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Childhood Asthma Control Test and airway inflammation evaluation in asthmatic children
G L Piacentini1, D G Peroni, A Bodini
1Clinica Pediatrica Università di Verona, Verona, Italy.
Insights
The Childhood Asthma Control Test (C-ACT) complements, but does not replace, other asthma control measures like FeNO and lung function in children. This is especially true during follow-up visits for pediatric asthma management.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Asthma Management
Background:
- The Childhood Asthma Control Test (C-ACT) is a proposed tool for assessing childhood asthma control.
- Its clinical utility requires evaluation alongside objective measures of airway inflammation and lung function.
Purpose of the Study:
- To evaluate the position of the C-ACT in clinical management of pediatric asthma.
- To assess C-ACT in relation to fractional exhaled nitric oxide (FeNO) and lung function (FEV1, FVC).
Main Methods:
- 200 asthmatic children were studied: 47 newly diagnosed and 153 on GINA guideline treatment.
- Evaluated C-ACT scores, FeNO levels, and lung function (FEV1, FVC).
Main Results:
- Newly diagnosed children had lower C-ACT, FVC, and FEV1, and higher FeNO compared to follow-up patients.
- Significant correlations between C-ACT and FeNO, FEV1, and FEV1/FVC were found in newly diagnosed children only.
- Lack of correlation in follow-up suggested C-ACT dissociation from other control markers.
Conclusions:
- C-ACT is a valuable tool but not a sole substitute for assessing asthma control in children.
- C-ACT should be used alongside FeNO and lung function, particularly during follow-up visits for comprehensive pediatric asthma management.
Background:
The Childhood Asthma Control Test (C-ACT) has been proposed as a tool in assessing the level of disease control in asthmatic children. To evaluate the position of C-ACT in the clinical management of asthmatic children, in relationship to the level of airway inflammation as assessed by fractional exhaled nitric oxide (FeNO) and with lung function.
Methods:
A total of 200 asthmatic children were included in the study: 47 children with newly diagnosed asthma ('New') and without any regular controller therapy; and 153 children with previously diagnosed asthma, treated according to GINA guidelines, and evaluated during a scheduled follow-up visit ('Follow-up'). Childhood Asthma Control Test, FeNO and lung function [forced expiratory volume 1 (FEV1) and forced vital capacity (FVC)] were evaluated.
Results:
In New vs Follow-up participants, C-ACT score (P < 0.001), FVC (P < 0.005) and FEV1 (P < 0.05) were significantly lower, and FeNO (P = 0.011) were significantly higher. In New, but not in Follow-up participants, significant correlations were observed between C-ACT score and FeNO (r = -0.51; P < 0.001), FEV1 (r = 0.34; P = 0.022) and FEV1/FVC (r = 0.32; P = 0.03). This lack of correlation in Follow-up visits seemed attributable to dissociation between inadequately controlled asthma by C-ACT ratings with normalization of other measures such as FeNO levels.
Conclusions:
This study confirms and expands the concept that C-ACT is complementary to, but not a substitute for, other markers of disease control in asthmatic children, especially in the context of follow-up visits.
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