ArticlePediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology2026
Early initiation of inhaled corticosteroid-long-acting β
Article in Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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Who cites it
1 citing paper in PubMed.
- Early initiation of inhaled corticosteroid-long-acting βPediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026Article
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3 authors.
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Abstract
backgroundEvidence supporting inhaled corticosteroid plus long-acting β
objectiveTo evaluate short- and long-term effectiveness of ICS + LABA initiation on severe asthma exacerbations (SAEs) and determine whether early-life asthma risk burden modifies treatment response.
methodsWe conducted a retrospective longitudinal cohort study using electronic health record data from the Indiana Network for Patient Care (2010-2024). Children aged ≤11 years with asthma who initiated ICS + LABA between 2010 and 2023 and had ≥12 months of pre- and post-initiation follow-up were included. The primary outcome was ≥1 SAE per year, defined per ATS/ERS criteria as asthma-related hospitalization or emergency department admission. Piecewise generalized linear mixed-effects models estimated annualized changes in SAE odds before versus after ICS + LABA initiation. Recurrent events were analyzed using Andersen-Gill models. Effect modification by age at diagnosis, age at prior ICS initiation, and early-life asthma risk burden (passive digital marker [PDM] score) was assessed.
resultsAmong 249 children (mean age at asthma diagnosis 2 years; at ICS + LABA initiation 5 years), annualized SAE incidence increased before initiation and declined thereafter. Adjusted SAE odds decreased by 15% per year following ICS + LABA initiation (aOR 0.85; 95% CI 0.58-0.98). Recurrent-event modeling demonstrated a 68% reduction in SAE hazard after ICS + LABA initiation (aHR 0.32; 95% CI 0.26-0.38), exceeding reductions observed with ICS alone (aHR 0.49). Treatment benefit was greatest among children initiating ICS before age 5 years (aOR 0.77; 95% CI 0.65-0.92) and those with high early-life asthma risk burden (aOR 0.80; 95% CI 0.67-0.97). No significant heterogeneity was observed by sex, race, or formulation.
conclusionsICS + LABA initiation was associated with sustained reductions in severe exacerbations, including among preschool children, in real-world clinical practice. These findings suggest that strict age-based treatment restrictions may not fully capture heterogeneity in exacerbation risk and support further prospective evaluation of risk-stratified escalation strategies.
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