ArticleThe Journal of allergy and clinical immunology2013
Do oral corticosteroids reduce the severity of acute lower respiratory tract illnesses in preschool children with recurrent wheezing?
Article in The Journal of allergy and clinical immunology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy of oral corticosteroids in the treatment of acute wheezing episodes in asthmatic preschoolers: Systematic review with meta-analysis.Pediatric pulmonology · 2016Pooled it
- Trial
- Management of Preschool Wheezing: Guideline from the Emilia-Romagna Asthma (ERA) Study Group.Journal of clinical medicine · 2022Article
- Prospective Observational Study of Clinical Outcomes After Intravenous Magnesium for Moderate and Severe Acute Asthma Exacerbations in Children.The journal of allergy and clinical immunology. In practice · 2022Observational
- Azithromycin during Wheezing Illnesses among Preschool Children: Does the Airway Microbiota Provide Insights into Mechanism?American journal of respiratory and critical care medicine · 2021Article
- Myths and maxims in paediatric respiratory medicine.Breathe (Sheffield, England) · 2018Article
- Management of preschool recurrent wheezing and asthma: a phenotype-based approach.Current opinion in allergy and clinical immunology · 2017Review
- Macrolides for Acute Wheezing Episodes in Preschool Children.Pediatric allergy, immunology, and pulmonology · 2016Article
- Prevalence, Severity, and Treatment of Recurrent Wheezing During the First Year of Life: A Cross-Sectional Study of 12,405 Latin American Infants.Allergy, asthma & immunology research · 2016Article
- Asthma.Nature reviews. Disease primers · 2015Review
- Virus-induced modulation of lower airway diseases: pathogenesis and pharmacologic approaches to treatment.Pharmacology & therapeutics · 2015Review
- Emerging issues in pediatric asthma: gaps in EPR-3 guidelines for infants and children.Current allergy and asthma reports · 2014Review
- An update on the efficacy of oral corticosteroids in the treatment of wheezing episodes in preschool children.Therapeutic advances in respiratory disease · 2014Review
- Empowering the child and caregiver: yellow zone Asthma Action Plan.Current allergy and asthma reports · 2014Article
- Recurrent wheezing is associated with intestinal protozoan infections in Warao Amerindian children in Venezuela: a cross-sectional survey.BMC infectious diseases · 2014Article
- The challenge of treating preschool wheezing episodes: the need for evidence-based approaches.The Journal of allergy and clinical immunology · 2014Article
- Advances in pediatric asthma in 2013: coordinating asthma care.The Journal of allergy and clinical immunology · 2014Article
- Infection-induced wheezing in young children.The Journal of allergy and clinical immunology · 2014Article
- Management of Preschool Children with Recurrent Wheezing: Lessons from the NHLBI's Asthma Research Networks.The journal of allergy and clinical immunology. In practiceReview
- Update on the utility of corticosteroids in acute pediatric respiratory disorders.Allergy and asthma proceedingsReview
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14 authors.
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Abstract
backgroundOral corticosteroids (OCSs) are recommended for severe wheezing episodes in children. However, limited evidence supports this intervention in preschool children with outpatient wheezing illnesses.
objectiveWe sought to investigate whether OCSs reduce symptom scores during acute lower respiratory tract illnesses (LRTIs) in preschool children with recurrent wheeze.
methodsWe performed post hoc and replication analyses in 2 outpatient cohorts of children aged 1 to 5 years with episodic wheezing participating in clinical trials. We compared symptom scores during LRTIs that were or were not treated with OCSs, adjusting for differences in disease and episode severity covariates. We stratified episodes by severity by using a propensity model. The primary outcome was the area under the curve (AUC) of total symptom scores among the more severe episodes.
resultsTwo hundred fifteen participants from the Acute Intervention Management Strategies trial experienced 798 acute LRTIs, 112 of which were defined as severe based on propensity scores. The AUCs of total symptom scores did not differ between the episodes that were (n = 70) and were not (n = 42) treated with OCSs (P = .46) nor was there an OCS treatment effect on individual symptom scores. Similar analyses of the Maintenance Versus Intermittent Inhaled Corticosteroids in Wheezing Toddlers trial, involving 278 participants with 133 severe LRTIs, confirmed the above findings (P = .46 for AUC of total symptoms score comparison).
conclusionIn 2 separate cohorts of preschool children with episodic wheezing, OCS treatment during clinically significant LRTIs did not reduce symptom severity during acute LRTIs, despite asthma controller medication use during most episodes. These findings need to be confirmed in a prospective randomized controlled trial.
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