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Evidence summaries

Prophylactic Inhaled Steroids in Childhood Asthma

Prophylactic inhaled steroids are effective in both improving clinical parameters peak flow rates in children with asthma. Level of evidence: "A"

A systematic review 1 including 24 placebo-controlled RCTs with a total of 1087 children aged 0 - 18 years was abstracted in DARE.

The overall weighted relative improvement in mean (RIM) total symptom score (15 trials) was 50% (95% CI 49% to 51%). Overall weighted RIM cough score (16 trials) was 24% (95% CI 23% to 25%). Overall weighted RIM wheeze score was 36% (95% CI 35% to 37%). Overall weighted relative decrease in mean beta-agonist use (14 trials) was 37% (95% CI 36% to 38%). Overall weighted absolute improvement in PEF rate was 11% predicted value (95% CI 9.5 to 12.5). There was no statistically significant difference in hospital admissions between steroid and placebo groups. All reported adverse effects were minor.

    References

    • Calpin C, Macarthur C, Stephens D, Feldman W, Parkin PC. Effectiveness of prophylactic inhaled steroids in childhood asthma: a systemic review of the literature. J Allergy Clin Immunol 1997 Oct;100(4):452-7. [PubMed] [DARE]

Primary/Secondary Keywords