Evidence map›Paper›PMID 41168642›Full record

Observational studyPharmacoepidemiology and drug safety2025

Comparative Risk for Neuropsychiatric Events in Leukotriene Receptor Antagonist vs. Inhaled Corticosteroid in Children With Asthma: A Nationwide Observational Study With a Complementary Analysis Using Natural Language Processing.

Subin Kim, Chang Hoon Han, Junhyuk Chang, Jaehyeong Cho, Kyunguk Jeong, Hamin Kim, Mireu Park, Soo Yeon Kim, Jong Deok Kim, Myung Hyun Sohn and 4 more

Abstract readObservational StudyComparative StudyMulticenter Study
In one paragraph

Observational study in Pharmacoepidemiology and drug safety, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Subin KimDepartment of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea.
Chang Hoon HanDepartment of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea.
Junhyuk ChangDepartment of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, South Korea.
Jaehyeong ChoDepartment of Research, Keimyung University Dongsan Medical Center, Daegu, South Korea.
Kyunguk JeongDepartment of Pediatrics, Ajou University School of Medicine, Suwon, South Korea.
Hamin KimDepartment of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Mireu ParkDepartment of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Soo Yeon KimDepartment of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Jong Deok KimDepartment of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Myung Hyun SohnDepartment of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Sooyoung LeeDepartment of Pediatrics, Ajou University School of Medicine, Suwon, South Korea.
Rae Woong ParkDepartment of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, South Korea.
Seng Chan YouDepartment of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea.ORCID 0000-0002-5052-6399
Kyung Won KimInstitute for Innovation in Digital Healthcare, Yonsei University, Seoul, South Korea.

Funding

Ministry of Food and Drug Safety 22213MFDS486Ministry of Health and Welfare (Ministry of Health, Welfare and Family Affairs), South Korea.National Research Foundation of Korea RS-2024-00341426
6 · The paper itself

Abstract

purposeLeukotriene receptor antagonists (LTRAs) are widely prescribed as controller medications for pediatric asthma. However, there have been increasing concerns about potential neuropsychiatric adverse reactions associated with LTRAs. Findings from observational studies have been inconsistent, and direct comparisons of the risk of neuropsychiatric events (NPEs) between LTRAs and inhaled corticosteroids (ICS) remain limited in the pediatric population.

methodsA retrospective cohort study was conducted utilizing a nationwide claims database (January 2018-April 2022) and a multicenter electronic health record (EHR) database (January 2006-March 2022) from South Korea. Patients aged 5-18 years diagnosed with asthma before initiating LTRA or ICS were included. The primary outcome was NPEs within 90 days of exposure, defined using two methods: diagnostic code-based analysis and natural language processing (NLP)-based analysis using clinical notes. After propensity score stratification, Cox proportional hazards models were used to estimate risks.

resultsThe diagnostic code-based analysis on the claims database included 169 636 LTRA users and 28 845 ICS users. There was no statistically significant difference in the risk of NPEs between LTRA and ICS (calibrated hazard ratios [HRs], 1.14 [95% CI, 0.92-1.42]). In the NLP-based analysis using EHR database, 1641 LTRA users and 1607 ICS users were included. The results were consistent with those of the diagnostic code-based analysis (calibrated HR, 1.33 [95% CI, 0.66-2.68]).

conclusionsLTRA use was not found to be associated with a significantly increased risk of NPEs in children with asthma. These findings offer valuable insights to support clinical decision-making in pediatric asthma treatment.

Indexed as

Adrenal Cortex HormonesAnti-Asthmatic AgentsAsthmaLeukotriene AntagonistsMental DisordersAdministration, InhalationAdolescentChildChild, PreschoolDatabases, FactualElectronic Health RecordsFemaleHumansMaleNatural Language ProcessingRepublic of KoreaAdrenal Cortex HormonesAnti-Asthmatic AgentsLeukotriene Antagonistsdrug‐related side effects and adverse reactionsleukotriene antagonistsnatural language processing

Identifiers

PMID41168642
PMCPMC12575417

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.