Effects of inhaled fluticasone propionate administered with metered dose inhaler and spacer in mild to moderate croup: a negative preliminary report

Roorda, R. J.; Walhof, Christel M.

doi:10.1002/(sici)1099-0496(199802)25:2<114::aid-ppul7>3.0.co;2-n

Cited by 19 publications

(3 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Database and grey literature searches yielded 9134 records. Eighty-six papers (85 studies)23–108 involving 11 505 participants were included (figure 1). Characteristics of the included studies are in online supplementary file 3.…”

Section: Resultsmentioning

confidence: 99%

Safety of corticosteroids in young children with acute respiratory conditions: a systematic review and meta-analysis

et al. 2019

View full text Add to dashboard Cite

ObjectiveAdverse events (AEs) associated with short-term corticosteroid use for respiratory conditions in young children.DesignSystematic review of primary studies.Data sourcesMedline, Cochrane CENTRAL, Embase and regulatory agencies were searched September 2014; search was updated in 2017.Eligibility criteriaChildren <6 years with acute respiratory condition, given inhaled (high-dose) or systemic corticosteroids up to 14 days.Data extraction and synthesisOne reviewer extracted with another reviewer verifying data. Study selection and methodological quality (McHarm scale) involved duplicate independent reviews. We extracted AEs reported by study authors and used a categorisation model by organ systems. Meta-analyses used Peto ORs (pORs) and DerSimonian Laird inverse variance method utilising Mantel-Haenszel Q statistic, with 95% CI. Subgroup analyses were conducted for respiratory condition and dose.ResultsEighty-five studies (11 505 children) were included; 68 were randomised trials. Methodological quality was poor overall due to lack of assessment and inadequate reporting of AEs. Meta-analysis (six studies; n=1373) found fewer cases of vomiting comparing oral dexamethasone with prednisone (pOR 0.29, 95% CI 0.17 to 0.48; I2=0%). The mean difference in change-from-baseline height after one year between inhaled corticosteroid and placebo was 0.10 cm (two studies, n=268; 95% CI −0.47 to 0.67). Results from five studies with heterogeneous interventions, comparators and measurements were not pooled; one study found a smaller mean change in height z-score with recurrent high-dose inhaled fluticasone over one year. No significant differences were found comparing systemic or inhaled corticosteroid with placebo, or between corticosteroids, for other AEs; CIs around estimates were often wide, due to small samples and few events.ConclusionsEvidence suggests that short-term high-dose inhaled or systemic corticosteroids use is not associated with an increase in AEs across organ systems. Uncertainties remain, particularly for recurrent use and growth outcomes, due to low study quality, poor reporting and imprecision.

show abstract

Section: Resultsmentioning

confidence: 99%

Safety of corticosteroids in young children with acute respiratory conditions: a systematic review and meta-analysis

et al. 2019

View full text Add to dashboard Cite

show abstract

“…However, for a population of patients with more severe clinical course (3 points on a scale of Wesley), results indicated that such approach (a combination of systemic and inhaled corticosteroids) provides a faster clinical response [13]. It was shown that, being given an additional appointment of budesonide suspension (2 mg) along with dexamethasone treatment (0.6 mg / kg orally) 84% of patients had clinically significant improvement after 4 h, versus only 56% of treated with dexamethasone solely [13]. It is important to mention, that there is no published evidence of clinical efficacy of inhaled hydrocortisone, prednisolone, or any other systemically used corticosteroid.…”

Section: Inhaled Corticosteroidsmentioning

confidence: 99%

Pharmacotherapy of Acute Stenosing Laryngotracheitis. What Drugs Are Data-Based?

Ogorodova¹,

Петровский²

2012

Pediatr. farmakol.

View full text Add to dashboard Cite

Acute stenosing laryngotracheitis is the most common cause of upper respiratory tract obstruction in children aged from 6 months to 6 years old and is a rapidly developing syndrome, which includes barking cough, hoarseness and stridor. The disease can be associated with development of respiratory failure and asphyxia, so its rational pharmacotherapy should be well known to pediatricians and emergency physicians. This review describes the drugs, effectiveness of which has been confirmed by credible evidence.

show abstract

“…Nebulized budesonide may also play a role as adjunct therapy to dexamethasone in the management of mild-moderate croup in the outpatient setting [99], but it does not add benefit in the treatment of children hospitalized with croup [100]. Conversely, the administration of high-dose fluticasone (2,000 micrograms) via metered dose inhaler (MDI) and spacer did not provide any clinical benefit in children with viral croup in a small RCT with 17 patients [101]. This might suggest that the correct use of MDI inhalers results in much less medication deposition in the upper airway and these devices may not be indicated for the treatment of stridor.…”

Section: Clinical Evidence Of the Use Of α-Ar Agonists And Gc In Tmentioning

confidence: 99%

Scientific Rationale for the Use of Alpha-Adrenergic Agonists and Glucocorticoids in the Therapy of Pediatric Stridor

Niño

Baloğlu

Gutiérrez

et al. 2011

International Journal of Otolaryngology

View full text Add to dashboard Cite

Purpose. The most common pharmacological therapies used in the treatment of stridor in children are glucocorticosteroids (GC) and alpha-adrenergic (αAR) agonists. Despite the long-standing reported efficacy of these medications, there is a paucity of data relating to their actual mechanisms of action in the upper airway. Summary. There is compelling scientific evidence supporting the use of αAR-agonists and GCs in pediatric stridor. αAR signaling and GCs regulate the vasomotor tone in the upper airway mucosa. The latter translates into better airflow dynamics, as delineated by human and nonhuman upper airway physiological models. In turn, clinical trials have demonstrated that GCs and the nonselective αAR agonist, epinephrine, improve respiratory distress scores and reduce the need for further medical care in children with stridor. Future research is needed to investigate the role of selective αAR agonists and the potential synergism of GCs and αAR-signaling in the treatment of upper airway obstruction and stridor.

show abstract

Effects of inhaled fluticasone propionate administered with metered dose inhaler and spacer in mild to moderate croup: a negative preliminary report

Cited by 19 publications

References 17 publications

Safety of corticosteroids in young children with acute respiratory conditions: a systematic review and meta-analysis

Safety of corticosteroids in young children with acute respiratory conditions: a systematic review and meta-analysis

Pharmacotherapy of Acute Stenosing Laryngotracheitis. What Drugs Are Data-Based?

Scientific Rationale for the Use of Alpha-Adrenergic Agonists and Glucocorticoids in the Therapy of Pediatric Stridor

Contact Info

Product

Resources

About