Related Experiment Videos

[Prospective observational study of clinical course after stopping inhaled corticosteroids in child asthma]

Akira Akasawa1, Tomoko Suda, Masayuki Akashi

  • 1Department of Interdisciplinary Medicine, National Center for Child Health and Development, Japan. akasawa-a@ncchd.go.jp

Arerugi = [Allergy]
|November 11, 2009
PubMed

Insights

Most children with asthma can stop inhaled corticosteroids (ICS) if well-controlled. This study found over 80% remained symptom-free after stopping ICS, indicating successful asthma management.

Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Clinical Therapeutics

Context:

  • Asthma management in children often involves inhaled corticosteroids (ICS).
  • Determining criteria for safely discontinuing ICS is crucial for long-term patient care.
  • Predicting outcomes after ICS cessation requires understanding clinical and immunological factors.

Purpose:

  • To evaluate the clinical course and identify predictors of outcome after stopping inhaled corticosteroids (ICS) in children with asthma.
  • To assess the feasibility of ICS withdrawal in children achieving complete asthma control.

Summary:

  • A prospective study followed 112 children with asthma, controlled on 100 microg/day ICS, who met methacholine challenge test (MCT) criteria (PC20 > 0.5 mg/mL) for ICS cessation.
  • After stopping ICS, 81% of 63 children followed for 24 months remained symptom-free with stable lung function.
  • Factors like duration of ICS use and baseline plasma IgE levels influenced outcomes, with lower IgE and shorter ICS duration associated with sustained remission.

Impact:

  • This research suggests that a significant majority of well-controlled asthmatic children can successfully discontinue ICS therapy.
  • Identifying specific clinical indices can help guide personalized treatment decisions for ICS withdrawal in pediatric asthma.
  • The findings support a potential shift towards de-escalation of therapy in select pediatric asthma populations, improving quality of life and reducing long-term medication burden.
Abstract

Related Concept Videos

Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids01:25

Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids

Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
COPD: Management Using Bronchodilators and Corticosteroids01:26

COPD: Management Using Bronchodilators and Corticosteroids

Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
Asthma III: Clinical Manifestations01:13

Asthma III: Clinical Manifestations

Asthma presents with a characteristic pattern of episodic respiratory symptoms that reflect underlying airway inflammation, bronchoconstriction, and mucus hypersecretion. Although severity varies among individuals, certain clinical manifestations are considered hallmarks of the disorder and often guide diagnosis and assessment.Respiratory SymptomsA persistent cough is one of the most common early features of asthma. It is frequently dry and tends to worsen at night or in the early morning,...
Asthma: Pathogenesis and Management01:20

Asthma: Pathogenesis and Management

Asthma is a chronic pulmonary condition involving inflammation of the airways, hyper-reactivity, and reversible obstruction of the airways. This condition can significantly impact a person's quality of life, making breathing difficult and leading to distressing symptoms.
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
Asthma-IV: Diagnostic and Management01:30

Asthma-IV: Diagnostic and Management

The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Asthma-II: Pathophysiology and Classification01:26

Asthma-II: Pathophysiology and Classification

Asthma is a prevalent chronic respiratory condition marked by inflammation and hyperresponsiveness of the airways. Its pathophysiology involves complex interactions among inflammatory pathways, immune responses, and neural mechanisms.
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include: