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Predicting short term response to anti-inflammatory therapy in young children with asthma

Stefan Zielen1, Martin Christmann, Magdalena Kloska

  • 1Allergologie, Pneumologie und Mukoviszidose, Klinikum der Johann Wolfgang-Goethe-Universität, 60590 Frankfurt, Germany.

Current Medical Research and Opinion
|December 17, 2009
PubMed

Insights

Predicting asthma treatment response in children is possible using lung function tests. Pre-bronchodilatory Forced Expiratory Volume in one second (FEV1) and airway reversibility effectively indicate short-term response to inhaled corticosteroids (ICS) and montelukast.

Area of Science:

  • Pediatric Pulmonology
  • Asthma Management
  • Biomarker Discovery

Background:

  • Current anti-inflammatory asthma treatments for young children include inhaled corticosteroids (ICS) and montelukast (LTRA).
  • Identifying predictors of treatment response is crucial for optimizing pediatric asthma care.

Purpose of the Study:

  • To identify biomarkers that predict short-term (6-week) response to ICS and LTRAs in children with asthma.
  • To evaluate the efficacy of pre-bronchodilatory FEV1 and airway reversibility as predictive markers.

Main Methods:

  • 102 children (4-7 years) with episodic asthma were enrolled.
  • 45 symptomatic children were randomized to receive either montelukast or fluticasone for 6 weeks.
  • Biomarkers including FEV1, airway reversibility, methacholine challenge, eNO, allergy status, IgE levels, and eosinophils were assessed.

Main Results:

  • Both montelukast and fluticasone showed equal effectiveness in improving FEV1 (p = 0.44).
  • Pre-bronchodilatory FEV1 (p < 0.001) and airway reversibility (p = 0.04) at randomization strongly correlated with favorable treatment response.
  • Other tested biomarkers, including exhaled nitric oxide and IgE levels, were not predictive.

Conclusions:

  • Pre-bronchodilatory FEV1 and airway reversibility are promising indicators for predicting short-term anti-inflammatory therapy response in young children with asthma.
  • These lung function parameters may aid in tailoring asthma treatment strategies for pediatric patients.
Abstract

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