Challenges in assessing the efficacy of systemic corticosteroids for severe wheezing episodes in preschool children

National Heart, Lung, and Blood Institute's AsthmaNet

doi:10.1016/j.jaci.2018.10.071

Challenges in assessing the efficacy of systemic corticosteroids for severe wheezing episodes in preschool children

National Heart, Lung, and Blood Institute's AsthmaNet

Pediatrics

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Original language	English (US)
Pages (from-to)	1934-1937.e4
Journal	Journal of Allergy and Clinical Immunology
Volume	143
Issue number	5
DOIs	https://doi.org/10.1016/j.jaci.2018.10.071
State	Published - May 2019

ASJC Scopus subject areas

Immunology and Allergy
Immunology

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10.1016/j.jaci.2018.10.071

Cite this

@article{1cf1d403881a4257bf33e4b238388abf,

title = "Challenges in assessing the efficacy of systemic corticosteroids for severe wheezing episodes in preschool children",

author = "{National Heart, Lung, and Blood Institute's AsthmaNet} and Guilbert, {Theresa W.} and Bacharier, {Leonard B.} and Mauger, {David T.} and Wanda Phipatanakul and Szefler, {Stanley J.} and Susan Boehmer and Avraham Beigelman and Fitzpatrick, {Anne M.} and Jackson, {Daniel J.} and Baxi, {Sachin N.} and Mindy Benson and Burnham, {Carey Ann D.} and Cabana, {Michael D.} and Mario Castro and Chmiel, {James F.} and Ronina Covar and Michael Daines and Gaffin, {Jonathan M.} and Gentile, {Deborah A.} and Fernando Holguin and Elliot Israel and Kelly, {H. William} and Lazarus, {Stephen C.} and Lemanske, {Robert F.} and Ngoc Ly and Kelley Meade and Wayne Morgan and James Moy and Olin, {J. Tod} and Peters, {Stephen P.} and Pongracic, {Jacqueline A.} and Raissy, {Hengameh H.} and Kristie Ross and Sheehan, {William J.} and Christine Sorkness and Teague, {W. Gerald} and Shannon Thyne and Martinez, {Fernando D.} and Lisa Bartnikas and Alisha Bouzaher and Christopher Burke and Matthew Cavanaugh and Julia Chen and Elizabeth Cunningham and Amparito Cunningham and James Friedlander and Enal Hindi and David Kantor and Perdita Permaul and Devako Rao",

