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Childhood asthma treatment based on indirect hyperresponsiveness test: Randomized controlled trial
Janusz Ciółkowski1, Paweł Hydzik2, Marta Rachel3
1Allergology Outpatient Clinic, The Regional Public Hospital in Lesko, Lesko, Poland.
Pediatric Pulmonology
|June 21, 2023
Summary
An indirect airway hyperresponsiveness (AHR) test using hypertonic saline helped reduce mild asthma exacerbations in children. This simple test aids in monitoring asthma treatment effectively.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Respiratory Medicine
Background:
- Childhood asthma management requires effective monitoring tools.
- Assessing airway hyperresponsiveness (AHR) is crucial for asthma control.
- Inhaled corticosteroids (ICS) are a mainstay treatment for persistent asthma.
Purpose of the Study:
- To evaluate the utility of an indirect AHR test with hypertonic saline.
- To determine if this test can guide ICS dosing for optimal asthma control in children.
- To compare AHR-guided management with symptom-based monitoring.
Main Methods:
- 104 children (7-15 years) with mild-moderate atopic asthma participated.
- Patients were randomized into symptom-monitored or AHR-guided therapy groups.
- Asthma control, spirometry, exhaled nitric oxide, and blood eosinophils were assessed over 1 year.
Main Results:
- The AHR-guided group had significantly fewer mild exacerbations (0.83 vs. 1.67 per patient).
- Clinical control, inflammatory markers, and lung function improvements were similar between groups.
- Baseline blood eosinophils correlated with AHR and exacerbation risk.
Conclusions:
- Indirect AHR testing reduced mild exacerbations in childhood asthma.
- The hypertonic saline AHR test is a practical, cost-effective monitoring tool.
- This method complements symptom monitoring for mild-to-moderate asthma in children.
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