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Will symptom-based therapy be effective for treating asthma in children?
Marianne Nuijsink1, Johan C De Jongste, Mariëlle W Pijnenburg
1Department of Paediatrics, Juliana Children's Hospital, The Hague, The Netherlands, m.nuijsink@hagaziekenhuis.nl.
Current Allergy and Asthma Reports
|June 19, 2013
Summary
Asthma symptom-based management is often sufficient, especially for young children. However, selected children with specific asthma phenotypes may benefit from incorporating lung function and inflammation markers into treatment decisions for better outcomes.
Area of Science:
- Pulmonology
- Pediatric Asthma Research
- Clinical Outcomes Assessment
Background:
- Asthma control assessment traditionally relies on patient-reported symptoms.
- Key asthma components like variable airflow obstruction, airway hyperresponsiveness, and inflammation correlate weakly with symptoms.
- This raises questions about the universal efficacy of symptom-based asthma therapy in children.
Purpose of the Study:
- To evaluate the effectiveness of symptom-based asthma management versus approaches incorporating objective measures.
- To identify specific pediatric asthma patient groups who might benefit from advanced monitoring.
Main Methods:
- Review of current evidence on asthma monitoring strategies.
- Comparison of symptom-based monitoring with lung function measurements and airway inflammation markers.
- Analysis of phenotypic characteristics influencing treatment response.
Main Results:
- No definitive evidence shows lung function or inflammation monitoring is superior to symptom monitoring for most asthma patients.
- Symptom-based management is generally sufficient and the only feasible method for preschool children.
- Selected pediatric groups, including those with poor symptom perception, discordant phenotypes, or persistent severe asthma, may benefit from integrated monitoring.
Conclusions:
- Symptom monitoring is adequate for the majority of children with asthma.
- Personalized asthma management considering lung function, hyperresponsiveness, and inflammation may improve outcomes in specific patient subgroups.
- Further research into phenotypically guided asthma treatment is warranted.
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