note = "Funding Information: Disclosure of potential conflict of interest: T. W. Guilbert reports personal fees from the American Board of Pediatrics–Pediatric Pulmonary Subboard, GlaxoSmithKline, Regeneron Pharmaceuticals, Merck, Novartis/Regeneron, Aviragen, GlaxoSmithKline/Regneron, and TEVA; grants from the National Institutes of Health (NIH); grants and personal fees from Sanofi / Regenero ; and other support from UpToDate outside the submitted work. L. B. Bacharier reports grants from the NIH during the conduct of the study and reports personal fees from Aerocrine, GlaxoSmithKline, Genentech/Novartis, Merck, DBV Technologies, Teva, Boehringer Ingelheim, AstraZeneca, WebMD/Medscape, Sanofi/Regeneron, Vectura, and Circassia outside the submitted work. D. T. Mauger reports grants from the National Heart, Lung, and Blood Institute (NHLBI) during the conduct of the study and has received nonfinancial support from GlaxoSmithKline , Merck , TEVA , and Boehringer Ingelheim outside the submitted work. W. Phipatanakul reports grants from the NIH during the conduct of the study, reports grants and other support from Genentech and GlaxoSmithKline , and reports other support from Novartis , Teva , and Sanofi / Regeneron . S. J. Szefler reports grants and other from NHLBI AsthmaNet during the conduct of the study and reports grants from GlaxoSmithKline and other support from Boehringer Ingelheim , Genentech , GlaxoSmithKline , Aerocrine , AstraZeneca , Daiichi Sankyo , Roche , Teva , and Propeller Health outside the submitted work. A. Beigelman and A. M. Fitzpatrick report grants from the NIH during the conduct of the study. D. J. Jackson reports grants from the NHLBI during the conduct of the study and reports grants from the National Institute of Allergy and Infectious Diseases (NIAID), personal fees from Vectura, Boehringer Ingelheim, and Pfizer, and grants and personal fees from GlaxoSmithKline outside the submitted work. M. D. Cabana reports personal fees from Novartis, Genentech, and Phadea outside the submitted work. M. Castro receives University Grant Funding from the NIH , American Lung Association , and PCORI ; receives pharmaceutical grant funding from AstraZeneca , Boehringer Ingelheim , Chiesi , GlaxoSmithKline , Novartis , and Sanofi Aventis; is a consultant for Aviragen, Boston Scientific, Genentech, Nuvaira, Neutronic, Therabron, Theravance, Vectura, 4D Pharma, VIDA, Mallincrodt, Teva, and Sanofi-Aventis; is a speaker for AstraZeneca, Boehringer Ingelheim, Boston Scientific, Genentech, Regeneron, Sanofi, and Teva; and receives royalties from Elsevier. J. F. Chmiel reports grants from the NIH during the conduct of the study and reports personal fees from the American Board of Pediatrics, the Cystic Fibrosis Foundation, Albumedix, Catabasis, Patara Pharma, and Paka Pharma; reports nonfinancial support from GlaxoSmithKline , Teva , Merck , Sunovion , Corbus Pharmaceuticals , and Vertex Pharmaceuticals ; and reports grants from the Cystic Fibrosis Foundation outside the submitted work. R. Covar reports grants from GlaxoSmithKline and Novartis outside the submitted work. E. Israel reports personal fees from AstraZeneca , Novartis , Regeneron Pharmaceuticals , Bird Rock Bio , Nuvelution Pharmaceuticals , Vitaeris , Sanofi Genzyme , Merck , Entrinsic Health Solutions , GlaxoSmithKline , Pneuma Respiratory , 4D Pharma, Sienna Biopharmaceutical, and Equillium; reports personal fees and other from TEVA Specialty Pharmaceuticals; reports grants from Genentech , Sanofi , and Boehringer Ingelheim ; reports nonfinancial support from Boehringer Ingelheim , GlaxoSmithKline , Merck , Sunovion , TEVA, and TEVA Specialty Pharmaceuticals; and reports other support from Vorso Corp outside the submitted work. S. C. Lazarus reports grants from the NIH / NHLBI during the conduct of the study. R. F. Lemanske, Jr, reports grants from the NHLBI during the conduct of the study; reports nonfinancial support from the American Academy of Allergy, Asthma & Immunology; reports grants from the Clinical and Translational Science Award from the NIH , Childhood Origins of Asthma (COAST), and AsthmaNet; and reports personal fees from LSU, Elsevier, UpToDate, the EAACI, the Japanese Society of Allergology, and the APAAACI and APAPARI outside the submitted work. N. Ly reports grants from Vertex 2018 and Vertex 2017 and personal fees from Gilead and has a patent null pending. W. Morgan reports grants from the NIH / NHLBI during the conduct of the study and reports grants from the Cystic Fibrosis Foundation , the NIH / NIAID and the NIH / NHLBI ; and reports personal fees from Genentech , the Cystic Fibrosis Foundation , and the American College of Chest Physicians outside the submitted work. J. Moy reports grants from the NIH / NHLBI during the conduct of the study. S. P. Peters reports grants from the NIH / NHLBI during the conduct of the study and reports personal fees from AstraZeneca, Regeneron-Sanofi, Genentech, TEVA, Quintiles, Novartis, and Mylan outside the submitted work. J. A. Pongracic reports grants from the NHLBI (subcontract through Northwestern University Feinberg School of Medicine ) during the conduct of the study and reports other support from GlaxoSmithKline and Novartis outside the submitted work. K. Ross reports nonfinancial support from Boehringer Ingelheim , GlaxoSmithKline , and Merck ; grants and nonfinancial support from TEVA ; and grants from Flamel , Jazz , and the NHLBI outside the submitted work. C. Sorkness reports grants from the NIAID and NHLBI during the conduct of the study. W. G. Teague reports grants from the NIH / NHLBI and TEVA Respiratory and personal fees from Genentech outside the submitted work. F. D. Martinez reports grants from the NIH / NHLBI during the conduct of the study; reports grants from the NIH / NHLBI , NIH / National Institute of Environmental Health Sciences , NIH / NIAID , and NIH /Office of Director, and Johnson & Johnson ; and reports personal fees from Copeval and Commense outside the submitted work. The rest of