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

Abstract

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.

Comparable Function of γ-Tocopherols in Asthma Remission by Affecting Eotaxin and IL-4

“…The finding of an eotaxin decrease compared to the asthma subgroup in blood serum and BALF further showed the efficiency of γT in asthma relief. Furthermore, there were comparable or even better effects of γT than dexamethasone, which is a good drug for asthma treatment but with some of side effects [23][24][25].…”

Update on the utility of corticosteroids in acute pediatric respiratory disorders

“…A recent metaanalysis concluded there was no difference in the relative risk of relapse between dexamethasone (intramuscular or oral, one or two doses) and prednisone/prednisolone (oral for five days) and that children treated with dexamethasone were less likely to experience emesis. 12 Given the well-described side effect profile of repeated or continuous use of systemic corticosteroids, frequency of OCS courses should always be minimized. There is no evidence for clinically significant hypothalamic-pituitary-adrenal axis suppression after short "bursts" of systemic corticosteroids for acute exacerbations of asthma, 13 and tapering is not required with courses of 10 days or less in duration.…”

Mortality in Asthma-Chronic Obstructive Pulmonary Disease Overlap in the United States

“…Oral dexamethasone for 2 days can also be used but there are concerns about metabolic side-effects if it is continued beyond 2 days. 375 Evidence from studies in which all patients were taking maintenance ICS after discharge suggests that there is no benefit in tapering the dose of OCS, either in the short term 376 or over several weeks 377 (Evidence B).…”