Abstract
Background
The GINA recommends inhaled corticosteroids (ICSs) for the treatment of steps 2–3 of childhood asthma. However, the difference in efficacy between these drugs remains unclear. The purpose of this study was to compare the efficacy of different ICS drugs in the treatment of childhood asthma.
Methods
We searched PubMed and EMBASE for randomized controlled trials of ICSs in the treatment of childhood asthma. Using forced expiratory volume in the first second (FEV1) as the primary outcome, a time-course model of ICSs was constructed. In addition, the symptom-free days% were analyzed as a secondary outcome.
Results
Six studies involving 2237 children that reported FEV1 were included. The results showed that the ET50 of ciclesonide (CIC) and budesonide (BUD) was 1.23 and 2.97 weeks, respectively. Compared with them, FP had a higher efficacy. In terms of symptom-free days%, we found that the efficacy of beclometasone dipropionate was lower than that of CIC and fluticasone propionate.
Conclusion
In this study, the efficacy of three ICS drugs was quantitatively compared, providing necessary information for the implementation of medication guidelines for steps 2–3 of asthma in children.
Impact
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This study analyzed the entire time-course of the drug efficacy of Inhaled corticosteroids in the treatment of asthma in children aged 5–12, which found that although the maximum efficacy of both ciclesonide and budesonide was the same, the onset speed of ciclesonide was faster than that of budesonide.
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The above information provides the necessary quantitative information for the implementation of medication guidelines for steps 2–3 asthma in children.
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Data availability
The datasets analyzed during this study are available in PubMed and EMBASE.
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Acknowledgements
The authors wish to thank all the staff of the Center for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine.
Funding
This was not an industry-supported study. This work received financial support from the project Shanghai S&T Innovation Plan (17401970900).
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H.Z.: data curation-lead, formal analysis-lead, investigation-lead, resources-lead, writing-original draft-lead. H.L.: conceptualization-supporting, formal analysis-supporting, funding acquisition-equal, methodology-supporting, writing-review and editing-supporting. Z.S.: data curation-supporting. J.Y.: data curation-supporting. Q.Z.: conceptualization-lead, funding acquisition-lead, methodology-lead, writing-review and editing-equal. L.L.: conceptualization-lead, formal analysis-supporting, funding acquisition-supporting, investigation-equal, methodology-lead, project administration-equal, software-equal, supervision-equal, validation-equal, visualization-equal, writing-original draft-supporting, writing-review and editing-lead.
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Zhu, H., Liu, H., Sui, Z. et al. Quantitative comparison of different inhaled corticosteroids in the treatment of asthma in children. Pediatr Res 93, 31–38 (2023). https://doi.org/10.1038/s41390-022-02095-8
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DOI: https://doi.org/10.1038/s41390-022-02095-8
