As-Needed Use of Short-Acting β2-Agonists Alone Versus As-Needed Use of Short-Acting β2-Agonists Plus Inhaled Corticosteroids in Pediatric Patients With Mild Intermittent (Step 1) Asthma: A Cost-Effectiveness Analysis

The Quality of Economic Evaluations of Interventions to Improve Women and Child Health in Latin America: A Systematic Review

OBJECTIVES

This study aims to characterize and assess the reporting and methodological quality of health economic evaluations (HEEs) of interventions to improve women's and children's health in Latin America from 2004 to 2023.

METHODS

A systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed was searched for HEEs published between 2004 and 2023. The search terms included HEEs or cost-benefit analysis, Latin America or Latin American countries, and pediatrics and/or gynecology. Articles were eligible for inclusion if they were HEEs; published in English, Spanish, or Portuguese; and focused on pediatrics and/or gynecology in Latin America. Data extraction included study characteristics, methodological aspects, reporting, and methodological quality based on the Consolidated Health Economic Evaluation Reporting Standards 2013 and Quality of Health Economic Studies checklists.

RESULTS

Of 141 articles identified, 55 met the inclusion criteria. Most articles were cost-effectiveness evaluations conducted in Colombia and were aimed at pediatric patients. The quality assessment revealed that most Consolidated Health Economic Evaluation Reporting Standards and Quality of Health Economic Studies items were reported in at least 60% of the articles and that the study setting, justification for study perspective, bias acknowledgment, and subgroup analyses were the least frequently reported items.

CONCLUSIONS

This study highlights that although the number of HEEs in pediatrics and/or gynecology in Latin American countries is growing, to improve the transparency and generalizability of HEEs, the reporting and methodological quality of HEEs need to be improved. Seven key areas were identified for improving adherence to international quality standards.

The Saudi initiative for asthma - 2024 update: Guidelines for the diagnosis and management of asthma in adults and children

The Saudi Initiative for Asthma 2024 (SINA-2024) is the sixth version of asthma guidelines for the diagnosis and management of asthma for adults and children that was developed by the SINA group, a subsidiary of the Saudi Thoracic Society. The main objective of the SINA is to have guidelines that are up-to-date, simple to understand, and easy to use by healthcare workers dealing with asthma patients. To facilitate achieving the goals of asthma management, the SINA Panel approach is mainly based on the assessment of symptom control and risk for both adults and children. The approach to asthma management is aligned for age groups: adults, adolescents, children aged 5-12 years, and children aged <5 years. SINA guidelines have focused more on personalized approaches reflecting a better understanding of disease heterogeneity with the integration of recommendations related to biologic agents, evidence-based updates on treatment, and the role of immunotherapy in management. The medication appendix has also been updated with the addition of recent evidence, new indications for existing medication, and new medications. The guidelines are constructed based on the available evidence, local literature, and the current situation at national and regional levels. There is also an emphasis on patient-doctor partnership in the management that also includes a self-management plan.

Maintenance Therapy for Children and Adolescents with Asthma: Guidelines and Recommendations from the Emilia-Romagna Asthma (ERA) Study Group

Asthma is the most frequent chronic disease of childhood, affecting up to 20% of children worldwide. The main guidelines on asthma maintenance therapy in pediatrics suggest different approaches and describe different stages of asthma to determine the most appropriate treatment. This project aims to summarize the most recent evidence regarding maintenance therapy for asthma in children and adolescents. A multidisciplinary panel of experts was asked clinical questions regarding the treatment of children and adolescents with asthma. Overall, 10 clinical questions were addressed, and the search strategy included accessing electronic databases and a manual search of gray literature published in the last 25 years. After data extraction and narrative synthesis of results, recommendations were developed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) methodology. Results showed that the choice of medication depends on the severity of the child's asthma, phenotype, age, preference, and individual factors. In addition to medications, the identification of comorbidities and modifiable factors is crucial to obtaining good control. Asthma in children is heterogeneous, and its evolution varies over time. Since most recommendations for asthma management in childhood are extrapolated from clinical studies performed in adults, more clinical trials specifically designed for young children should be conducted.