the authors declare that they have no relevant conflicts of interest. Letter to the Editor Funding Information: Disclosure of potential conflict of interest: T. W. Guilbert reports personal fees from the American Board of Pediatrics?Pediatric Pulmonary Subboard, GlaxoSmithKline, Regeneron Pharmaceuticals, Merck, Novartis/Regeneron, Aviragen, GlaxoSmithKline/Regneron, and TEVA; grants from the National Institutes of Health (NIH); grants and personal fees from Sanofi/Regenero; and other support from UpToDate outside the submitted work. L. B. Bacharier reports grants from the NIH during the conduct of the study and reports personal fees from Aerocrine, GlaxoSmithKline, Genentech/Novartis, Merck, DBV Technologies, Teva, Boehringer Ingelheim, AstraZeneca, WebMD/Medscape, Sanofi/Regeneron, Vectura, and Circassia outside the submitted work. D. T. Mauger reports grants from the National Heart, Lung, and Blood Institute (NHLBI)during the conduct of the study and has received nonfinancial support from GlaxoSmithKline, Merck, TEVA, and Boehringer Ingelheim outside the submitted work. W. Phipatanakul reports grants from the NIH during the conduct of the study, reports grants and other support from Genentech and GlaxoSmithKline, and reports other support from Novartis, Teva, and Sanofi/Regeneron. S. J. Szefler reports grants and other from NHLBI AsthmaNet during the conduct of the study and reports grants from GlaxoSmithKline and other support from Boehringer Ingelheim, Genentech, GlaxoSmithKline, Aerocrine, AstraZeneca, Daiichi Sankyo, Roche, Teva, and Propeller Health outside the submitted work. A. Beigelman and A. M. Fitzpatrick report grants from the NIH during the conduct of the study. D. J. Jackson reports grants from the NHLBI during the conduct of the study and reports grants from the National Institute of Allergy and Infectious Diseases (NIAID), personal fees from Vectura, Boehringer Ingelheim, and Pfizer, and grants and personal fees from GlaxoSmithKline outside the submitted work. M. D. Cabana reports personal fees from Novartis, Genentech, and Phadea outside the submitted work. M. Castro receives University Grant Funding from the NIH, American Lung Association, and PCORI; receives pharmaceutical grant funding from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis, and Sanofi Aventis; is a consultant for Aviragen, Boston Scientific, Genentech, Nuvaira, Neutronic, Therabron, Theravance, Vectura, 4D Pharma, VIDA, Mallincrodt, Teva, and Sanofi-Aventis; is a speaker for AstraZeneca, Boehringer Ingelheim, Boston Scientific, Genentech, Regeneron, Sanofi, and Teva; and receives royalties from Elsevier. J. F. Chmiel reports grants from the NIH during the conduct of the study and reports personal fees from the American Board of Pediatrics, the Cystic Fibrosis Foundation, Albumedix, Catabasis, Patara Pharma, and Paka Pharma; reports nonfinancial support from GlaxoSmithKline, Teva, Merck, Sunovion, Corbus Pharmaceuticals, and Vertex Pharmaceuticals; and reports grants from the Cystic Fibrosis Foundation outside the submitted work. R. Covar reports grants from GlaxoSmithKline and Novartis outside the submitted work. E. Israel reports personal fees from AstraZeneca, Novartis, Regeneron Pharmaceuticals, Bird Rock Bio, Nuvelution Pharmaceuticals, Vitaeris, Sanofi Genzyme, Merck, Entrinsic Health Solutions, GlaxoSmithKline, Pneuma Respiratory, 4D Pharma, Sienna Biopharmaceutical, and Equillium; reports personal fees and other from TEVA Specialty Pharmaceuticals; reports grants from Genentech, Sanofi, and Boehringer Ingelheim; reports nonfinancial support from Boehringer Ingelheim, GlaxoSmithKline, Merck, Sunovion, TEVA, and TEVA Specialty Pharmaceuticals; and reports other support from Vorso Corp outside the submitted work. S. C. Lazarus reports grants from the NIH/NHLBI during the conduct of the study. R. F. Lemanske, Jr, reports grants from the NHLBI during the conduct of the study; reports nonfinancial support from the American Academy of Allergy, Asthma & Immunology; reports grants from the Clinical and Translational Science Award from the NIH, Childhood Origins of Asthma (COAST), and AsthmaNet; and reports personal fees from LSU, Elsevier, UpToDate, the EAACI, the Japanese Society of Allergology, and the APAAACI and APAPARI outside the submitted work. N. Ly reports grants from Vertex 2018 and Vertex 2017 and personal fees from Gilead and has a patent null pending. W. Morgan reports grants from the NIH/NHLBI during the conduct of the study and reports grants from the Cystic Fibrosis Foundation, the NIH/NIAID and the NIH/NHLBI; and reports personal fees from Genentech, the Cystic Fibrosis Foundation, and the American College of Chest Physicians outside the submitted work. J. Moy reports grants from the NIH/NHLBI during the conduct of the study. S. P. Peters reports grants from the NIH/NHLBI during the conduct of the study and reports personal fees from AstraZeneca, Regeneron-Sanofi, Genentech, TEVA, Quintiles, Novartis, and Mylan outside the submitted work. J. A. Pongracic reports grants from the NHLBI (subcontract through Northwestern University Feinberg School of Medicine)during the conduct of the study and reports other support from GlaxoSmithKline and Novartis outside the submitted work. K. Ross reports nonfinancial support from Boehringer Ingelheim, GlaxoSmithKline, and Merck; grants and nonfinancial support from TEVA; and grants from Flamel, Jazz, and the NHLBI outside the submitted work. C. Sorkness reports grants from the NIAID and NHLBI during the conduct of the study. W. G. Teague reports grants from the NIH/NHLBI and TEVA Respiratory and personal fees from Genentech outside the submitted work. F. D. Martinez reports grants from the NIH/NHLBI during the conduct of the study; reports grants from the NIH/NHLBI, NIH/National Institute of Environmental Health Sciences, NIH/NIAID, and NIH/Office of Director, and Johnson & Johnson; and reports personal fees from Copeval and Commense outside the submitted work. The rest of the authors declare that they