Trial reportThe New England journal of medicine2011
Daily or intermittent budesonide in preschool children with recurrent wheezing.
Trial report in The New England journal of medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 75 papers, 5 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.
Childhood Asthma Research and Education (CARE) Network Trial - Maintenance Versus Intermittent Inhaled Steroids in Wheezing Toddlers (MIST)
Randomized, Placebo-controlled, Multicenter Study to Assess the Efficacy, Safety and Tolerability of ORal Bacterial EXtract for the Prevention of Wheezing Lower Respiratory Tract Illness (ORBEX)
Who cites it
75 citing papers in PubMed, 5 syntheses or guidelines pooled it, 213 citations in OpenAlex.
- Establishing the best step-up treatments for children with uncontrolled asthma despite inhaled corticosteroids: the EINSTEIN systematic review, network meta-analysis and cost-effectiveness analysis using individual participant data.Health technology assessment (Winchester, England) · 2025Pooled it
- Cost-utility analysis of daily versus intermittent inhaled corticosteroids in mild-persistent asthma.Pediatric pulmonology · 2015Pooled it
- Intermittent inhaled corticosteroid therapy versus placebo for persistent asthma in children and adults.The Cochrane database of systematic reviews · 2015Pooled it
- Intermittent versus daily inhaled corticosteroids for persistent asthma in children and adults.The Cochrane database of systematic reviews · 2013Pooled it
- Canadian Thoracic Society 2012 guideline update: diagnosis and management of asthma in preschoolers, children and adults.Canadian respiratory journalGuideline
- Efficacy of three different budesonide treatments in Chinese preschool children with recurrent wheezing.Scientific reports · 2022Trial
- [Effect of intermittent versus daily inhalation of budesonide on pulmonary function and fractional exhaled nitric oxide in children with mild persistent asthma].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2020Trial
- Phenotypes of Recurrent Wheezing in Preschool Children: Identification by Latent Class Analysis and Utility in Prediction of Future Exacerbation.The journal of allergy and clinical immunology. In practice · 2019Trial
- Quintupling Inhaled Glucocorticoids to Prevent Childhood Asthma Exacerbations.The New England journal of medicine · 2018Trial
- Individualized therapy for persistent asthma in young children.The Journal of allergy and clinical immunology · 2016Trial
- Trial
- Discrepancies between medical record data and parent reported use of preventive asthma medications.The Journal of asthma : official journal of the Association for the Care of Asthma · 2014Trial
- The association between vitamin D status and the rate of exacerbations requiring oral corticosteroids in preschool children with recurrent wheezing.The Journal of allergy and clinical immunology · 2014Trial
- Evidence-based guideline for clinical practice in the diagnosis, treatment, management, and prevention of recurrent wheezing in infants and toddlers in China.Pediatric investigation · 2026Article
- Plasma metabolomics identifies differing endotypes of recurrent wheezing in preschool children differentiated by symptoms and social disadvantage.Scientific reports · 2024Article
- Questions in Mild Asthma: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2023Article
- Blood Eosinophils for Prediction of Exacerbation in Preschool Children With Recurrent Wheezing.The journal of allergy and clinical immunology. In practice · 2023Article
- Approaches to Management of Asthma: Guidelines for Stepped Care and Self-Monitoring.Advances in experimental medicine and biology · 2023Article
- Diagnosis and management of asthma in infants and preschoolers.Clinical and experimental pediatrics · 2022Article
- Healthcare Use in the Year Following Bronchiolitis Hospitalization.Hospital pediatrics · 2022Observational
15 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
25 authors at 10 institutions in 1 country.
Funding
Abstract
backgroundDaily inhaled glucocorticoids are recommended for young children at risk for asthma exacerbations, as indicated by a positive value on the modified asthma predictive index (API) and an exacerbation in the preceding year, but concern remains about daily adherence and effects on growth. We compared daily therapy with intermittent therapy.
methodsWe studied 278 children between the ages of 12 and 53 months who had positive values on the modified API, recurrent wheezing episodes, and at least one exacerbation in the previous year but a low degree of impairment. Children were randomly assigned to receive a budesonide inhalation suspension for 1 year as either an intermittent high-dose regimen (1 mg twice daily for 7 days, starting early during a predefined respiratory tract illness) or a daily low-dose regimen (0.5 mg nightly) with corresponding placebos. The primary outcome was the frequency of exacerbations requiring oral glucocorticoid therapy.
resultsThe daily regimen of budesonide did not differ significantly from the intermittent regimen with respect to the frequency of exacerbations, with a rate per patient-year for the daily regimen of 0.97 (95% confidence interval [CI], 0.76 to 1.22) versus a rate of 0.95 (95% CI, 0.75 to 1.20) for the intermittent regimen (relative rate in the intermittent-regimen group, 0.99; 95% CI, 0.71 to 1.35; P=0.60). There were also no significant between-group differences in several other measures of asthma severity, including the time to the first exacerbation, or adverse events. The mean exposure to budesonide was 104 mg less with the intermittent regimen than with the daily regimen.
conclusionsA daily low-dose regimen of budesonide was not superior to an intermittent high-dose regimen in reducing asthma exacerbations. Daily administration led to greater exposure to the drug at 1 year. (Funded by the National Heart, Lung, and Blood Institute and others; MIST ClinicalTrials.gov number, NCT00675584.).
Indexed as
Identifiers
What OpenQuestion holds
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.