as was peak expiratory flow. Results: The initial clinical score, arterial oxygen saturation by pulse oximetry and peak expiratory flow correlated with the number of inhalations performed, as well as with the need for corticosteroid treatment. Mean initial clinical score and mean arterial oxygen saturation by pulse oximetry of the hospitalized patients were statistically different from those of patients who were not hospitalized. Initial clinical score, arterial oxygen saturation and prior treatment for the same exacerbation were predictive of the need for hospitalization. Conclusion: The measurement of arterial oxygen saturation by pulse oximetry and the clinical score were useful in predicting the occurrence and course of acute asthma attacks in children. The measurement and interpretation of peak expiratory flow is difficult in children and, under these conditions, served no practical application.

show abstract

“…[5][6][7] How ever, some literature suggests that this regimen lacks consistent patient compliance [8][9][10] and has poor pala tability. 11 One study demonstrated that complete adherence to the full course of PO prednisone for pediatric asthma exacerbation was only 64%.…”

Section: An Official Journal Of the American Academy Of Pediatricsmentioning

confidence: 99%

Is Dexamethasone an Effective Alternative to Oral Prednisone in the Treatment of Pediatric Asthma Exacerbations?

Meyer

Riese

Biondi

2014

Hospital Pediatrics

View full text Add to dashboard Cite

Background: A short course of systemic corticosteroids is an important therapy in the treatment of pediatric asthma exacerbations. Although a 5-day course of oral prednisone or prednisolone has become the most commonly used regimen, dexamethasone has also been used for a shorter duration (1–2 days) with potential for improvement in compliance and palatability. We reviewed the literature to determine if there is sufficient evidence that dexamethasone can be used as an effective alternative in the treatment of pediatric asthma exacerbations in the inpatient setting. Methods: A Medline search was conducted on the use of dexamethasone in the treatment of asthma exacerbations in children. The studies selected were clinical trials comparing the efficacy of dexamethasone with prednisone. Meta-analysis was performed examining physician revisitation rates and symptomatic return to baseline. Results: Six completed pediatric clinical trials met the inclusion criteria. All of the pediatric trials found that prednisone is not superior to dexamethasone in treating mild to moderate asthma exacerbations. Meta-analysis demonstrated homogeneity between the dexamethasone and prednisone groups when examining symptomatic return to baseline and unplanned physician revisits after the initial emergency department encounter. Some studies found potential additional benefits of dexamethasone, including improved compliance and less vomiting. Conclusions: The current literature suggests that dexamethasone can be used as an effective alternative to prednisone in the treatment of mild to moderate acute asthma exacerbations in children, with the added benefits of improved compliance, palatability, and cost. However, more research is needed to examine the role of dexamethasone in hospitalized children.

show abstract

Corticosteroids in Acute Asthma: Past, Present, and Future

Cited by 25 publications

References 37 publications

Dexamethasone for Acute Asthma Exacerbations in Children: A Meta-analysis

Dexamethasone for Acute Asthma Exacerbations in Children: A Meta-analysis

Fatores preditivos da evolução da asma aguda em crianças

Is Dexamethasone an Effective Alternative to Oral Prednisone in the Treatment of Pediatric Asthma Exacerbations?

Contact Info

Product

Resources

About