Is dexamethasone as effective as other corticosteroids for acute asthma exacerbation in children?

Medwave. 2017 Apr 18;17(Suppl2):e6931. doi: 10.5867/medwave.2017.6931.
[Article in Spanish, English]

Abstract

Dexamethasone has been proposed as an alternative in the treatment of acute asthma exacerbation in children. It allows shortening the duration of treatment, reducing costs and adverse effects. However, it is not clear whether its efficacy is similar to the traditional steroid regimen. To answer this question, we searched in Epistemonikos database, which is maintained by screening multiple information sources. We identified six systematic reviews including 10 randomized trials. We extracted data, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We concluded dexamethasone has probably fewer adverse effects than others corticosteroids, and might be equally effective in reducing hospitalizations and revisits.

La dexametasona se ha planteado como una opción en el tratamiento de exacerbación asmática en niños, acortando el tratamiento, lo que además de ventajas prácticas, podría reducir costos y potenciales efectos adversos. No está claro, sin embargo, si su eficacia es similar al esquema esteroidal tradicional. Para responder esta interrogante utilizamos la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en múltiples fuentes de información. Identificamos seis revisiones sistemáticas que en conjunto incluyen diez ensayos controlados aleatorizados. Extrajimos los datos, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. Concluimos que la dexametasona, en comparación con otros corticoides, probablemente tiene menos efectos adversos, y podría ser igual de efectiva en reducir hospitalizaciones y reconsulta.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Acute Disease
  • Anti-Asthmatic Agents / administration & dosage
  • Anti-Asthmatic Agents / adverse effects
  • Anti-Asthmatic Agents / therapeutic use
  • Asthma / drug therapy*
  • Asthma / physiopathology
  • Child
  • Dexamethasone / administration & dosage
  • Dexamethasone / adverse effects
  • Dexamethasone / therapeutic use*
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / adverse effects
  • Glucocorticoids / therapeutic use*
  • Hospitalization / statistics & numerical data
  • Humans
  • Randomized Controlled Trials as Topic

Substances

  • Anti-Asthmatic Agents
  • Glucocorticoids
  • Dexamethasone