Cochrane · systematic review · CD011801
Different oral corticosteroid regimens for acute asthma
Normansell, R, Kew, KM, Mansour, G · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
AirwaysAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
24
current version
GRADE rated
20
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 4 · 16.7%Very low 9 · 37.5%Low 9 · 37.5%Moderate 2 · 8.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Adults: higher dose/longer course compared with lower dose/shorter course for acute asthma
Population: adults with an acute exacerbation of asthma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Re‐admission in Adults: higher dose/longer course vs lower dose/shorter course | OR 1.35 [0.38, 4.79] | 4 studies · 142 participants | Low Downgraded: indirectness |
Asthma symptoms Asthma severity score Adults: higher dose/longer course vs lower dose/shorter course | no estimate extracted | 1 study · 44 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Asthma symptoms Complete resolution by day 28 Adults: higher dose/longer course vs lower dose/shorter course | OR 0.55 [0.13, 2.26] | 1 study · 35 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
New exacerbation in Adults: higher dose/longer course vs lower dose/shorter course | OR 0.98 [0.17, 5.56] | 2 studies · 55 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
New exacerbation in Adults: higher dose/longer course vs lower dose/shorter course | OR 0.62 [0.23, 1.68] | 3 studies · 122 participants | Low Downgraded: indirectness |
Lung function tests FEV1% predicted Adults: higher dose/longer course vs lower dose/shorter course | no estimate extracted | 2 studies · 41 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
All adverse events Adults: higher dose/longer course vs lower dose/shorter course | OR 4.15 [0.94, 18.41] | 1 study · 43 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Adults: prednisolone compared with dexamethasone for acute asthma
Population: adults with an acute exacerbation of asthma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Re‐admission during Adults: prednisolone vs dexamethasone | OR 0.35 [0.04, 3.47] | 1 study · 200 participants | Very low Downgraded: imprecision |
Asthma symptoms Returned to normal activities within 3 days Adults: prednisolone vs dexamethasone | OR 0.44 [0.19, 1.01] | 1 study · 191 participants | Low Downgraded: risk of bias, imprecision |
New exacerbation during Adults: prednisolone vs dexamethasone | OR 1.32 [0.39, 4.47] | 1 study · 200 participants | Very low Downgraded: imprecision |
New exacerbation during Adults: prednisolone vs dexamethasone | OR 1.85 [0.43, 7.96] | 1 study · 200 participants | Very low Downgraded: imprecision |
Children: higher dose/longer course compared with lower dose/shorter course for acute asthma
Population: children with an acute exacerbation of asthma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Re‐admission during Children: higher dose/longer course vs lower dose/shorter course | no estimate extracted | 1 study · 98 participants | Very low Downgraded: risk of bias, imprecision |
Asthma symptoms Symptom free by 7 days Children: higher dose/longer course vs lower dose/shorter course | OR 1.22 [0.67, 2.19] | 1 study · 201 participants | Moderate Downgraded: risk of bias, imprecision, indirectness |
Serious adverse events Children: higher dose/longer course vs lower dose/shorter course | no estimate extracted | 1 study · 201 participants | Ungraded |
New exacerbation during Children: higher dose/longer course vs lower dose/shorter course | OR 1.38 [0.25, 7.47] | 2 studies · 231 participants | Low Downgraded: risk of bias, imprecision, indirectness |
New exacerbation during Children: higher dose/longer course vs lower dose/shorter course | OR 2.17 [0.67, 7.01] | 1 study · 100 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Lung function tests FEV1% predicted at discharge Children: higher dose/longer course vs lower dose/shorter course | no estimate extracted | 1 study · 34 participants | Ungraded |
All adverse events Children: higher dose/longer course vs lower dose/shorter course | OR 0.67 [0.11, 4.08] | 1 study · 201 participants | Moderate Downgraded: risk of bias, imprecision, indirectness |
Children: prednisolone compared with dexamethasone for acute asthma
Population: children with acute exacerbation of asthma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Admission at initial presentation Children: prednisolone vs dexamethasone | OR 1.08 [0.74, 1.58] | 3 studies · 1007 participants | Low Downgraded: risk of bias |
Re‐admission during Children: prednisolone vs dexamethasone | OR 0.44 [0.15, 1.33] | 3 studies · 985 participants | Low Downgraded: risk of bias |
Asthma symptoms scores Pulmonary Index Score (PIS); Patient Self Assessment Score (PSAS); Paediatric Respiratory Assessment Measure (PRAM) Children: prednisolone vs dexamethasone | no estimate extracted | 2 studies · 328 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Asthma symptoms Persistent cough, wheeze, chest tightness, night‐time wakening and difficulty maintaining normal activities Children: prednisolone vs dexamethasone | no estimate extracted | 1 study · 533 participants | Ungraded |
Serious adverse events Children: prednisolone vs dexamethasone | no estimate extracted | 2 studies · 255 participants | Ungraded |
New exacerbation during Children: prednisolone vs dexamethasone | OR 0.85 [0.54, 1.34] | 4 studies · 981 participants | Low Downgraded: risk of bias |