have no relevant conflicts of interest. Funding Information: Disclosure of potential conflict of interest: T. W. Guilbert reports personal fees from the American Board of Pediatrics–Pediatric Pulmonary Subboard, GlaxoSmithKline, Regeneron Pharmaceuticals, Merck, Novartis/Regeneron, Aviragen, GlaxoSmithKline/Regneron, and TEVA; grants from the National Institutes of Health (NIH); grants and personal fees from Sanofi/Regenero; and other support from UpToDate outside the submitted work. L. B. Bacharier reports grants from the NIH during the conduct of the study and reports personal fees from Aerocrine, GlaxoSmithKline, Genentech/Novartis, Merck, DBV Technologies, Teva, Boehringer Ingelheim, AstraZeneca, WebMD/Medscape, Sanofi/Regeneron, Vectura, and Circassia outside the submitted work. D. T. Mauger reports grants from the National Heart, Lung, and Blood Institute (NHLBI) during the conduct of the study and has received nonfinancial support from GlaxoSmithKline, Merck, TEVA, and Boehringer Ingelheim outside the submitted work. W. Phipatanakul reports grants from the NIH during the conduct of the study, reports grants and other support from Genentech and GlaxoSmithKline, and reports other support from Novartis, Teva, and Sanofi/Regeneron. S. J. Szefler reports grants and other from NHLBI AsthmaNet during the conduct of the study and reports grants from GlaxoSmithKline and other support from Boehringer Ingelheim, Genentech, GlaxoSmithKline, Aerocrine, AstraZeneca, Daiichi Sankyo, Roche, Teva, and Propeller Health outside the submitted work. A. Beigelman and A. M. Fitzpatrick report grants from the NIH during the conduct of the study. D. J. Jackson reports grants from the NHLBI during the conduct of the study and reports grants from the National Institute of Allergy and Infectious Diseases (NIAID), personal fees from Vectura, Boehringer Ingelheim, and Pfizer, and grants and personal fees from GlaxoSmithKline outside the submitted work. M. D. Cabana reports personal fees from Novartis, Genentech, and Phadea outside the submitted work. M. Castro receives University Grant Funding from the NIH, American Lung Association, and PCORI; receives pharmaceutical grant funding from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis, and Sanofi Aventis; is a consultant for Aviragen, Boston Scientific, Genentech, Nuvaira, Neutronic, Therabron, Theravance, Vectura, 4D Pharma, VIDA, Mallincrodt, Teva, and Sanofi-Aventis; is a speaker for AstraZeneca, Boehringer Ingelheim, Boston Scientific, Genentech, Regeneron, Sanofi, and Teva; and receives royalties from Elsevier. J. F. Chmiel reports grants from the NIH during the conduct of the study and reports personal fees from the American Board of Pediatrics, the Cystic Fibrosis Foundation, Albumedix, Catabasis, Patara Pharma, and Paka Pharma; reports nonfinancial support from GlaxoSmithKline, Teva, Merck, Sunovion, Corbus Pharmaceuticals, and Vertex Pharmaceuticals; and reports grants from the Cystic Fibrosis Foundation outside the submitted work. R. Covar reports grants from GlaxoSmithKline and Novartis outside the submitted work. E. Israel reports personal fees from AstraZeneca, Novartis, Regeneron Pharmaceuticals, Bird Rock Bio, Nuvelution Pharmaceuticals, Vitaeris, Sanofi Genzyme, Merck, Entrinsic Health Solutions, GlaxoSmithKline, Pneuma Respiratory, 4D Pharma, Sienna Biopharmaceutical, and Equillium; reports personal fees and other from TEVA Specialty Pharmaceuticals; reports grants from Genentech, Sanofi, and Boehringer Ingelheim; reports nonfinancial support from Boehringer Ingelheim, GlaxoSmithKline, Merck, Sunovion, TEVA, and TEVA Specialty Pharmaceuticals; and reports other support from Vorso Corp outside the submitted work. S. C. Lazarus reports grants from the NIH/NHLBI during the conduct of the study. R. F. Lemanske, Jr, reports grants from the NHLBI during the conduct of the study; reports nonfinancial support from the American Academy of Allergy, Asthma & Immunology; reports grants from the Clinical and Translational Science Award from the NIH, Childhood Origins of Asthma (COAST), and AsthmaNet; and reports personal fees from LSU, Elsevier, UpToDate, the EAACI, the Japanese Society of Allergology, and the APAAACI and APAPARI outside the submitted work. N. Ly reports grants from Vertex 2018 and Vertex 2017 and personal fees from Gilead and has a patent null pending. W. Morgan reports grants from the NIH/NHLBI during the conduct of the study and reports grants from the Cystic Fibrosis Foundation, the NIH/NIAID and the NIH/NHLBI; and reports personal fees from Genentech, the Cystic Fibrosis Foundation, and the American College of Chest Physicians outside the submitted work. J. Moy reports grants from the NIH/NHLBI during the conduct of the study. S. P. Peters reports grants from the NIH/NHLBI during the conduct of the study and reports personal fees from AstraZeneca, Regeneron-Sanofi, Genentech, TEVA, Quintiles, Novartis, and Mylan outside the submitted work. J. A. Pongracic reports grants from the NHLBI (subcontract through Northwestern University Feinberg School of Medicine) during the conduct of the study and reports other support from GlaxoSmithKline and Novartis outside the submitted work. K. Ross reports nonfinancial support from Boehringer Ingelheim, GlaxoSmithKline, and Merck; grants and nonfinancial support from TEVA; and grants from Flamel, Jazz, and the NHLBI outside the submitted work. C. Sorkness reports grants from the NIAID and NHLBI during the conduct of the study. W. G. Teague reports grants from the NIH/NHLBI and TEVA Respiratory and personal fees from Genentech outside the submitted work. F. D. Martinez reports grants from the NIH/NHLBI during the conduct of the study; reports grants from the NIH/NHLBI, NIH/National Institute of Environmental Health Sciences, NIH/NIAID, and NIH/Office of Director, and Johnson & Johnson; and reports personal fees from Copeval and Commense outside the submitted work. The rest of the authors declare that they have no relevant conflicts of interest.",

