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Auricular Acupressure as an Adjuvant Treatment for Wheezing in Stable Chronic Obstructive Pulmonary Disease
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Auricular Acupressure as an Adjuvant Treatment for Wheezing in Stable Chronic Obstructive Pulmonary Disease

Published on: May 10, 2024

Phenotype-directed treatment of pre-school-aged children with recurrent wheeze

André Schultz1, Paul L P Brand

  • 1Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital for Children, Perth, Western Australia, Australia. andre.schultz@health.wa.gov.au

Journal of Paediatrics and Child Health
|June 18, 2011
PubMed

Insights

Treating preschool wheeze effectively requires understanding distinct phenotypes. Current treatments offer limited benefits, and phenotype-specific therapies are hindered by diagnostic challenges.

Area of Science:

  • Pediatric Pulmonology
  • Clinical Trials Research
  • Respiratory Medicine

Background:

  • Childhood wheeze encompasses diverse underlying conditions, necessitating targeted therapies for improved outcomes.
  • Differentiating preschool wheeze phenotypes is crucial for effective, individualized treatment strategies.

Purpose of the Study:

  • To review clinical trial data on preschool wheeze treatments, focusing on population characteristics and phenotypes.
  • To evaluate the efficacy of various therapeutic approaches for different preschool wheeze phenotypes.

Main Methods:

  • Systematic review of clinical trials investigating treatments for preschool wheeze.
  • Analysis of study populations' characteristics and identified wheeze phenotypes.
  • Assessment of treatment outcomes, including symptom improvement and hospitalization rates.

Main Results:

  • Systemic corticosteroids show no benefit for mild-to-moderate preschool wheeze exacerbations.
  • High-dose intermittent inhaled corticosteroids are not recommended due to side effects.
  • Regular inhaled corticosteroids and leukotriene antagonists provide modest benefits but do not reduce hospitalizations.
  • Emerging evidence suggests potential phenotype-specific treatment effects.

Conclusions:

  • Current evidence does not support routine systemic corticosteroid use for preschool wheeze.
  • While some treatments offer modest benefits, none consistently reduce hospitalizations.
  • Accurate differentiation of clinically relevant preschool wheeze phenotypes is essential for advancing phenotype-directed treatment.
  • Further research is needed to refine phenotype identification and guide targeted therapies.

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