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Evidence summaries

Inhaled Corticosteroids for Prevention of Exercise Induced Bronchoconstriction

Inhaled corticosteroids given for at least 4 weeks may attenuate exercise-induced bronchoconstriction in both adults and children. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 8 studies (2 involving adults, 6 children) with a total of 162 participants. Combining results from the 3 parallel studies with at least 4 weeks duration of inhaled corticosteroids, the use of inhaled corticosteroids significantly attenuated the percent fall index in forced expiratory volume in 1 second (WMD 11.74%; 95% CI 10.06% to 13.42%; statistical heterogeneity I2 81%). The result from one crossover study with duration of inhaled corticosteroids of 4 weeks revealed significant attenuation of percent fall in forced expiratory volume in 1 second (WMD 6.90%; 95% CI 1.40% to 12.40%) and the percent fall in peak expiratory flow (WMD 11.50%; 95% CI 6.31% to 16.69%). The small amount of data from placebo-controlled trials using a single treatment do not currently allow conclusions to be drawn.

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment) and by imprecice results (few patients).

    References

    • Koh MS, Tee A, Lasserson TJ, Irving LB. Inhaled corticosteroids compared to placebo for prevention of exercise induced bronchoconstriction. Cochrane Database Syst Rev 2007;(3):CD002739 [Review content assessed as up-to-date: 28 October 2008]. [PubMed]

Primary/Secondary Keywords