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Published on: November 4, 2010

Clinical predictors and outcomes of consistent bronchodilator response in the childhood asthma management program

Sunita Sharma1, Augusto A Litonjua, Kelan G Tantisira

  • 1Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. ssharma4@partners.org

The Journal of Allergy and Clinical Immunology
|October 14, 2008
PubMed

Insights

Children with consistent bronchodilator response (BDR) to asthma medications over time often have poorer outcomes. Predictors include lower lung function and higher IgE levels, indicating a need for closer monitoring.

Area of Science:

  • Pediatric Pulmonology
  • Asthma Phenotyping
  • Clinical Outcomes Research

Background:

  • Bronchodilator response (BDR) to beta(2)-agonists in asthma is variable.
  • The long-term significance of a consistent BDR is not well understood.

Purpose of the Study:

  • To identify baseline clinical predictors of a consistent BDR over 4 years in children with mild-to-moderate persistent asthma.
  • To determine the clinical outcomes associated with a consistent BDR phenotype.

Main Methods:

  • Analysis of 1041 children from the Childhood Asthma Management Program.
  • Defined consistent BDR as a >=12% and >=200 mL FEV(1) increase after beta(2)-agonist at yearly visits.
  • Compared clinical outcomes between children with and without consistent BDR.

Main Results:

  • Identified 52 children with consistent BDRs over 4 years.
  • Consistent BDR associated with lower baseline FEV(1), higher IgE, and no inhaled corticosteroid use.
  • Consistent BDR linked to increased hospital visits, prednisone use, nocturnal awakenings, and missed school days.

Conclusions:

  • Identified key predictors for a consistent bronchodilator response phenotype in pediatric asthma.
  • Demonstrated that a consistent BDR is associated with significantly worse asthma-related clinical outcomes.
Abstract

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