Japanese guidelines for childhood asthma 2020

Area of Science:

• Pediatric Allergy and Immunology
• Respiratory Medicine
• Evidence-Based Medicine

Background:

• The Japanese Pediatric Guideline for the Treatment and Management of Asthma (JPGL) 2017 provides a foundation for asthma care.
• The JPGL 2017 was the first to adopt the GRADE system and Minds approach for evidence-based updates.
• Asthma management in children requires specific considerations for different age groups.

Purpose of the Study:

• To translate and disseminate the JPGL 2017 into English as the JGCA 2020.
• To provide updated, evidence-based recommendations for childhood asthma management.
• To guide non-specialist physicians in caring for children with asthma.

Main Methods:

• The guideline development followed the GRADE system and Minds approach.
• Eight key clinical questions regarding childhood asthma treatment were addressed.
• Recommendations cover diagnosis, acute exacerbations, and long-term management strategies.

Main Results:

• Diagnosis for infants and preschool children (≤5 years) involves response to short-acting beta2 agonists or a trial of controller treatment.
• Long-term management emphasizes pharmacological therapy, risk factor control, patient education, and a collaborative approach.
• A cyclical approach of evaluation, adjustment, and treatment is recommended for sustained management.
• Short-term additional treatments, including transdermal patches and oral beta2 agonists, are suggested for symptom stabilization during transient deteriorations.

Conclusions:

• The JGCA 2020 provides comprehensive, evidence-based guidance for childhood asthma management.
• The guidelines are crucial for improving the care of pediatric asthma patients.
• Effective asthma management requires a dynamic, patient-centered, and evidence-informed strategy.