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Efficacy and safety of inhalation budesonide in the treatment of pediatric asthma in the emergency department: a systematic review and meta-analysis

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A Correction to this article was published on 19 May 2020

This article has been updated

Abstract

Background

This study was aimed to evaluate the beneficial role of inhalation budesonide(BUD) in improving the pulmonary functions, and reducing the hospital admission rate, worsening of asthma and commonly encountered adverse events in pediatric asthma.

Methods

The electronic search was performed using PubMed, Scopus, CENTRAL (Cochrane Central Register of Controlled Trials) and Google scholar databases to identify the randomized control trials(RCTs).

Results

21 RCTs involving 12,787 subjects were included. The meta-analysis revealed that the BUD has reduced the hospitalization rate (Mantel–Haenszel (M–H), random effects odd ratio (RE-OR) of 0.34, p = 0.003, I2 = 75%), and worsening of asthma (M–H, RE-OR 0.38, p = 0.001, I2 = 73%); significantly improved the pulmonary functions such as FEV1 (Inverse variance (IV): 1.05, p < 0.0001, I2 = 94%), PEFR (IV: 1.40, p < 0.0001, I2 = 87%), morning PEF (IV: 1.04, p < 0.0001, I2 = 91%), and evening PEF (IV: 1.29, p < 0.0001, I2 = 92%) compared to control. Further, the incidences of adverse events like Pharyngitis (M–H, RE-OR 0.88, at 95% CI, p = 0.69, I2 = 0%), Sinusitis (M–H, RE-OR 0.78, p = 0.79, I2 = 0%), Respiratory infections (M–H, RE-OR 0.96, p = 0.46, I2 = 0%), Otitis media (M–H, RE-OR 0.82, p = 0.32, I2 = 12%) and Fever (M–H, RE-OR 0.78, p = 0.64, I2 = 0%) were almost same between BUD and control.

Conclusion

The outcomes of the meta-analysis suggest that high-dose inhalation BUD could benefit the pediatric patients in minimizing the worsening of asthma and hospitalization rate, along with improving the pulmonary functions, with negligible adverse drug reactions.

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Change history

  • 19 May 2020

    The original version of this article, published on 29 March 2020 unfortunately contains a mistake.

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Authors and Affiliations

  1. No.387/511/A, Megalabeedi, Kengeri, Bangalore, Karnataka, 560 060, India

    Gollapalle Lakshminarayanashastry Viswanatha

  2. Kengeri, Bangalore, 560060, India

    Hanumanthappa Shylaja

  3. Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal, 576104, India

    Krishnadas Nandakumar

  4. Connexios Life Sciences Pvt. Ltd, Bangalore, 560060, India

    Marikunte Venkatanarasappa Venkataranganna

  5. OT and PRI, JNT University Anantapur, Ananthapuramu, 515002, India

    Nunna Bheema Lingeswara Prasad

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  1. Gollapalle Lakshminarayanashastry Viswanatha
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Viswanatha, G.L., Shylaja, H., Nandakumar, K. et al. Efficacy and safety of inhalation budesonide in the treatment of pediatric asthma in the emergency department: a systematic review and meta-analysis. Pharmacol. Rep 72, 783–798 (2020). https://doi.org/10.1007/s43440-020-00098-y

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