Randomized Trial of Dexamethasone Versus Prednisone for Children with Acute Asthma Exacerbations

Paniagua, Natalia; Lopez, Rebeca; Muñoz, Natalia Lorenzo; Tames, Miriam; Mojica, Elisa; Arana-Arri, Eunate; Mintegi, Santiago; Benito, Javier

doi:10.1016/j.jpeds.2017.08.030

Cited by 45 publications

(51 citation statements)

References 35 publications

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“…Three studies evaluated intramuscular dexamethasone vs. prednisone and hence were excluded (9,11,12). A total of seven unique articles were included in this systematic review and meta-analysis (1,7,13,(18)(19)(20)(21).…”

Section: Resultsmentioning

confidence: 99%

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Oral Dexamethasone vs. Oral Prednisone for Children With Acute Asthma Exacerbations: A Systematic Review and Meta-Analysis

Wei

Han

et al. 2019

Front. Pediatr.

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Background: This systematic review and meta-analysis was conducted to compare relapse rates and adverse effects with oral dexamethasone vs. oral prednisone for acute asthma exacerbations in pediatric patients. Methods:A computerized literature search of PubMed, Embase, Scopus, CENTRAL (Cochrane Central Register of Controlled Trials) and Google scholar databases was carried out till 1st August 2019. Six Randomized controlled trials (RCTs) and 1 quasi-RCT were included. Dosage of dexamethasone and prednisone varied across studies. Studies were grouped based on the follow-up period and duration of dexamethasone administration.Results: There was no significant difference in the relapse rate between dexamethasone and prednisone at 1-5 days (RR 1.46, 95%CI 0.69-3.7, P = 0.32; I 2 = 0%) and 10-15 days of follow up (RR 1.16, 95%CI 0.80-1.68, P = 0.44; I 2 = 0%). Pooled analysis found no significant difference in relapse rates with 1-day (RR 1.15, 95%CI 0.68-1.95, P = 0.60; I 2 = 0%) and 2-day dosage of dexamethasone (RR 1.25, 95%CI 0.82-1.92, P = 0.30; I 2 = 0%) compared to prednisone. Hospital readmission rates after initial discharge were not significantly different between the two drugs (RR 1.49, 95%CI 0.56-4.01, P = 0.43; I 2 = 0%). Frequency of vomiting at ED (RR 0.21, 95%CI 0.05-0.96, P = 0.04; I 2 = 50%) and at home (RR 0.42, 95%CI 0.25-0.69, P = 0.0007; I 2 = 0%) was significantly higher with prednisone as compared to dexamethasone.Conclusion: While our results indicate that both dexamethasone and prednisone have similar relapse rates when used for acute asthmatic exacerbations, strong conclusions cannot be drawn due to paucity of large scale RCTs and limited quality of evidence. Dexamethasone is however associated with lower incidence of vomiting as compared to prednisone. Further homogenous RCTs are needed to provide robust evidence on this topic.

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Section: Resultsmentioning

confidence: 99%

“…Details of individual studies are presented in Table 1. There were six RCTs (1,13,(18)(19)(20)(21) and one quasi-RCT (7). All trials included pediatric patients, however, the age group varied across studies.…”

Section: Resultsmentioning

confidence: 99%

Oral Dexamethasone vs. Oral Prednisone for Children With Acute Asthma Exacerbations: A Systematic Review and Meta-Analysis

Wei

Han

et al. 2019

Front. Pediatr.

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“…One more trial comparing prednisone and dexamethasone has been recently published [10]. The trial characteristics are compared to the previous trials in VOLUME 55 __ …”

Section: Evidence-based Medicine Viewpointmentioning

confidence: 99%

Oral Dexamethasone versus Oral Prednisolone in Acute Asthma: A New Randomized Controlled Trial and Updated Meta-analysis

Mathew

2018

Indian Pediatr

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“…Asthmatic children may be more responsive to systemic corticosteroids than adults, perhaps reflecting reduced reversibility of asthma with age. 20 Paniaqua et al 21 Research continues on the development or refinement of inhaled corticosteroid formulations and biological agents. The efficacy and safety of inhaled mometasone furoate were assessed in a multi-center, double-blind, placebo-controlled trial that enrolled 578 children aged 5-11 years with persistent asthma.…”

Section: -Year-old Children With Asthma; Intraclass Correlation Coefmentioning

confidence: 99%

“…Asthmatic children may be more responsive to systemic corticosteroids than adults, perhaps reflecting reduced reversibility of asthma with age . Paniaqua et al conducted a randomized, noninferiority trial including patients aged 1‐14 years who presented to the ED with acute asthma to compare the efficacy of two doses of dexamethasone (0.6 mg/kg/dose) versus a 5‐day course of prednisolone (1.5 mg/kg/d, followed by 1 mg/kg/d on days 2‐5). At Day 7, the groups did not show differences related to persistence of symptoms, quality of life score, admission rate, or other parameters.…”

Section: Introductionmentioning

confidence: 99%

Pediatric Pulmonology year in review 2017: Part 3

Ren

Muston

Yılmaz

et al. 2018

Pediatric Pulmonology

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Our journal covers a broad range of research and scholarly topics related to children's respiratory disorders. For updated perspectives on the rapidly expanding knowledge in our field, we will summarize the past year's publications in our major topic areas, as well as selected publications in these areas from the core clinical journal literature outside our own pages. The current review covers articles on neonatal lung disease, pulmonary physiology, and respiratory infection.Word count: 71 3

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Randomized Trial of Dexamethasone Versus Prednisone for Children with Acute Asthma Exacerbations

Cited by 45 publications

References 35 publications

Oral Dexamethasone vs. Oral Prednisone for Children With Acute Asthma Exacerbations: A Systematic Review and Meta-Analysis

Oral Dexamethasone vs. Oral Prednisone for Children With Acute Asthma Exacerbations: A Systematic Review and Meta-Analysis

Oral Dexamethasone versus Oral Prednisolone in Acute Asthma: A New Randomized Controlled Trial and Updated Meta-analysis

Pediatric Pulmonology year in review 2017: Part 3

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