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Quintupling Inhaled Glucocorticoids to Prevent Childhood Asthma Exacerbations

Overview of attention for article published in New England Journal of Medicine, March 2018
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (99th percentile)
  • Good Attention Score compared to outputs of the same age and source (68th percentile)

Mentioned by

news
15 news outlets
blogs
4 blogs
policy
1 policy source
twitter
211 X users
facebook
13 Facebook pages
googleplus
3 Google+ users

Citations

dimensions_citation
116 Dimensions

Readers on

mendeley
210 Mendeley
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Title
Quintupling Inhaled Glucocorticoids to Prevent Childhood Asthma Exacerbations
Published in
New England Journal of Medicine, March 2018
DOI 10.1056/nejmoa1710988
Pubmed ID
Authors

Daniel J Jackson, Leonard B Bacharier, David T Mauger, Susan Boehmer, Avraham Beigelman, James F Chmiel, Anne M Fitzpatrick, Jonathan M Gaffin, Wayne J Morgan, Stephen P Peters, Wanda Phipatanakul, William J Sheehan, Michael D Cabana, Fernando Holguin, Fernando D Martinez, Jacqueline A Pongracic, Sachin N Baxi, Mindy Benson, Kathryn Blake, Ronina Covar, Deborah A Gentile, Elliot Israel, Jerry A Krishnan, Harsha V Kumar, Jason E Lang, Stephen C Lazarus, John J Lima, Dayna Long, Ngoc Ly, Jyothi Marbin, James N Moy, Ross E Myers, J Tod Olin, Hengameh H Raissy, Rachel G Robison, Kristie Ross, Christine A Sorkness, Robert F Lemanske

Abstract

Background Asthma exacerbations occur frequently despite the regular use of asthma-controller therapies, such as inhaled glucocorticoids. Clinicians commonly increase the doses of inhaled glucocorticoids at early signs of loss of asthma control. However, data on the safety and efficacy of this strategy in children are limited. Methods We studied 254 children, 5 to 11 years of age, who had mild-to-moderate persistent asthma and had had at least one asthma exacerbation treated with systemic glucocorticoids in the previous year. Children were treated for 48 weeks with maintenance low-dose inhaled glucocorticoids (fluticasone propionate at a dose of 44 μg per inhalation, two inhalations twice daily) and were randomly assigned to either continue the same dose (low-dose group) or use a quintupled dose (high-dose group; fluticasone at a dose of 220 μg per inhalation, two inhalations twice daily) for 7 days at the early signs of loss of asthma control ("yellow zone"). Treatment was provided in a double-blind fashion. The primary outcome was the rate of severe asthma exacerbations treated with systemic glucocorticoids. Results The rate of severe asthma exacerbations treated with systemic glucocorticoids did not differ significantly between groups (0.48 exacerbations per year in the high-dose group and 0.37 exacerbations per year in the low-dose group; relative rate, 1.3; 95% confidence interval, 0.8 to 2.1; P=0.30). The time to the first exacerbation, the rate of treatment failure, symptom scores, and albuterol use during yellow-zone episodes did not differ significantly between groups. The total glucocorticoid exposure was 16% higher in the high-dose group than in the low-dose group. The difference in linear growth between the high-dose group and the low-dose group was -0.23 cm per year (P=0.06). Conclusions In children with mild-to-moderate persistent asthma treated with daily inhaled glucocorticoids, quintupling the dose at the early signs of loss of asthma control did not reduce the rate of severe asthma exacerbations or improve other asthma outcomes and may be associated with diminished linear growth. (Funded by the National Heart, Lung, and Blood Institute; STICS ClinicalTrials.gov number, NCT02066129 .).

X Demographics

X Demographics

The data shown below were collected from the profiles of 211 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 210 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 210 100%

Demographic breakdown

Readers by professional status Count As %
Other 43 20%
Student > Bachelor 21 10%
Student > Master 20 10%
Student > Ph. D. Student 17 8%
Researcher 16 8%
Other 42 20%
Unknown 51 24%
Readers by discipline Count As %
Medicine and Dentistry 114 54%
Biochemistry, Genetics and Molecular Biology 6 3%
Pharmacology, Toxicology and Pharmaceutical Science 6 3%
Sports and Recreations 5 2%
Nursing and Health Professions 3 1%
Other 20 10%
Unknown 56 27%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 258. 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 17 June 2022.
All research outputs
#142,983
of 25,541,640 outputs
Outputs from New England Journal of Medicine
#3,190
of 32,565 outputs
Outputs of similar age
#3,427
of 347,370 outputs
Outputs of similar age from New England Journal of Medicine
#86
of 270 outputs
Altmetric has tracked 25,541,640 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 32,565 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 122.4. This one has done particularly well, scoring higher than 90% 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 347,370 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 99% of its contemporaries.
We're also able to compare this research output to 270 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.