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[THE COURSE OF ASTHMA SYMPTOMS IN JAPANESE CHILDREN; THE FIRST REPORT FROM A MULTICENTER PROSPECTIVE COHORT STUDY]
Akira Akasawa1, Hiroko Watanabe2, Mayumi Furukawa1
1Division of Allergy, Tokyo Metropolitan Children's Medical Center.
Insights
Most preschool children in Japan with asthma saw their symptoms improve over five years. Asthma severity decreased significantly, with fewer children relying on quick-relief medications.
Area of Science:
- Pediatric Pulmonology
- Asthma Epidemiology
- Clinical Pediatrics
Background:
- Asthma guidelines and anti-inflammatory drugs have reduced severe cases and mortality.
- Limited prospective cohort studies exist in Japan on pediatric asthma symptom progression with treatment.
Purpose of the Study:
- To describe the 5-year course of asthma symptoms and treatment in Japanese children.
- To analyze factors influencing asthma progression in early childhood.
Main Methods:
- 851 children diagnosed with asthma were recruited from 90 Japanese hospitals/clinics (2004-2006).
- Annual questionnaires collected data on symptoms, treatment, and environmental exposures.
- Disease course was analyzed for 641 children registered at age 4 or younger, focusing on the first 5 years.
Main Results:
- Intermittent asthma symptoms increased from 37.6% to 86.5% over 5 years.
- Intermittent asthma severity increased from 7.0% to 38.9%, indicating reduced overall severity.
- Use of beta2-stimulants decreased from 87.8% to 53.5%; inhaled corticosteroid use remained stable (41.6% to 38.1%).
Conclusions:
- The majority of preschool-onset asthma cases in this cohort achieved symptom control.
- Asthma severity significantly decreased over the 5-year follow-up period.
- Treatment patterns shifted, with reduced reliance on short-acting bronchodilators.
Background:
The use of asthma control guidelines and anti-inflammatory drugs have significantly decreased the number of severe asthma cases including death from asthma. However, there are few prospective cohort studies among pediatric asthma patients in Japan describing the course of asthma symptoms with the treatment taken into consideration.
Method:
We recruited a total of 851 children diagnosed with asthma through 90 hospitals and clinics in 2004 to 2006. Questionnaires were posted annually to collect data on their asthma symptoms, treatment and environmental exposures. We analyzed the disease course in the first 5 years among the children who were registered at age 4 or younger.
Results:
The disease course of a total of 641 children, aged 2.8+/-1.1 (mean+/-SD) at registration were analyzed. The proportion of children who had intermittent symptoms increased from 37.6% at registration to 86.5% at 5 years, and the proportion of children with intermittent severity increased from 7.0% to 38.9%, showing a significant decrease in the overall severity. The proportion of children using β2 stimulants decreased from 87.8% at registration to 53.5% at 5 years, while the use of inhaled cortico-steroids were 41.6% at registration and 38.1% at 5 years.
Conclusion:
Most of the children with pre-school onset asthma had their symptoms controlled, and had decreased severity over 5 years.
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