year = "2019",

month = may,

doi = "10.1016/j.jaci.2018.10.071",

language = "English (US)",

volume = "143",

pages = "1934--1937.e4",

journal = "Journal of Allergy and Clinical Immunology",

issn = "0091-6749",

publisher = "Mosby Inc.",

number = "5",

}

TY - JOUR

T1 - Challenges in assessing the efficacy of systemic corticosteroids for severe wheezing episodes in preschool children

AU - National Heart, Lung, and Blood Institute's AsthmaNet

AU - Guilbert, Theresa W.

AU - Bacharier, Leonard B.

AU - Mauger, David T.

AU - Phipatanakul, Wanda

AU - Szefler, Stanley J.

AU - Boehmer, Susan

AU - Beigelman, Avraham

AU - Fitzpatrick, Anne M.

AU - Jackson, Daniel J.

AU - Baxi, Sachin N.

AU - Benson, Mindy

AU - Burnham, Carey Ann D.

AU - Cabana, Michael D.

AU - Castro, Mario

AU - Chmiel, James F.

AU - Covar, Ronina

AU - Daines, Michael

AU - Gaffin, Jonathan M.

AU - Gentile, Deborah A.

AU - Holguin, Fernando

AU - Israel, Elliot

AU - Kelly, H. William

AU - Lazarus, Stephen C.

AU - Lemanske, Robert F.

AU - Ly, Ngoc

AU - Meade, Kelley

AU - Morgan, Wayne

AU - Moy, James

AU - Olin, J. Tod

AU - Peters, Stephen P.

AU - Pongracic, Jacqueline A.

AU - Raissy, Hengameh H.

AU - Ross, Kristie

AU - Sheehan, William J.

AU - Sorkness, Christine

AU - Teague, W. Gerald

AU - Thyne, Shannon

AU - Martinez, Fernando D.

