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Effect of budesonide on hospitalization rates among children with acute asthma attending paediatric emergency department: a systematic review and meta-analysis

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Abstract

Introduction

The efficacy of inhaled budesonide for managing moderate-to-severe acute exacerbations in children is not clear. Therefore, this study aimed to evaluate hospital admission rates, need for use of systemic corticosteroids, length of hospital stay and adverse events when inhaled budesonide is added to standard pediatric emergency department management of moderate-to-severe acute exacerbations of asthma.

Methods

A systematic search was conducted in PubMed, Scopus, CENTRAL (Cochrane Central Register of Controlled Trials) and Google scholar databases. Randomized controlled trials that evaluated the effect of nebulized budesonide in moderate-to-severe acute exacerbations of asthma in pediatric patients were included for this meta-analysis. Statistical analysis was done using STATA version 13.0.

Results

A total of 16 RCTs were included. Children receiving nebulized budesonide had 43% lower risk of being hospitalized (RR 0.57; 95% CI, 0.39; 0.85) and 66% lower risk of requiring systemic corticosteroids (RR 0.34; 95 % CI, 0.21; 0.55) compared with those receiving placebo. There were no differences in the length of hospital stay (Hedges’s g standardized mean difference − 1.53; 95% CI, − 3.64; 0.58) and risk of adverse events (RR 0.87, 95% CI; 0.65; 1.17) between the two groups. There was no evidence of publication bias for any of the outcomes considered.

Conclusion

The findings of this meta-analysis support the use of inhaled budesonide in reducing risk of hospitalization and the need for systemic corticosteroids among children with acute moderate-to-severe asthma exacerbation.

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Authors and Affiliations

  1. Department of Pediatrics, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Rd, Liaoning Province, Dalian, 116011, China

    Cheng-Yao Li & Zhang Liu

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  1. Cheng-Yao Li
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  2. Zhang Liu
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Contributions

CL designed the project; CL and ZL were involved in data collection and data analysis; CL prepared the manuscript; ZL edited the manuscript; all authors read and approved the final manuscript.

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Correspondence to Zhang Liu.

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Li, CY., Liu, Z. Effect of budesonide on hospitalization rates among children with acute asthma attending paediatric emergency department: a systematic review and meta-analysis. World J Pediatr 17, 152–163 (2021). https://doi.org/10.1007/s12519-020-00403-y

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  • DOI: https://doi.org/10.1007/s12519-020-00403-y

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