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Can early intervention in pediatric asthma improve long-term outcomes? A question that needs an answer
Miguel J Lanz1, Ileen Gilbert2, Stanley J Szefler3
1Allergy and Asthma, AAADRS Clinical Research Center, Coral Gables, Florida.
Insights
Poorly controlled childhood asthma may lead to adult lung issues. Monitoring lung function and exploring new treatments are crucial for managing pediatric asthma progression and long-term outcomes.
Area of Science:
- Pediatric Pulmonology
- Asthma Pathophysiology
- Clinical Therapeutics
Background:
- Childhood asthma may persist into adulthood, with uncontrolled cases linked to adult airflow obstruction.
- Limited data exists on pediatric asthma progression, hindering predictive capabilities for clinicians.
- Early childhood asthma can impact lung development, but intervention effectiveness in preserving lung function is not fully understood.
Purpose of the Study:
- To review current knowledge on childhood asthma treatment and progression.
- To identify knowledge gaps in understanding asthma's long-term effects.
- To explore the impact of early asthma control on adult lung health.
Main Methods:
- Nonsystematic literature search of PubMed.
- Inclusion of articles based on authors' expertise in childhood asthma.
- Focus on treatment and progression into adulthood.
Main Results:
- Uncontrolled asthma in early childhood can negatively affect lung development.
- Effectiveness of traditional interventions in preserving lung function in very young children remains unclear.
- Identification of specific asthma phenotypes may guide treatment responses.
Conclusions:
- Continuous monitoring of pediatric asthma control and pulmonary function is essential.
- Minimizing exacerbations is key to preserving lung development.
- While biologic therapies show promise for severe asthma in children, knowledge gaps regarding efficacy and safety in younger populations persist, impacting long-term outcome understanding.
Objective:
Although many children with asthma do not experience persistence into adulthood, recent studies have suggested that poorly controlled asthma in childhood may be associated with significant airflow obstruction in adulthood. However, data regarding disease progression are lacking, and clinicians are not yet able to predict the course of a child's asthma. The goal of this article was to assess the current understanding of childhood asthma treatment and progression and to highlight gaps in information that remain.
Data Sources:
Nonsystematic PubMed literature search and authors' expertise.
Study Selection:
Articles were selected at the authors' discretion based on areas of interest in childhood asthma treatment and progression into adulthood.
Results:
Uncontrolled asthma in early childhood can potentially have lasting effects on lung development, but it is unclear whether traditional interventions in very young children preserve lung function. Although not all children respond to standard interventions, certain asthma phenotypes have been identified that can help to understand which children may respond to a particular treatment.
Conclusion:
Clinicians should monitor children's asthma control and pulmonary function over time to assess the long-term impact of an intervention and to minimize the effect of uncontrolled asthma, especially exacerbations, on lung development. New biologic therapies have shown promise in treating adults with severe, uncontrolled asthma, and some of these therapies are approved in the United States for children as young as age 6. However, knowledge gaps regarding the efficacy and safety of these treatments in younger children hamper our understanding of their effect on long-term outcomes.
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