Best step-up treatments for children with uncontrolled asthma: a systematic review and network meta-analysis of individual participant data Article Swipe
Sofia Cividini
,
Ian Sinha
,
Sarah Donegan
,
Michelle Maden
,
Katie Rose
,
Olivia Fulton
,
Giovanna Culeddu
,
Dyfrig Hughes
,
Steve Turner
,
Catrin Tudur Smith
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1183/13993003.01011-2023
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1183/13993003.01011-2023
Background There is uncertainty about the best treatment option for children/adolescents with uncontrolled asthma despite inhaled corticosteroids (ICS) and international guidelines make different recommendations. We evaluated the pharmacological treatments to reduce asthma exacerbations and symptoms in uncontrolled patients age <18 years on ICS. Methods We searched MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Embase, Web of Science, National Institute for Health and Care Excellence Technology Appraisals, National Institute for Health and Care Research Health Technology Assessment series, World Health Organization International Clinical Trials Registry, conference abstracts and internal clinical trial registers (1 July 2014 to 5 May 2023) for randomised controlled trials of participants age <18 years with uncontrolled asthma on any ICS dose alone at screening. Studies before July 2014 were retrieved from previous systematic reviews/contact with authors. Patients had to be randomised to any dose of ICS alone or combined with long-acting β 2 -agonists (LABA) or combined with leukotriene receptor antagonists (LTRA), LTRA alone, theophylline or placebo. Primary outcomes were exacerbation and asthma control. The interventions evaluated were ICS (low/medium/high dose), ICS+LABA, ICS+LTRA, LTRA alone, theophylline and placebo. Results Of the 4708 publications identified, 144 trials were eligible. Individual participant data were obtained from 29 trials and aggregate data were obtained from 19 trials. Compared with ICS Low, ICS Medium+LABA was associated with the lowest odds of exacerbation (OR 0.44, 95% credibility interval (95% CrI) 0.19–0.90) and with an increased forced expiratory volume in 1 s (mean difference 0.71, 95% CrI 0.35–1.06). Treatment with LTRA was the least preferred. No apparent differences were found for asthma control. Conclusions Uncontrolled children/adolescents on low-dose ICS should be recommended a change to medium-dose ICS+LABA to reduce the risk for exacerbation and improve lung function.
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Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1183/13993003.01011-2023
- https://erj.ersjournals.com/content/erj/62/6/2301011.full.pdf
- OA Status
- hybrid
- Cited By
- 5
- References
- 76
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4388524182
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4388524182Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1183/13993003.01011-2023Digital Object Identifier
- Title
-
Best step-up treatments for children with uncontrolled asthma: a systematic review and network meta-analysis of individual participant dataWork title
- Type
-
reviewOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-11-09Full publication date if available
- Authors
-
Sofia Cividini, Ian Sinha, Sarah Donegan, Michelle Maden, Katie Rose, Olivia Fulton, Giovanna Culeddu, Dyfrig Hughes, Steve Turner, Catrin Tudur SmithList of authors in order
- Landing page
-
https://doi.org/10.1183/13993003.01011-2023Publisher landing page
- PDF URL
-
https://erj.ersjournals.com/content/erj/62/6/2301011.full.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
hybridOpen access status per OpenAlex
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https://erj.ersjournals.com/content/erj/62/6/2301011.full.pdfDirect OA link when available
- Concepts
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Medicine, Asthma, Meta-analysis, Placebo, Systematic review, Clinical trial, Exacerbation, Psychological intervention, MEDLINE, Physical therapy, Internal medicine, Pediatrics, Alternative medicine, Nursing, Political science, Law, PathologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
5Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 1, 2024: 4Per-year citation counts (last 5 years)
- References (count)
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76Number of works referenced by this work
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-
10Other works algorithmically related by OpenAlex
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| referenced_works | https://openalex.org/W2490831979, https://openalex.org/W3207588227, https://openalex.org/W2139580590, https://openalex.org/W2139291708, https://openalex.org/W2112468123, https://openalex.org/W6639450505, https://openalex.org/W6675510063, https://openalex.org/W2119248902, https://openalex.org/W1947857456, https://openalex.org/W1997179582, https://openalex.org/W3127883866, https://openalex.org/W6685021679, https://openalex.org/W6629451926, https://openalex.org/W6670653062, https://openalex.org/W2601675613, https://openalex.org/W2616424562, https://openalex.org/W2160302514, https://openalex.org/W2098923148, https://openalex.org/W2128450617, https://openalex.org/W1883034450, https://openalex.org/W1991683671, https://openalex.org/W2088340248, https://openalex.org/W2074251930, https://openalex.org/W1904369796, https://openalex.org/W2133801069, https://openalex.org/W2533342247, https://openalex.org/W2068455992, https://openalex.org/W2104526821, https://openalex.org/W2140441261, https://openalex.org/W2077456532, https://openalex.org/W2916781871, https://openalex.org/W2091215885, https://openalex.org/W2037952886, https://openalex.org/W2118866729, https://openalex.org/W2519843625, https://openalex.org/W2339588068, https://openalex.org/W2083121402, https://openalex.org/W2413097463, https://openalex.org/W2045868513, https://openalex.org/W2293620483, https://openalex.org/W2514696388, https://openalex.org/W2116173647, https://openalex.org/W2123309257, https://openalex.org/W2976923195, https://openalex.org/W1996099244, https://openalex.org/W1963853409, https://openalex.org/W2035762677, https://openalex.org/W2091535286, https://openalex.org/W2145352586, https://openalex.org/W2018270746, https://openalex.org/W2027543843, https://openalex.org/W2129397351, https://openalex.org/W1987622884, https://openalex.org/W1980574092, https://openalex.org/W2058969608, https://openalex.org/W2092982642, https://openalex.org/W2045002632, https://openalex.org/W6715344049, https://openalex.org/W2156639523, https://openalex.org/W2087410653, https://openalex.org/W2013674635, https://openalex.org/W2063905372, https://openalex.org/W2152587755, https://openalex.org/W6639918144, https://openalex.org/W2130062856, https://openalex.org/W2104067989, https://openalex.org/W1897527580, https://openalex.org/W2034106034, https://openalex.org/W2588681363, https://openalex.org/W4211219977, https://openalex.org/W3086111808, https://openalex.org/W1900566994, https://openalex.org/W2170374219, https://openalex.org/W1496980575, https://openalex.org/W2081360527, https://openalex.org/W4211102322 |
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