Only one trial compared preemptive nebulized budesonide to preemptive montelukast or placebo: there was no statistically significant group difference, despite a nonsignificant trend favoring ICS over LTRA for rescue oral steroids and symptom-free days. 40 Consequently, there is insufficient evidence to firmly conclude on the equivalence or superiority of any of these three preemptive options. 42 However, in view of the absence of a significant effect of preemptive LTRA or OCS
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