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Published on: August 7, 2017
Characteristics and severity of asthma in children with and without atopic conditions: a cross-sectional study
Ali Arabkhazaeli1, Susanne J H Vijverberg2, Francine C van Erp3
1Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, P.O. Box 80082, David de Wied Building, Universiteitsweg 99, Utrecht, 3508 TB, The Netherlands. a.arabkhazaeli@uu.nl.
Insights
Children using asthma medication frequently have other allergies, increasing their risk for more severe asthma symptoms and exacerbations. This highlights the link between co-occurring allergic conditions and childhood asthma severity.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Clinical Pediatrics
Background:
- Childhood allergic diseases significantly impact children's quality of life.
- Asthma medication users were studied for co-existing allergies.
- The hypothesis tested was that asthma severity increases with specific allergic condition combinations.
Purpose of the Study:
- To investigate the prevalence of co-morbid allergic conditions in children using asthma medication.
- To determine if combinations of allergies correlate with increased asthma severity.
- To analyze the clinical differences between subgroups of children with varying allergic profiles.
Main Methods:
- Cross-sectional study of 703 children (ages 4-12) from the PACMAN cohort.
- Children were categorized into nine subgroups based on parental-reported allergies (hay fever, eczema, food allergy, or combinations).
- Clinical parameters assessed included asthma exacerbations (oral corticosteroid use, emergency department visits), asthma control, fractional exhaled nitric oxide (FeNO), and antihistamine use.
Main Results:
- 79% of children had at least one atopic condition; 25.6% had all three (hay fever, eczema, food allergy).
- Multiple allergic conditions correlated with increased risk of oral corticosteroid (OCS) use (OR=3.3) and emergency department (ED) visits (OR=2.3).
- Having more than one allergy was linked to a higher likelihood of inadequate short-term asthma control (OR=1.9).
Conclusions:
- Co-existence of allergic conditions is common in children using asthma medication.
- Parent-reported allergies are associated with increased asthma severity, including more complaints and exacerbations.
- Managing co-morbid allergies may be crucial for improving asthma control in pediatric patients.
Background:
Childhood allergic diseases have a major impact on a child's quality of life, as well as that of their parents. We studied the coexistence of reported allergies in children who use asthma medication. Additionally, we tested the hypothesis that asthma severity is greater among children with certain combinations of co-morbid allergic conditions.
Methods:
For this cross-sectional study, 703 children (ages 4 to 12 years) from the PACMAN cohort study were selected. All of the children were regular users of asthma medication. The study population was divided into nine subgroups according to parental-reported allergies of the child (hay fever, eczema, food allergy or combinations of these). In order to assess whether these subgroups differed clinically, the groups were compared for child characteristics (age, gender, family history of asthma), asthma exacerbations in the past year (oral corticosteroids (OCS) use; asthma-related emergency department (ED) visits), asthma control, fractional exhaled nitric oxide level (FeNO), and antihistaminic usage.
Results:
In our study, 79.0% of the parents reported that their child suffered from at least one atopic condition (hay fever, food allergy and eczema), and one quarter of the parents (25.6%) reported that their child suffered from all three atopic conditions. Having more than one atopic condition was associated with an increased risk of OCS use (OR = 3.3, 95% CI = 1.6 - 6.6), ED visits (OR = 2.3, 95% CI = 1.2 - 4.6) in the past year and inadequate short term asthma control (OR = 1.9, 95% CI = 1.3 - 2.8).
Conclusions:
Children who use asthma medication often also have other allergic conditions. Parental reported allergies were associated with a higher risk of more severe asthma (more asthma complaints and more asthma exacerbations).
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