March 2026. Volume 22. Number 1

Second-line treatment in severe pediatric asthma crisis: in search of the best option

 
 
 
 
 
 
 
 
 
 
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AVC | Critically appraised articles

Abdelgadir IS, Mudawi K, Hamud A, Tonbari A, Alhaji A, Salem R, et al. Second-line treatment option for children aged 18 years and under with an acute severe asthma exacerbation: a systematic review and meta-analysis of randomized controlled trials. Arch Dis Child. 2025;0:1-7.

Reviewers: Gimeno Díaz de Atauri Á1, González Rodríguez MP2.
1Sección de Neumología y Alergia Infantil. Servicio de Pediatría. Hospital Universitario 12 de Octubre. Madrid. España.
2Pediatra. CS Barrio del Pilar. Madrid. España.
Correspondence: Álvaro Gimeno Díaz de Atauri. Email: agimenodatauri@gmail.com
Reception date: 23/01/2026
Acceptance date: 02/02/2026
Publication date: 11/02/2026

Abstract

Authors’ conclusions: there is low-to-very-low certainty evidence demonstrating the superiority of any intravenous second-line treatment options for acute asthma.

Reviewers’ commentary: among pediatric patients with a severe asthma exacerbation, the evidence supporting the use of intravenous second-line-treatment when first line treatment fails, remains limited. Current data indicate that magnesium sulfate exhibits the most substantial efficacy; nonetheless, further high-quality studies are warranted to establish robust recommendations for its broader clinical application.

How to cite this article

Gimeno Díaz de Atauri A, González MP. Tratamiento de segunda línea en crisis asmática grave pediátrica: en busca de la mejor opción. Evid Pediatr. 2026;22:6.

AVC | Critically appraised articles

Abdelgadir IS, Mudawi K, Hamud A, Tonbari A, Alhaji A, Salem R, et al. Second-line treatment option for children aged 18 years and under with an acute severe asthma exacerbation: a systematic review and meta-analysis of randomized controlled trials. Arch Dis Child. 2025;0:1-7.

Reviewers: Gimeno Díaz de Atauri Á1, González Rodríguez MP2.
1Sección de Neumología y Alergia Infantil. Servicio de Pediatría. Hospital Universitario 12 de Octubre. Madrid. España.
2Pediatra. CS Barrio del Pilar. Madrid. España.
Correspondence: Álvaro Gimeno Díaz de Atauri. Email: agimenodatauri@gmail.com
Reception date: 23/01/2026
Acceptance date: 02/02/2026
Publication date: 11/02/2026

How to cite this article

Gimeno Díaz de Atauri A, González MP. Tratamiento de segunda línea en crisis asmática grave pediátrica: en busca de la mejor opción. Evid Pediatr. 2026;22:6.

11/02/2026

Linked Comment

Methodological note