| Title |
Budesonide versus placebo for chronic asthma in children and adults
|
|---|---|
| Published in |
Cochrane database of systematic reviews, October 1999
|
| DOI | 10.1002/14651858.cd003274 |
| Pubmed ID | |
| Authors |
Nick P Adams, Janine C Bestall, Paul Jones |
| Abstract |
Inhaled budesonide is a widely used inhaled corticosteroid for asthma. The objectives of this review was to compare the efficacy of budesonide with placebo in the treatment of chronic asthma. The Cochrane Airways Group Trial Register and reference lists of articles was searched. We contacted trialists for additional studies and searched abstracts of major respiratory society meetings (1997-1999). Randomised trials in children and adults comparing budesonide to placebo in the treatment of chronic asthma. Two reviewers independently assessed articles for inclusion and methodological quality. One reviewer extracted data. 43 studies met the inclusion criteria (2801 subjects). In non-oral steroid treated asthmatics, budesonide led to significant improvements in a number of measures of airway function. These included FEV1, Weighted Mean Difference (WMD) 3.7% predicted (95% CI 0.1, 7.2%); improvement in morning peak flow (PEF) from baseline WMD 29 L/min (95% CI 22, 36 L/min); improvement in evening PEF from baseline WMD 21 L/min (95% CI 13, 29 L/min). Varying methods of reporting symptoms limited the pooling of studies but all high methodological quality studies demonstrated significant improvements compared to placebo. Health status was not reported. Risk of trial withdrawal due to asthma exacerbation was lower with budesonide compared to placebo, relative risk 0.17 (95% CI 0.09, 0.33). Doses of 500-800 mcg/d appeared to have slightly larger effect sizes than lower doses, but no advantage for high doses were apparent. A single high quality RCT reported significant reductions in daily prednisolone requirement and the number of patients able to discontinue prednisolone completely in budesonide treated subjects compared to placebo. No difference in risk of oropharyngeal soreness/hoarseness or oral Candidiasis was apparent for budesonide compared to placebo. Long-term risk of adrenal insufficiency was not reported. This review strongly supports use of budesonide in chronic asthma. Consensus guidelines for chronic asthma suggest titrating inhaled steroid dose to individual requirements. Evidence from this review of trials does not present a case for routine dose titration above 800 mcg/d. |
Mendeley readers
The data shown below were compiled from readership statistics for 148 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | <1% |
| Korea, Republic of | 1 | <1% |
| United States | 1 | <1% |
| Singapore | 1 | <1% |
| Unknown | 144 | 97% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 21 | 14% |
| Student > Bachelor | 16 | 11% |
| Researcher | 15 | 10% |
| Other | 9 | 6% |
| Student > Ph. D. Student | 8 | 5% |
| Other | 20 | 14% |
| Unknown | 59 | 40% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 50 | 34% |
| Nursing and Health Professions | 15 | 10% |
| Pharmacology, Toxicology and Pharmaceutical Science | 5 | 3% |
| Psychology | 4 | 3% |
| Social Sciences | 3 | 2% |
| Other | 7 | 5% |
| Unknown | 64 | 43% |
Attention Score in Context
This research output has an Altmetric Attention Score of 31. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 April 2020.
All research outputs
#1,259,391
of 25,461,852 outputs
Outputs from Cochrane database of systematic reviews
#2,646
of 12,090 outputs
Outputs of similar age
#592
of 36,441 outputs
Outputs of similar age from Cochrane database of systematic reviews
#2
of 15 outputs
Altmetric has tracked 25,461,852 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 12,090 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 38.2. This one has done well, scoring higher than 78% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 36,441 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 98% of its contemporaries.
We're also able to compare this research output to 15 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 86% of its contemporaries.