5. Symptoms and quality of life (in‐ and outpatients)*.
| Study | Population | Duration of follow‐up | Parameter | Glucocorticoid‐including group | Placebo or comparator group | Notes |
| GLUCOCORTICOID versus PLACEBO | ||||||
| Teeratakulpisarn 2007 | Inpatients | Days 1 to 30 | Time from treatment to being symptom free ‐ mean ± SD | 7.0 ± 5.9 | 9.0 ± 6.4 | P = 0.035 |
| Cade 2000 | Inpatients | Days 1 to 28 | Time taken for half of infants to become asymptomatic for 48 hours (95% CI) ‐ time to event analysis | 10 (10 to 13) | 12 (10 to 16) | HR 1.41 (95% CI 0.98 to 2.04), P = 0.07 |
| Days with coughing or wheezing episodes ‐ mean ± SD | 17.0 ± 7.6 days | 17.1 ± 8.5 | Mean difference: 0.91 days (95% CI ‐2.72 to 2.41), P = 0.91 | |||
| Roosevelt 1996# | Inpatients | Day 10 to 14 | No current difficulty breathing ‐ n/N (%) | 45/45 (100) | 37/42 (88) | P = 0.07 |
| Feeding and drinking well ‐ n/N (%) | 45/45 (100) | 40/42 (95) | P = 0.57 | |||
| GLUCOCORTICOID versus PLACEBO, GLUCOCORTICOID versus EPINEPHRINE, GLUCOCORTICOID AND EPINEPHRINE versus PLACEBO | ||||||
| Plint 2009 (epinephrine ‐ E; dexamethasone ‐ D; placebo ‐ P) | Outpatients | Days 1 to 22 | Time to return to normal feeding ‐ median (IQR) | D + E: 0.6 (0.2 to 1.3) D + P: 0.8 (0.3 to 1.9) P + E: 0.5 (0.2 to 1.2) P + P: 0.9 (0.3 to 2.1) | Time to return to normal feeding ‐ mean symptom duration ratio D + E versus P + P: 0.63 (unadjusted 95% CI 0.5 to 0.8)¶ Time to return to quiet breathing ‐ mean symptom duration ratio D + E versus P + P: 0.83 (unadjusted 95% CI 0.69 to 1.00) No other reported comparison was statistically significant in adjusted analysis |
|
| Time to return to normal sleeping ‐ median (IQR) | D + E: 0.7 (0.2 to 1.7) D + P: 0.8 (0.3 to 1.9) P + E: 0.8 (0.3 to 1.9) P + P: 0.8 (0.3 to 1.8) | |||||
| Time to no coughing ‐ median (IQR) | D + E: 12.6 (7.8 to 18.5) D + P: 13.8 (8.5 to 20.2) P + E: 13.2 (8.1 to 19.3) P + P: 13.3 (8.2 to 19.5) | |||||
| Time to quiet breathing ‐ median (IQR) | D + E: 3.1 (1.4 to 6.1) D + P: 3.7 (1.6 to 7.1) P + E: 3.6 (1.5 to 6.9) P + P: 3.7 (1.6 to 7.2) | |||||
*Units in days unless otherwise stated; no study assessed or reported data from generic or disease‐specific quality of life instruments; Richter 1998 also reported number of symptom‐free days for a 6‐week follow‐up period
#Roosevelt 1996 primary outcome was time to resolution (defined as number of 12 h periods needed to achieve: O2 saturation > 95% at room air, accessory muscle score = 0, wheeze = 0 or 1, and normal feeding); only association measures were reported: HR 1.3 (95% CI 0.9 to 1.3), P = 0.22
¶time to symptom relief was analysed by means of parametric survival models with Weibull distributions assumed; 95% CI adjusted for multiple analysis in a factorial trial.
CI = confidence interval HR = hazard ratio IQR = interquartile range SD = standard deviation