Effectiveness of long term therapy of inhaled Steroids  in Childhood Asthma: A Systemic Review

Ghamela Saleh Saeed Ali

doi:10.47957/ijpda.v11i2.548

Authors

Ghamela Saleh Saeed Ali Paediatric Department, Faculty of Medicine, Tobruk University/Libya

DOI:

https://doi.org/10.47957/ijpda.v11i2.548

Keywords:

Asthma, inhaled steroid, clinical trial, randomized controlled trial

Abstract

Asthma exacerbations are a common and important cause of attendance at emergency departments and subsequent hospital admissions. This systemic review aimed to evaluate the effectiveness of long term therapy of inhaled steroids in childhood asthma. A search of PubMed (Medline) from January 1996 through February 2021 by using the keywords inhaled steroids in childhood asthma, identified potential studies. All randomized controlled trials and clinical trials of prophylactic inhaled steroid therapy for childhood asthma that included data on clinical outcomes (symptoms improvement and concomitant drug use) or laboratory outcomes (peak expiratory flow rate PEFR and (or) forced expiratory volume in first second FEV1) were included. Studies of children (?18?years old) with mild-to-moderate chronic or persistent asthma will be included.
Results: In total, 15 of 116 studies met the inclusion criteria. Inhaled corticosteroids (ICS)versus placebo(3studies): ICS show good control on bronchial asthma by ratio(66.7%) and there was no improvement by placebo.ICS versus Mast cell stabilizer (DSCG, cromolyn sodium or nedocromil)(6 studies): by ICS there was better control of asthma, lower of airway hyperresponsivness, decrease risk for hospitalization in comparing to mast cell stabilizers by ratio of (66.7%).ICS versus LTRA (Montelukast)(3 studies) : by ICS better control of symptoms, modified exacerbation risk, improvement of pulmonary function in comparing to LTRA by ratio of (66.7%).ICS versus OCS (2 studies):more rapid clinical improvement results by OCS (50%), more improvement in the inflammatory markers by ICS(50%), reduction in rescue medication in both groups(100%).ICS alone (3 studies): good control of asthma including exercise asthma(66.7%).This Research concluded that the prophylactic inhaled steroids are more effective compared to placebo, mast cell stabilizer drugs and leukotriene receptor antagonist. ICS improving both clinical and laboratory outcomes in childhood asthma.

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