The Journal of Allergy and Clinical Immunology: In Practice
Original ArticleInhaled Corticosteroids in Acute Asthma: A Systemic Review and Meta-Analysis
Section snippets
Search strategy
This review is registered with PROSPERO (registration number: CRD42018111273). The review protocol can be found at https://www.crd.york.ac.uk/PROSPEROFILES/111273_PROTOCOL_20190110.pdf.
The literature search was undertaken using the following electronic bibliographic databases: PubMed, The Cochrane Library, EMBASE, and clinicaltrials.gov.
The search terms were asthma AND (emergency or acute or severe or exacerbation or hospital or intensive or admit or admission or discharge) AND (steroid or
Description of studies
The search identified 4612 papers, of which 25 papers9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33 were included in the analyses, which involved 2733 participants. The flow of studies is shown in Figure 1. No additional papers were identified from the reference lists of the included papers. All studies were randomized controlled trials. Five new studies had been published since the last updated Cochrane review.7 The details of the identified
Discussion
The systematic review and meta-analysis found that in patients presenting to ED with an exacerbation of asthma, the addition of ICS to SCS reduces the risk of admission to hospital. The magnitude of the effect was of clinical importance with a fixed-effects OR for admission of 0.73, although there was some evidence of heterogeneity and the CIs were wide. Although lung function was poorly reported, there was supporting evidence of improvement in clinical scores and vital signs. Although the
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2021, Journal of Allergy and Clinical Immunology: In PracticeCitation Excerpt :There was no statistically significant relationship (χ2 0.62 [1 degree of freedom], P = .43) between the age category of participants and the outcome of the MA. On this basis, the authors concluded that variability in the age of participants across included studies did not explain heterogeneity observed in the MA.26 Similar to subgroup analysis, this technique may reveal differential effects of an intervention across populations or settings.2,6
Impact of the Asthma Quality Assessment Program on Burden of Asthma
2021, Journal of Allergy and Clinical Immunology: In PracticeCitation Excerpt :This suggested that the type of clinic visited by subjects has a decisive role in their asthma prognosis. These considerable effects are even comparable to those of corticosteroids or recently developed biologics.21-23 The government needs to educate and encourage clinics to obtain good results from AQAP.
The Medical Research Institute of New Zealand (MRINZ) is supported by Health Research Council of New Zealand Independent Research Organisation funding.
Conflicts of interest: R. Beasley declares the conflict of the MRINZ receiving funding from AstraZeneca, Genentech, and GSK, outside of the submitted work. The rest of the authors declare that they have no relevant conflicts of interest.