A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Efficacy of inhaled salbutamol with and without prednisolone for first acute rhinovirus-induced wheezing episode
Tekijät: Hurme Pekka, Homil Kiara, Lehtinen Pasi, Turunen Riitta, Vahlberg Tero, Vuorinen Tytti, Camargo Carlos A, Gern James E, Jartti Tuomas
Julkaisuvuosi: 2021
Journal: Clinical and Experimental Allergy
Tietokannassa oleva lehden nimi: Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
Lehden akronyymi: Clin Exp Allergy
Vuosikerta: 51
Numero: 9
Aloitussivu: 1121
Lopetussivu: 1132
ISSN: 0954-7894
eISSN: 1365-2222
DOI: https://doi.org/10.1111/cea.13960
Rinnakkaistallenteen osoite: https://research.utu.fi/converis/portal/detail/Publication/66915173
Background
Acute rhinovirus-induced wheezing is common in young children and may respond to systemic corticosteroid. There are no trials on the efficacy of inhaled beta2-agonist in this clinical scenario.
ObjectiveTo study post hoc the short-term (up to 2 months) efficacy of inhaled beta2-agonist with and without oral corticosteroid in the first acute rhinovirus-induced severe wheezing episode in young hospitalized children.
MethodsThe study population came from two randomized controlled trials comparing oral prednisolone (2 mg/kg/d for 3 days) to placebo: Vinku (n = 35, NCT00494624) used high-dose regular nebulized salbutamol (0.15 mg/kg 2–4 h intervals) and Vinku2 (n = 60, NCT00731575, EudraCT 2006-007100-42) used inhaled salbutamol on-demand. Both studies used identical detailed follow-up assessments. The primary outcome of the former was the duration of hospitalization and of the latter the occurrence of and the time to a new physician-confirmed wheezing episode within 2 months after discharge. Treatment groups included salbutamol high-dose vs. salbutamol on-demand while adjusting for prednisolone status and acknowledging for interactions with exception of the duration of hospitalization in which prednisolone groups could not be fully used due to protocol differences.
ResultsMedian age of subjects was 13 months, 32% were sensitized and 22% had doctor-diagnosed eczema. In the duration of hospitalization, salbutamol high-dose/placebo versus salbutamol on-demand/placebo groups did not differ (p = .12). In the occurrence of and time to relapse within 2 months, a significant group × treatment interaction was observed (both p = .02), such that high-dose group had less and longer time to relapses than on-demand group in prednisolone arm (both p < .05), but no difference was detected in placebo arm (both p > .26).
ConclusionsIn young, hospitalized children with first episode of rhinovirus-induced wheezing, high-dose inhaled salbutamol may interact with oral prednisolone. However, further trials are warranted.
Ladattava julkaisu This is an electronic reprint of the original article. |