Dose response of inhaled corticosteroids in children with persistent asthma: a systematic review
Autor(a) principal: | |
---|---|
Data de Publicação: | 2011 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da FURG (RI FURG) |
Texto Completo: | http://repositorio.furg.br/handle/1/7018 |
Resumo: | To assess the dose-response relationship (benefits and harms) of inhaled corticosteroids (ICSs) in children with persistent asthma. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) that compared 2 doses of ICSs in children aged 3 to 18 years with persistent asthma. Medline was searched for articles published between 1950 and August 2009. Main outcomes of our analyses included morning and evening peak expiratory flow, forced expiratory volume in 1 second, asthma symptom score, 2-agonist use, withdrawal because of lack of efficacy, and adverse events. Meta-analyses were performed to compare moderate (300 – 400 g/day) with low ( 200 g/day beclomethasoneequivalent) doses of ICSs. RESULTS: Fourteen RCTs (5768 asthmatic children) that evaluated 5 ICSs were included. The pooled standardized mean difference from 6 trials revealed a small but statistically significant increase of moderate over low doses in improving forced expiratory volume in 1 second (standardized mean difference: 0.11 [95% confidence interval: 0.01– 0.21]) among children with mild-to-moderate asthma. There was no significant difference between 2 doses in terms of other efficacy outcomes. Local adverse events were uncommon, and there was no evidence of dose-response relationship at low-to-moderate doses. CONCLUSIONS: Compared with low doses, moderate doses of ICSs may not provide clinically relevant therapeutic advantage in children with mild-to-moderate persistent asthma. Additional RCTs are needed to clarify the dose-response relationship of ICSs in persistent childhood asthma. Pediatrics 2011;127:129–138 A |
id |
FURG_bb261386fc002df88f45f9b6dde5d9bf |
---|---|
oai_identifier_str |
oai:repositorio.furg.br:1/7018 |
network_acronym_str |
FURG |
network_name_str |
Repositório Institucional da FURG (RI FURG) |
repository_id_str |
|
spelling |
Zhang, LinjieAxelsson, IngeChung, MeiLau, Joseph2017-01-15T20:08:33Z2017-01-15T20:08:33Z2011ZHANG, Linjie et al. Dose response of inhaled corticosteroids in children with persistent asthma: a systematic review. Pediatrics, v. 127, p. 129-138, 2011. Disponível em: < http/ Dose+Response+of+Inhaled+Corticosteroids+in+Children+With+Persistent+Asthma.+A+Systematic+Review.+Pediatricas+2011.pdf>. Acesso em: 18 Dez. 2016.1098-4275http://repositorio.furg.br/handle/1/701810.1542/peds.2010-1223To assess the dose-response relationship (benefits and harms) of inhaled corticosteroids (ICSs) in children with persistent asthma. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) that compared 2 doses of ICSs in children aged 3 to 18 years with persistent asthma. Medline was searched for articles published between 1950 and August 2009. Main outcomes of our analyses included morning and evening peak expiratory flow, forced expiratory volume in 1 second, asthma symptom score, 2-agonist use, withdrawal because of lack of efficacy, and adverse events. Meta-analyses were performed to compare moderate (300 – 400 g/day) with low ( 200 g/day beclomethasoneequivalent) doses of