Intermittent Versus Daily Inhaled Corticosteroids (ICS) In Children And Adults With Mild Persistent Asthma: A Cochrane Review
Bibliographic record
Abstract
Introduction Although guidelines recommend daily ICS in mild persistent asthma, most patients use, and many physicians prescribe, intermittent ICS. Objectives To compare the safety and efficacy of intermittent versus daily ICS in mild persistent asthma. METHODS: Randomised trials comparing intermittent vs. daily ICS in children and adults were eligible. Outcomes included: patients requiring rescue oral steroids (primary efficacy), serious adverse health events (primary safety), hospitalisations, lung function, asthma control, adverse effects, and withdrawals. Results Six (4 children; 2 adult) parallel-group trials using beclomethasone or budesonide, were included. There was no significant group difference in patients requiring rescue oral steroids (RR=1.07, 95%CI 0.87, 1.32) and serious adverse events (RR=0.82, 95%CI 0.33, 2.03). Compared to daily ICS, intermittent ICS was associated with lower change in PEF, fewer control days, more β 2 -agonists use, and higher exhaled nitric oxide. There was no group difference in acute care visits, hospitalisations, FEV 1 , adverse effects, and withdrawals. Compared to intermittent, daily budesonide was associated with lower growth in children (MD=0.41cm, 95%CI 0.13, 0.69). Conclusions Intermittent and daily ICS strategies did not significantly differ in the use of rescue oral steroids, nor did they reach equivalence. Daily ICS was superior to intermittent ICS in several indicators of lung function, airway inflammation, control, and reliever use. The findings would support the greater efficacy of daily ICS in children and adults with mild persistent asthma, while using the safest, and lowest effective dose of, ICS in children.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.005 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".