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Here’s a bullet-gist summary of the article:
Bullet-Gist Summary
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Objective: Compare effectiveness of various oral systemic corticosteroid regimens for treating acute asthma exacerbations in children and adolescents (<21 years).
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Methods:
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Systematic review + network meta-analysis.
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Searched four databases through March 2024.
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Included 11 RCTs with 2353 patients.
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Compared 6 corticosteroid regimens, varying by drug (dexamethasone vs prednisolone), dose, and duration.
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Primary outcome: 14-day relapse (unplanned ED or primary care visit).
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Regimens evaluated:
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DEXA 0.3 mg/kg × 1 day
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DEXA 0.6 mg/kg × 1 day
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DEXA 0.6 mg/kg × 2 days
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PSL 1.0 mg/kg/day × 3 days
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PSL 1.0–1.5 mg/kg/day × 5 days
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PSL 2.0 mg/kg/day × 5 days
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Key Findings:
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No significant differences in relapse rates among any of the 15 pairwise comparisons.
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Example network estimates:
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DEXA 0.3 mg/kg ×1 vs PSL 1 mg/kg ×3: RR 0.99 (95% CI 0.56–1.74)
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DEXA 0.6 mg/kg ×2 vs PSL 1–1.5 mg/kg ×5: RR 1.29 (95% CI 0.84–1.98)
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Certainty of evidence: low to very low.
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Conclusion:
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No corticosteroid regimen was clearly superior.
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Short-course dexamethasone appears to be an acceptable alternative to longer prednisolone courses for pediatric acute asthma exacerbations.
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If your everyday practice is to open to your emotions, to all the people you meet, to all the situations you encounter, without closing down, trusting that you can do that—then that will take you as far as you can go. And then you’ll understand all the teachings that anyone has ever taught. —PEMA CHÖDRÖN, BUDDHIST TEACHER
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