ICSs. RESULTS: Fourteen RCTs (5768 asthmatic children) that evaluated 5 ICSs were included. The pooled standardized mean difference from 6 trials revealed a small but statistically significant increase of moderate over low doses in improving forced expiratory volume in 1 second (standardized mean difference: 0.11 [95% confidence interval: 0.01– 0.21]) among children with mild-to-moderate asthma. There was no significant difference between 2 doses in terms of other efficacy outcomes. Local adverse events were uncommon, and there was no evidence of dose-response relationship at low-to-moderate doses. CONCLUSIONS: Compared with low doses, moderate doses of ICSs may not provide clinically relevant therapeutic advantage in children with mild-to-moderate persistent asthma. Additional RCTs are needed to clarify the dose-response relationship of ICSs in persistent childhood asthma. Pediatrics 2011;127:129–138 AengInhaled corticosteroidsAsthmaDose-response relationshipTreatment efficacyAdverse eventSystematic reviewMeta-analysisDose response of inhaled corticosteroids in children with persistent asthma: a systematic reviewinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FURG (RI FURG)instname:Universidade Federal do Rio Grande (FURG)instacron:FURGORIGINALDose+Response+of+Inhaled+Corticosteroids+in+Children+With+Persistent+Asthma.+A+Systematic+Review.+Pediatricas+2011.pdfDose+Response+of+Inhaled+Corticosteroids+in+Children+With+Persistent+Asthma.+A+Systematic+Review.+Pediatricas+2011.pdfapplication/pdf523675https://repositorio.furg.br/bitstream/1/7018/1/Dose%2bResponse%2bof%2bInhaled%2bCorticosteroids%2bin%2bChildren%2bWith%2bPersistent%2bAsthma.%2bA%2bSystematic%2bReview.%2bPediatricas%2b2011.pdfa7e9ab397e984bc15c6d4d163cd49e81MD51open accessLICENSElicense.txtlicense.txttext/plain; charset=utf-81748https://repositorio.furg.br/bitstream/1/7018/2/license.txt8a4605be74aa9ea9d79846c1fba20a33MD52open access1/70182017-01-15 18:08:33.131open accessoai:repositorio.furg.br:1/7018Tk9URTogUExBQ0UgWU9VUiBPV04gTElDRU5TRSBIRVJFClRoaXMgc2FtcGxlIGxpY2Vuc2UgaXMgcHJvdmlkZWQgZm9yIGluZm9ybWF0aW9uYWwgcHVycG9zZXMgb25seS4KCk5PTi1FWENMVVNJVkUgRElTVFJJQlVUSU9OIExJQ0VOU0UKCkJ5IHNpZ25pbmcgYW5kIHN1Ym1pdHRpbmcgdGhpcyBsaWNlbnNlLCB5b3UgKHRoZSBhdXRob3Iocykgb3IgY29weXJpZ2h0Cm93bmVyKSBncmFudHMgdG8gRFNwYWNlIFVuaXZlcnNpdHkgKERTVSkgdGhlIG5vbi1leGNsdXNpdmUgcmlnaHQgdG8gcmVwcm9kdWNlLAp0cmFuc2xhdGUgKGFzIGRlZmluZWQgYmVsb3cpLCBhbmQvb3IgZGlzdHJpYnV0ZSB5b3VyIHN1Ym1pc3Npb24gKGluY2x1ZGluZwp0aGUgYWJzdHJhY3QpIHdvcmxkd2lkZSBpbiBwcmludCBhbmQgZWxlY3Ryb25pYyBmb3JtYXQgYW5kIGluIGFueSBtZWRpdW0sCmluY2x1ZGluZyBidXQgbm90IGxpbWl0ZWQgdG8gYXVkaW8gb3IgdmlkZW8uCgpZb3UgYWdyZWUgdGhhdCBEU1UgbWF5LCB3aXRob3V0IGNoYW5naW5nIHRoZSBjb250ZW50LCB0cmFuc2xhdGUgdGhlCnN1Ym1pc3Npb24gdG8gYW55IG1lZGl1bSBvciBmb3JtYXQgZm9yIHRoZSBwdXJwb3NlIG9mIHByZXNlcnZhdGlvbi4KCllvdSBhbHNvIGFncmVlIHRoYXQgRFNVIG1heSBrZWVwIG1vcmUgdGhhbiBvbmUgY29weSBvZiB0aGlzIHN1Ym1pc3Npb24gZm9yCnB1cnBvc2VzIG9mIHNlY3VyaXR5LCBiYWNrLXVwIGFuZCBwcmVzZXJ2YXRpb24uCgpZb3UgcmVwcmVzZW50IHRoYXQgdGhlIHN1Ym1pc3Npb24gaXMgeW91ciBvcmlnaW5hbCB3b3JrLCBhbmQgdGhhdCB5b3UgaGF2ZQp0aGUgcmlnaHQgdG8gZ3JhbnQgdGhlIHJpZ2h0cyBjb250YWluZWQgaW4gdGhpcyBsaWNlbnNlLiBZb3UgYWxzbyByZXByZXNlbnQKdGhhdCB5b3VyIHN1Ym1pc3Npb24gZG9lcyBub3QsIHRvIHRoZSBiZXN0IG9mIHlvdXIga25vd2xlZGdlLCBpbmZyaW5nZSB1cG9uCmFueW9uZSdzIGNvcHlyaWdodC4KCklmIHRoZSBzdWJtaXNzaW9uIGNvbnRhaW5zIG1hdGVyaWFsIGZvciB3aGljaCB5b3UgZG8gbm90IGhvbGQgY29weXJpZ2h0LAp5b3UgcmVwcmVzZW50IHRoYXQgeW91IGhhdmUgb2J0YWluZWQgdGhlIHVucmVzdHJpY3RlZCBwZXJtaXNzaW9uIG9mIHRoZQpjb3B5cmlnaHQgb3duZXIgdG8gZ3JhbnQgRFNVIHRoZSByaWdodHMgcmVxdWlyZWQgYnkgdGhpcyBsaWNlbnNlLCBhbmQgdGhhdApzdWNoIHRoaXJkLXBhcnR5IG93bmVkIG1hdGVyaWFsIGlzIGNsZWFybHkgaWRlbnRpZmllZCBhbmQgYWNrbm93bGVkZ2VkCndpdGhpbiB0aGUgdGV4dCBvciBjb250ZW50IG9mIHRoZSBzdWJtaXNzaW9uLgoKSUYgVEhFIFNVQk1JU1NJT04gSVMgQkFTRUQgVVBPTiBXT1JLIFRIQVQgSEFTIEJFRU4gU1BPTlNPUkVEIE9SIFNVUFBPUlRFRApCWSBBTiBBR0VOQ1kgT1IgT1JHQU5JWkFUSU9OIE9USEVSIFRIQU4gRFNVLCBZT1UgUkVQUkVTRU5UIFRIQVQgWU9VIEhBVkUKRlVMRklMTEVEIEFOWSBSSUdIVCBPRiBSRVZJRVcgT1IgT1RIRVIgT0JMSUdBVElPTlMgUkVRVUlSRUQgQlkgU1VDSApDT05UUkFDVCBPUiBBR1JFRU1FTlQuCgpEU1Ugd2lsbCBjbGVhcmx5IGlkZW50aWZ5IHlvdXIgbmFtZShzKSBhcyB0aGUgYXV0aG9yKHMpIG9yIG93bmVyKHMpIG9mIHRoZQpzdWJtaXNzaW9uLCBhbmQgd2lsbCBub3QgbWFrZSBhbnkgYWx0ZXJhdGlvbiwgb3RoZXIgdGhhbiBhcyBhbGxvd2VkIGJ5IHRoaXMKbGljZW5zZSwgdG8geW91ciBzdWJtaXNzaW9uLgo=Repositório InstitucionalPUBhttps://repositorio.furg.br/oai/request || http://200.19.254.174/oai/requestopendoar:2017-01-15T20:08:33Repositório Institucional da FURG (RI FURG) - Universidade Federal do Rio Grande (FURG)false |
dc.title.pt_BR.fl_str_mv |
Dose response of inhaled corticosteroids in children with persistent asthma: a systematic review |
title |
Dose response of inhaled corticosteroids in children with persistent asthma: a systematic review |
spellingShingle |
Dose response of inhaled corticosteroids in children with persistent asthma: a systematic review Zhang, Linjie Inhaled corticosteroids Asthma Dose-response relationship Treatment efficacy Adverse event Systematic review Meta-analysis |
title_short |
Dose response of inhaled corticosteroids in children with persistent asthma: a systematic review |
title_full |
Dose response of inhaled corticosteroids in children with persistent asthma: a systematic review |
title_fullStr |
Dose response of inhaled corticosteroids in children with persistent asthma: a systematic review |
title_full_unstemmed |
Dose response of inhaled corticosteroids in children with persistent asthma: a systematic review |
title_sort |
Dose response of inhaled corticosteroids in children with persistent asthma: a systematic review |
author |
Zhang, Linjie |
author_facet |
Zhang, Linjie Axelsson, Inge Chung, Mei Lau, Joseph |
author_role |
author |
author2 |
Axelsson, Inge Chung, Mei Lau, Joseph |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Zhang, Linjie Axelsson, Inge Chung, Mei Lau, Joseph |
dc.subject.por.fl_str_mv |
Inhaled corticosteroids Asthma Dose-response relationship Treatment efficacy Adverse event Systematic review Meta-analysis |
topic |
Inhaled corticosteroids Asthma Dose-response relationship Treatment efficacy Adverse event Systematic review Meta-analysis |
description |