AU - Bartnikas, Lisa

AU - Bouzaher, Alisha

AU - Burke, Christopher

AU - Cavanaugh, Matthew

AU - Chen, Julia

AU - Cunningham, Elizabeth

AU - Cunningham, Amparito

AU - Friedlander, James

AU - Hindi, Enal

AU - Kantor, David

AU - Permaul, Perdita

AU - Rao, Devako

N1 - Funding Information: Disclosure of potential conflict of interest: T. W. Guilbert reports personal fees from the American Board of Pediatrics–Pediatric Pulmonary Subboard, GlaxoSmithKline, Regeneron Pharmaceuticals, Merck, Novartis/Regeneron, Aviragen, GlaxoSmithKline/Regneron, and TEVA; grants from the National Institutes of Health (NIH); grants and personal fees from Sanofi / Regenero ; and other support from UpToDate outside the submitted work. L. B. Bacharier reports grants from the NIH during the conduct of the study and reports personal fees from Aerocrine, GlaxoSmithKline, Genentech/Novartis, Merck, DBV Technologies, Teva, Boehringer Ingelheim, AstraZeneca, WebMD/Medscape, Sanofi/Regeneron, Vectura, and Circassia outside the submitted work. D. T. Mauger reports grants from the National Heart, Lung, and Blood Institute (NHLBI) during the conduct of the study and has received nonfinancial support from GlaxoSmithKline , Merck , TEVA , and Boehringer Ingelheim outside the submitted work. W. Phipatanakul reports grants from the NIH during the conduct of the study, reports grants and other support from Genentech and GlaxoSmithKline , and reports other support from Novartis , Teva , and Sanofi / Regeneron . S. J. Szefler reports grants and other from NHLBI AsthmaNet during the conduct of the study and reports grants from GlaxoSmithKline and other support from Boehringer Ingelheim , Genentech , GlaxoSmithKline , Aerocrine , AstraZeneca , Daiichi Sankyo , Roche , Teva , and Propeller Health outside the submitted work. A. Beigelman and A. M. Fitzpatrick report grants from the NIH during the conduct of the study. D. J. Jackson reports grants from the NHLBI during the conduct of the study and reports grants from the National Institute of Allergy and Infectious Diseases (NIAID), personal fees from Vectura, Boehringer Ingelheim, and Pfizer, and grants and personal fees from GlaxoSmithKline outside the submitted work. M. D. Cabana reports personal fees from Novartis, Genentech, and Phadea outside the submitted work. M. Castro receives University Grant Funding from the NIH , American Lung Association , and PCORI ; receives pharmaceutical grant funding from AstraZeneca , Boehringer Ingelheim , Chiesi , GlaxoSmithKline , Novartis , and Sanofi Aventis; is a consultant for Aviragen, Boston Scientific, Genentech, Nuvaira, Neutronic, Therabron, Theravance, Vectura, 4D Pharma, VIDA, Mallincrodt, Teva, and Sanofi-Aventis; is a speaker for AstraZeneca, Boehringer Ingelheim, Boston Scientific, Genentech, Regeneron, Sanofi, and Teva; and receives royalties from Elsevier. J. F. Chmiel reports grants from the NIH during the conduct of the study and reports personal fees from the American Board of Pediatrics, the Cystic Fibrosis Foundation, Albumedix, Catabasis, Patara Pharma, and Paka Pharma; reports nonfinancial support from GlaxoSmithKline , Teva , Merck , Sunovion , Corbus Pharmaceuticals , and Vertex Pharmaceuticals ; and reports grants from the Cystic Fibrosis Foundation outside the submitted work. R. Covar reports grants from GlaxoSmithKline and Novartis outside the submitted work. E. Israel reports personal fees from AstraZeneca , Novartis , Regeneron Pharmaceuticals , Bird Rock Bio , Nuvelution Pharmaceuticals , Vitaeris , Sanofi Genzyme , Merck , Entrinsic Health Solutions , GlaxoSmithKline , Pneuma Respiratory , 4D Pharma, Sienna Biopharmaceutical, and Equillium; reports personal fees and other from TEVA Specialty Pharmaceuticals; reports grants from Genentech , Sanofi , and Boehringer Ingelheim ; reports nonfinancial support from Boehringer Ingelheim , GlaxoSmithKline , Merck , Sunovion , TEVA, and TEVA Specialty Pharmaceuticals; and reports other support from Vorso Corp outside the submitted work. S. C. Lazarus reports grants from the NIH / NHLBI during the conduct of the study. R. F. Lemanske, Jr, reports grants from the NHLBI during the conduct of the study; reports nonfinancial support from the American Academy of Allergy, Asthma & Immunology; reports grants from the Clinical and Translational Science Award from the NIH , Childhood Origins of Asthma (COAST), and AsthmaNet; and reports personal fees from LSU, Elsevier, UpToDate, the EAACI, the Japanese Society of Allergology, and the APAAACI and APAPARI outside the submitted work. N. Ly reports grants from Vertex 2018 and Vertex 2017 and personal fees from Gilead and has a patent null pending. W. Morgan reports grants from the NIH / NHLBI during the conduct of the study and reports grants from the Cystic Fibrosis Foundation , the NIH / NIAID and the NIH / NHLBI ; and reports personal fees from Genentech , the Cystic Fibrosis Foundation , and the American College of Chest Physicians outside the submitted work. J. Moy reports grants from the NIH / NHLBI during the conduct of the study. S. P. Peters reports grants from the NIH / NHLBI during the conduct of the study and reports personal fees from AstraZeneca, Regeneron-Sanofi, Genentech, TEVA, Quintiles, Novartis, and Mylan outside the submitted work. J. A. Pongracic reports grants from the NHLBI (subcontract through Northwestern University Feinberg School of Medicine ) during the conduct of the study and reports other support from GlaxoSmithKline and Novartis outside the submitted work. K. Ross reports nonfinancial support from Boehringer Ingelheim , GlaxoSmithKline , and Merck ; grants and nonfinancial support from TEVA ; and grants from Flamel , Jazz , and the NHLBI outside the submitted work. C. Sorkness reports grants from the NIAID and NHLBI during the conduct of the study. W. G. Teague reports grants from the NIH / NHLBI and TEVA Respiratory and personal fees from Genentech outside the submitted work. F. D. Martinez reports grants from the NIH / NHLBI during the conduct of the study; reports grants from the NIH / NHLBI , NIH / National Institute of Environmental Health Sciences , NIH / NIAID , and NIH /Office of Director, and Johnson & Johnson ; and reports personal fees from Copeval and Commense outside the submitted work. The rest of the authors declare that they