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Published on: August 25, 2020
Clinical Course and Factors Associated with Asthma Control in Children under Control-based Asthma Management: A
Qi Gao1, Huijie Huang2, Kang Zhu2
1Respiratory Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Insights
Control-based asthma management significantly improved asthma control rates and lung function in children. Factors like high visual analogue scale scores and fewer aeroallergen sensitizations were linked to difficulties in achieving short-term asthma control.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Clinical Medicine
Background:
- Asthma control remains a challenge in pediatric populations.
- Identifying factors influencing asthma control is crucial for effective management.
- Respiratory pathogens and aeroallergen sensitization are potential contributors to uncontrolled asthma.
Purpose of the Study:
- To evaluate the effectiveness of control-based asthma management in children.
- To identify factors influencing asthma control in pediatric patients.
- To monitor respiratory pathogens and aeroallergen sensitization during the management period.
Main Methods:
- Prospective study of 121 children (3-14 years) with uncontrolled asthma.
- Monitoring of respiratory pathogens via pharyngeal swabs and serum aeroallergen-specific IgE.
- Assessment of asthma control scores, airway resistance, and fractional concentrations of exhaled nitric oxide (FENO).
Main Results:
- Asthma control rates improved significantly at 1 month (59%) and 3 months (76%).
- Patients showed significant improvements in numeric scores and lung function parameters.
- Higher visual analogue scale (VAS) scores and fewer aeroallergen sensitizations were associated with less favorable short-term asthma control.
Conclusions:
- Control-based asthma management leads to significant improvements in asthma control and lung function in children.
- Respiratory pathogen prevalence did not significantly impact asthma control outcomes in this study.
- Baseline VAS scores and aeroallergen sensitization patterns are important predictors of short-term asthma control achievement.
Abstract:
In the current study, we sought to track the clinical course of children under control-based asthma management and focused on respiratory pathogens monitoring. We prospectively explored influencing factors for asthma control. 121 children with uncontrolled asthma between 3-14 years of age were recruited. Common respiratory pathogens were detected with pharyngeal swabs and serum aeroallergen-specific IgE was measured. Numeric asthma control scores, airway resistance and fractional concentrations of exhaled nitric oxide (FENO) were evaluated. A proper control-based asthma management plan was established by the study physician. Regular reviews were performed, with the above measurements retested at set time intervals. The proportion of patients achieving asthma control at 1 month and 3 months were 59% and 76% ; respectively (p=0.013). These patients exhibited significant improvement in numeric scores and lung function parameters. The prevalence of common respiratory pathogens did not significantly differ between reviews. The number of sensitized aeroallergens significantly increased with age (r=0.235, p=0.010). Children with a high visual analogue scale (VAS) score for asthma at baseline were less likely to achieve asthma control after 1 month, while those sensitized to more aeroallergens were more likely to achieve asthma control after 1 month (p=0.016 and 0.012). In summary, children with asthma showed significant improvements in control rates and lung function during control-based asthma management, independent of respiratory pathogens testing reults. Patients with high VAS scores and fewer sensitizations to aeroallergens had difficulty achieving short-term asthma control.
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