To assess the dose-response relationship (benefits and harms) of inhaled corticosteroids (ICSs) in children with persistent asthma. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) that compared 2 doses of ICSs in children aged 3 to 18 years with persistent asthma. Medline was searched for articles published between 1950 and August 2009. Main outcomes of our analyses included morning and evening peak expiratory flow, forced expiratory volume in 1 second, asthma symptom score, 2-agonist use, withdrawal because of lack of efficacy, and adverse events. Meta-analyses were performed to compare moderate (300 – 400 g/day) with low ( 200 g/day beclomethasoneequivalent) doses of ICSs. RESULTS: Fourteen RCTs (5768 asthmatic children) that evaluated 5 ICSs were included. The pooled standardized mean difference from 6 trials revealed a small but statistically significant increase of moderate over low doses in improving forced expiratory volume in 1 second (standardized mean difference: 0.11 [95% confidence interval: 0.01– 0.21]) among children with mild-to-moderate asthma. There was no significant difference between 2 doses in terms of other efficacy outcomes. Local adverse events were uncommon, and there was no evidence of dose-response relationship at low-to-moderate doses. CONCLUSIONS: Compared with low doses, moderate doses of ICSs may not provide clinically relevant therapeutic advantage in children with mild-to-moderate persistent asthma. Additional RCTs are needed to clarify the dose-response relationship of ICSs in persistent childhood asthma. Pediatrics 2011;127:129–138 A |
publishDate |
2011 |
dc.date.issued.fl_str_mv |
2011 |
dc.date.accessioned.fl_str_mv |
2017-01-15T20:08:33Z |
dc.date.available.fl_str_mv |
2017-01-15T20:08:33Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
ZHANG, Linjie et al. Dose response of inhaled corticosteroids in children with persistent asthma: a systematic review. Pediatrics, v. 127, p. 129-138, 2011. Disponível em: < http/ Dose+Response+of+Inhaled+Corticosteroids+in+Children+With+Persistent+Asthma.+A+Systematic+Review.+Pediatricas+2011.pdf>. Acesso em: 18 Dez. 2016. |
dc.identifier.uri.fl_str_mv |
http://repositorio.furg.br/handle/1/7018 |
dc.identifier.issn.none.fl_str_mv |
1098-4275 |
dc.identifier.doi.pt_BR.fl_str_mv |
10.1542/peds.2010-1223 |
identifier_str_mv |
ZHANG, Linjie et al. Dose response of inhaled corticosteroids in children with persistent asthma: a systematic review. Pediatrics, v. 127, p. 129-138, 2011. Disponível em: < http/ Dose+Response+of+Inhaled+Corticosteroids+in+Children+With+Persistent+Asthma.+A+Systematic+Review.+Pediatricas+2011.pdf>. Acesso em: 18 Dez. 2016. 1098-4275 10.1542/peds.2010-1223 |
url |
http://repositorio.furg.br/handle/1/7018 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da FURG (RI FURG) instname:Universidade Federal do Rio Grande (FURG) instacron:FURG |
instname_str |
Universidade Federal do Rio Grande (FURG) |
instacron_str |
FURG |
institution |
FURG |
reponame_str |
Repositório Institucional da FURG (RI FURG) |
collection |
Repositório Institucional da FURG (RI FURG) |
bitstream.url.fl_str_mv |
https://repositorio.furg.br/bitstream/1/7018/1/Dose%2bResponse%2bof%2bInhaled%2bCorticosteroids%2bin%2bChildren%2bWith%2bPersistent%2bAsthma.%2bA%2bSystematic%2bReview.%2bPediatricas%2b2011.pdf https://repositorio.furg.br/bitstream/1/7018/2/license.txt |
bitstream.checksum.fl_str_mv |
a7e9ab397e984bc15c6d4d163cd49e81 8a4605be74aa9ea9d79846c1fba20a33 |
bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 |
repository.name.fl_str_mv |
Repositório Institucional da FURG (RI FURG) - Universidade Federal do Rio Grande (FURG) |
repository.mail.fl_str_mv |
|
_version_ |
1794069242952286208 |