have no relevant conflicts of interest. Letter to the Editor Funding Information: Disclosure of potential conflict of interest: T. W. Guilbert reports personal fees from the American Board of Pediatrics?Pediatric Pulmonary Subboard, GlaxoSmithKline, Regeneron Pharmaceuticals, Merck, Novartis/Regeneron, Aviragen, GlaxoSmithKline/Regneron, and TEVA; grants from the National Institutes of Health (NIH); grants and personal fees from Sanofi/Regenero; and other support from UpToDate outside the submitted work. L. B. Bacharier reports grants from the NIH during the conduct of the study and reports personal fees from Aerocrine, GlaxoSmithKline, Genentech/Novartis, Merck, DBV Technologies, Teva, Boehringer Ingelheim, AstraZeneca, WebMD/Medscape, Sanofi/Regeneron, Vectura, and Circassia outside the submitted work. D. T. Mauger reports grants from the National Heart, Lung, and Blood Institute (NHLBI)during the conduct of the study and has received nonfinancial support from GlaxoSmithKline, Merck, TEVA, and Boehringer Ingelheim outside the submitted work. W. Phipatanakul reports grants from the NIH during the conduct of the study, reports grants and other support from Genentech and GlaxoSmithKline, and reports other support from Novartis, Teva, and Sanofi/Regeneron. S. J. Szefler reports grants and other from NHLBI AsthmaNet during the conduct of the study and reports grants from GlaxoSmithKline and other support from Boehringer Ingelheim, Genentech, GlaxoSmithKline, Aerocrine, AstraZeneca, Daiichi Sankyo, Roche, Teva, and Propeller Health outside the submitted work. A. Beigelman and A. M. Fitzpatrick report grants from the NIH during the conduct of the study. D. J. Jackson reports grants from the NHLBI during the conduct of the study and reports grants from the National Institute of Allergy and Infectious Diseases (NIAID), personal fees from Vectura, Boehringer Ingelheim, and Pfizer, and grants and personal fees from GlaxoSmithKline outside the submitted work. M. D. Cabana reports personal fees from Novartis, Genentech, and Phadea outside the submitted work. M. Castro receives University Grant Funding from the NIH, American Lung Association, and PCORI; receives pharmaceutical grant funding from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis, and Sanofi Aventis; is a consultant for Aviragen, Boston Scientific, Genentech, Nuvaira, Neutronic, Therabron, Theravance, Vectura, 4D Pharma, VIDA, Mallincrodt, Teva, and Sanofi-Aventis; is a speaker for AstraZeneca, Boehringer Ingelheim, Boston Scientific, Genentech, Regeneron, Sanofi, and Teva; and receives royalties from Elsevier. J. F. Chmiel reports grants from the NIH during the conduct of the study and reports personal fees from the American Board of Pediatrics, the Cystic Fibrosis Foundation, Albumedix, Catabasis, Patara Pharma, and Paka Pharma; reports nonfinancial support from GlaxoSmithKline, Teva, Merck, Sunovion, Corbus Pharmaceuticals, and Vertex Pharmaceuticals; and reports grants from the Cystic Fibrosis Foundation outside the submitted work. R. Covar reports grants from GlaxoSmithKline and Novartis outside the submitted work. E. Israel reports personal fees from AstraZeneca, Novartis, Regeneron Pharmaceuticals, Bird Rock Bio, Nuvelution Pharmaceuticals, Vitaeris, Sanofi Genzyme, Merck, Entrinsic Health Solutions, GlaxoSmithKline, Pneuma Respiratory, 4D Pharma, Sienna Biopharmaceutical, and Equillium; reports personal fees and other from TEVA Specialty Pharmaceuticals; reports grants from Genentech, Sanofi, and Boehringer Ingelheim; reports nonfinancial support from Boehringer Ingelheim, GlaxoSmithKline, Merck, Sunovion, TEVA, and TEVA Specialty Pharmaceuticals; and reports other support from Vorso Corp outside the submitted work. S. C. Lazarus reports grants from the NIH/NHLBI during the conduct of the study. R. F. Lemanske, Jr, reports grants from the NHLBI during the conduct of the study; reports nonfinancial support from the American Academy of Allergy, Asthma & Immunology; reports grants from the Clinical and Translational Science Award from the NIH, Childhood Origins of Asthma (COAST), and AsthmaNet; and reports personal fees from LSU, Elsevier, UpToDate, the EAACI, the Japanese Society of Allergology, and the APAAACI and APAPARI outside the submitted work. N. Ly reports grants from Vertex 2018 and Vertex 2017 and personal fees from Gilead and has a patent null pending. W. Morgan reports grants from the NIH/NHLBI during the conduct of the study and reports grants from the Cystic Fibrosis Foundation, the NIH/NIAID and the NIH/NHLBI; and reports personal fees from Genentech, the Cystic Fibrosis Foundation, and the American College of Chest Physicians outside the submitted work. J. Moy reports grants from the NIH/NHLBI during the conduct of the study. S. P. Peters reports grants from the NIH/NHLBI during the conduct of the study and reports personal fees from AstraZeneca, Regeneron-Sanofi, Genentech, TEVA, Quintiles, Novartis, and Mylan outside the submitted work. J. A. Pongracic reports grants from the NHLBI (subcontract through Northwestern University Feinberg School of Medicine)during the conduct of the study and reports other support from GlaxoSmithKline and Novartis outside the submitted work. K. Ross reports nonfinancial support from Boehringer Ingelheim, GlaxoSmithKline, and Merck; grants and nonfinancial support from TEVA; and grants from Flamel, Jazz, and the NHLBI outside the submitted work. C. Sorkness reports grants from the NIAID and NHLBI during the conduct of the study. W. G. Teague reports grants from the NIH/NHLBI and TEVA Respiratory and personal fees from Genentech outside the submitted work. F. D. Martinez reports grants from the NIH/NHLBI during the conduct of the study; reports grants from the NIH/NHLBI, NIH/National Institute of Environmental Health Sciences, NIH/NIAID, and NIH/Office of Director, and Johnson & Johnson; and reports personal fees from Copeval and Commense outside the submitted work. The rest of the authors declare that they have no relevant conflicts of interest. Funding Information: Disclosure of potential conflict of interest: T. W. Guilbert reports personal fees from the American Board of Pediatrics–Pediatric Pulmonary Subboard, GlaxoSmithKline, Regeneron Pharmaceuticals, Merck, Novartis/Regeneron, Aviragen, GlaxoSmithKline/Regneron, and