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ORIGINAL ARTICLE
Year : 2020  |  Volume : 13  |  Issue : 2  |  Page : 161-166

Role of inhaled corticosteroids for asthma exacerbation in children: An updated meta-analysis


1 Department of Biochemistry, Faculty of Medicine; Sleep Apnea Research Group, Research Center in Back, Neck and Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand
2 Sleep Apnea Research Group, Research Center in Back, Neck and Other Joint Pain and Human Performance; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
3 Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
4 Department of Pediatrics, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA

Correspondence Address:
Kittisak Sawanyawisuth
Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JETS.JETS_116_19

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Background: Several studies showed that inhaled corticosteroids (ICS) may be a potential treatment in acute asthma exacerbation in children. This study was an update meta-analysis on the roles of ICS in the management of acute asthma exacerbation in children presenting to the hospital. Materials and Methods: Published articles with key words of ICS for asthma exacerbation, asthma attacks, and acute asthma in children aged under 18 years in the hospital setting with outcome of hospital admission between 2009 and 2018 were enrolled. The databases used in this study were Medline, Scopus, and Web of Science. Odds ratio of comparison between ICS and other treatments on hospital admissions was calculated. Results: There were 311 eligible studies met the searching criteria; seven eligible studies for the analysis; comprised of three meta-analysis and four added studies. The ICS had a significant reduction in hospital admission compared with placebo in overall with odds ratio of 0.63 (95% confidence interval [CI]: 0.41–0.96) and in moderate-to-severe group with odds ratio of 0.17 (95% CI: 0.05–0.51). Comparing with systemic corticosteroid (SC), ICS had significantly lower hospital admissions overall and in mild-to-moderate group with odds ratios of 0.63 and 0.26, respectively. The combination of ICS and SC had odds ratio of 0.75 (95% CI: 0.57–0.99) over SC in moderate-to-severe asthma exacerbation. Conclusions: ICS significantly reduced hospital admission in asthma exacerbation in children. It may be used alone for mild-to-moderate asthma exacerbation and combination with SC for moderate-to-severe asthma exacerbation.


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