Trial reportThe Journal of allergy and clinical immunology2008
Factors associated with asthma exacerbations during a long-term clinical trial of controller medications in children.
Trial report in The Journal of allergy and clinical immunology, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
65 citing papers in PubMed, 7 syntheses or guidelines pooled it, 171 citations in OpenAlex.
- Pooled it
- The predictive value of impulse oscillometry for asthma exacerbations in childhood: A systematic review and meta-analyses.Pediatric pulmonology · 2021Pooled it
- Pooled it
- Predictors of repeated acute hospital attendance for asthma in children: A systematic review and meta-analysis.Pediatric pulmonology · 2018Pooled it
- Addition of long-acting beta2-agonists to inhaled corticosteroids for chronic asthma in children.The Cochrane database of systematic reviews · 2015Pooled it
- Addition to inhaled corticosteroids of long-acting beta2-agonists versus anti-leukotrienes for chronic asthma.The Cochrane database of systematic reviews · 2014Pooled it
- Anti-leukotriene agents compared to inhaled corticosteroids in the management of recurrent and/or chronic asthma in adults and children.The Cochrane database of systematic reviews · 2012Pooled it
- Trial
- Predictors of asthma exacerbation among patients with poorly controlled asthma despite inhaled corticosteroid treatment.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2016Trial
- The association between seasonal asthma exacerbations and viral respiratory infections in a pediatric population receiving inhaled corticosteroid therapy with or without long-acting beta-adrenoceptor agonist: a randomized study.Respiratory medicine · 2015Trial
- Development and validation of the Composite Asthma Severity Index--an outcome measure for use in children and adolescents.The Journal of allergy and clinical immunology · 2012Trial
- Most nocturnal asthma symptoms occur outside of exacerbations and associate with morbidity.The Journal of allergy and clinical immunology · 2011Trial
- Predictors of symptoms are different from predictors of severe exacerbations from asthma in children.Chest · 2011Trial
- Predictors of poor response during asthma therapy differ with definition of outcome.Pharmacogenomics · 2009Trial
- Efficacy and safety of fluticasone propionate/formoterol fumarate in pediatric asthma patients: a randomized controlled trial.Therapeutic advances in respiratory diseaseTrial
- Pediatric Mild Asthma: Bridging Current Gaps to Improve Future Care.Pediatric pulmonology · 2026Review
- Article
- Immune Training of the Interleukin 6 Gene in Airway Epithelial Cells is Central to Asthma Exacerbations.Allergy · 2026Article
- Factors associated with asthma attack recurrence in Ecuadorian children: longitudinal study of potential impact of the COVID-19 pandemic lockdown.BMJ open respiratory research · 2025Article
- Using mHealth to Predict Asthma Exacerbations in Children and Adolescents (Mobile Health for Kids With Asthma): Protocol for an Observational Study.JMIR research protocols · 2025Article
5 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundAsthma exacerbations are a common cause of critical illness in children.
objectiveTo determine factors associated with exacerbations in children with persistent asthma.
methodsRegression modeling was used to identify historical, phenotypic, treatment, and time-dependent factors associated with the occurrence of exacerbations, defined by need for oral corticosteroids or emergency or hospital care in the 48-week Pediatric Asthma Controller Trial study. Children age 6 to 14 years with mild-to-moderate persistent asthma were randomized to receive either fluticasone propionate 100 microg twice daily (FP monotherapy), combination fluticasone 100 microg AM and salmeterol twice daily, or montelukast 5 mg once daily.
resultsOf the 285 participants randomized, 48% had 231 exacerbations. Using a multivariate analysis, which included numerous demographic, pulmonary, and inflammatory parameters, only a history of an asthma exacerbation requiring a systemic corticosteroid in the past year (odds ratio [OR], 2.10; P < .001) was associated with a subsequent exacerbation during the trial. During the trial, treatment with montelukast versus FP monotherapy (OR, 2.00; P = .005), season (spring, fall, or winter vs summer; P < or = .001), and average seasonal 5% reduction in AM peak expiratory flow (OR, 1.21; P = .01) were each associated with exacerbations. Changes in worsening of symptoms, beta-agonist use, and low peak expiratory flow track together before an exacerbation, but have poor positive predictive value of exacerbation.
conclusionChildren with mild-to-moderate persistent asthma with previous exacerbations are more likely to have a repeat exacerbation despite controller treatment. Inhaled corticosteroids are superior to montelukast at modifying the exacerbation risk. Available physiologic measures and biomarkers and diary card tracking are not reliable predictors of asthma exacerbations.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.