NEW ORLEANS — Inhaled corticosteroids were significantly more effective than systemic corticosteroids in preventing hospitalization of children who presented to the emergency department with acute asthma exacerbation, based on a review of data from 10 studies including more than 1,000 children aged 6 months to 18 years.
Corticosteroids are widely used to treat pediatric asthma, but the efficacy of different routes of administration in an emergency department (ED) setting has not been well studied, noted Dr. Rabia Q. Chaudhry of the New Jersey Medical School, Newark. He and his associates reviewed 10 studies conducted between 1986 and 2009, including 388 patients treated with inhaled corticosteroids (ICS), 337 treated with systemic corticosteroids (SCS), and 298 treated with a placebo. The likelihood of hospitalization was significantly lower (40% reduced risk) in children who received ICS vs. SCS (14% vs. 21%). “The number needed to treat to prevent one hospitalization of a child with acute asthma exacerbation is five for ICS and eight for SCS,” they noted in a poster presentation.
Regardless of the delivery route, hospitalization rates were significantly higher in children who received a placebo (33%). Hospitalization rates ranged from 23% to 49% in the placebo group, 10% to 30% in the SCS group, and 0% to 32% in the ICS group across all the studies.
Studies that compared a combination of ICS and SCS to SCS alone were excluded from this analysis. The results were limited by the variation in sample sizes, and by the different brands of medications used in different studies, they said.
The investigators reported no relevant financial disclosures.