TEVA; grants from the National Institutes of Health (NIH); grants and personal fees from Sanofi/Regenero; and other support from UpToDate outside the submitted work. L. B. Bacharier reports grants from the NIH during the conduct of the study and reports personal fees from Aerocrine, GlaxoSmithKline, Genentech/Novartis, Merck, DBV Technologies, Teva, Boehringer Ingelheim, AstraZeneca, WebMD/Medscape, Sanofi/Regeneron, Vectura, and Circassia outside the submitted work. D. T. Mauger reports grants from the National Heart, Lung, and Blood Institute (NHLBI) during the conduct of the study and has received nonfinancial support from GlaxoSmithKline, Merck, TEVA, and Boehringer Ingelheim outside the submitted work. W. Phipatanakul reports grants from the NIH during the conduct of the study, reports grants and other support from Genentech and GlaxoSmithKline, and reports other support from Novartis, Teva, and Sanofi/Regeneron. S. J. Szefler reports grants and other from NHLBI AsthmaNet during the conduct of the study and reports grants from GlaxoSmithKline and other support from Boehringer Ingelheim, Genentech, GlaxoSmithKline, Aerocrine, AstraZeneca, Daiichi Sankyo, Roche, Teva, and Propeller Health outside the submitted work. A. Beigelman and A. M. Fitzpatrick report grants from the NIH during the conduct of the study. D. J. Jackson reports grants from the NHLBI during the conduct of the study and reports grants from the National Institute of Allergy and Infectious Diseases (NIAID), personal fees from Vectura, Boehringer Ingelheim, and Pfizer, and grants and personal fees from GlaxoSmithKline outside the submitted work. M. D. Cabana reports personal fees from Novartis, Genentech, and Phadea outside the submitted work. M. Castro receives University Grant Funding from the NIH, American Lung Association, and PCORI; receives pharmaceutical grant funding from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis, and Sanofi Aventis; is a consultant for Aviragen, Boston Scientific, Genentech, Nuvaira, Neutronic, Therabron, Theravance, Vectura, 4D Pharma, VIDA, Mallincrodt, Teva, and Sanofi-Aventis; is a speaker for AstraZeneca, Boehringer Ingelheim, Boston Scientific, Genentech, Regeneron, Sanofi, and Teva; and receives royalties from Elsevier. J. F. Chmiel reports grants from the NIH during the conduct of the study and reports personal fees from the American Board of Pediatrics, the Cystic Fibrosis Foundation, Albumedix, Catabasis, Patara Pharma, and Paka Pharma; reports nonfinancial support from GlaxoSmithKline, Teva, Merck, Sunovion, Corbus Pharmaceuticals, and Vertex Pharmaceuticals; and reports grants from the Cystic Fibrosis Foundation outside the submitted work. R. Covar reports grants from GlaxoSmithKline and Novartis outside the submitted work. E. Israel reports personal fees from AstraZeneca, Novartis, Regeneron Pharmaceuticals, Bird Rock Bio, Nuvelution Pharmaceuticals, Vitaeris, Sanofi Genzyme, Merck, Entrinsic Health Solutions, GlaxoSmithKline, Pneuma Respiratory, 4D Pharma, Sienna Biopharmaceutical, and Equillium; reports personal fees and other from TEVA Specialty Pharmaceuticals; reports grants from Genentech, Sanofi, and Boehringer Ingelheim; reports nonfinancial support from Boehringer Ingelheim, GlaxoSmithKline, Merck, Sunovion, TEVA, and TEVA Specialty Pharmaceuticals; and reports other support from Vorso Corp outside the submitted work. S. C. Lazarus reports grants from the NIH/NHLBI during the conduct of the study. R. F. Lemanske, Jr, reports grants from the NHLBI during the conduct of the study; reports nonfinancial support from the American Academy of Allergy, Asthma & Immunology; reports grants from the Clinical and Translational Science Award from the NIH, Childhood Origins of Asthma (COAST), and AsthmaNet; and reports personal fees from LSU, Elsevier, UpToDate, the EAACI, the Japanese Society of Allergology, and the APAAACI and APAPARI outside the submitted work. N. Ly reports grants from Vertex 2018 and Vertex 2017 and personal fees from Gilead and has a patent null pending. W. Morgan reports grants from the NIH/NHLBI during the conduct of the study and reports grants from the Cystic Fibrosis Foundation, the NIH/NIAID and the NIH/NHLBI; and reports personal fees from Genentech, the Cystic Fibrosis Foundation, and the American College of Chest Physicians outside the submitted work. J. Moy reports grants from the NIH/NHLBI during the conduct of the study. S. P. Peters reports grants from the NIH/NHLBI during the conduct of the study and reports personal fees from AstraZeneca, Regeneron-Sanofi, Genentech, TEVA, Quintiles, Novartis, and Mylan outside the submitted work. J. A. Pongracic reports grants from the NHLBI (subcontract through Northwestern University Feinberg School of Medicine) during the conduct of the study and reports other support from GlaxoSmithKline and Novartis outside the submitted work. K. Ross reports nonfinancial support from Boehringer Ingelheim, GlaxoSmithKline, and Merck; grants and nonfinancial support from TEVA; and grants from Flamel, Jazz, and the NHLBI outside the submitted work. C. Sorkness reports grants from the NIAID and NHLBI during the conduct of the study. W. G. Teague reports grants from the NIH/NHLBI and TEVA Respiratory and personal fees from Genentech outside the submitted work. F. D. Martinez reports grants from the NIH/NHLBI during the conduct of the study; reports grants from the NIH/NHLBI, NIH/National Institute of Environmental Health Sciences, NIH/NIAID, and NIH/Office of Director, and Johnson & Johnson; and reports personal fees from Copeval and Commense outside the submitted work. The rest of the authors declare that they have no relevant conflicts of interest.

PY - 2019/5

Y1 - 2019/5

UR - http://www.scopus.com/inward/record.url?scp=85061157615&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061157615&partnerID=8YFLogxK

U2 - 10.1016/j.jaci.2018.10.071

DO - 10.1016/j.jaci.2018.10.071

M3 - Article

C2 - 30660645

AN - SCOPUS:85061157615

SN - 0091-6749

VL - 143

SP - 1934-1937.e4

JO - Journal of Allergy and Clinical Immunology

JF - Journal of Allergy and Clinical Immunology

IS - 5

ER -

Challenges in assessing the efficacy of systemic corticosteroids for severe wheezing episodes in preschool children

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