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Relationship between the level of asthma control, lung function and bronchodilator response in asthmatic children on

Javier Mallol1, Viviana Aguirre-Camposano1, Alejandro Gallardo1

  • 1Department of Pediatric Respiratory Medicine, Hospital El Pino, University of Santiago de Chile, Santiago.

Monaldi Archives for Chest Disease = Archivio Monaldi Per Le Malattie Del Torace
|May 21, 2025
PubMed

Insights

The Global Initiative for Asthma criteria (GINAc) identified more uncontrolled asthma cases in children than the Asthma Control Test (ACT). Lung function tests may help identify controlled asthma with underlying issues.

Area of Science:

  • Pediatric Pulmonology
  • Asthma Management
  • Clinical Assessment Tools

Background:

  • Asthma control assessment in children is crucial for effective management.
  • Inhaled corticosteroids are a cornerstone of pediatric asthma therapy.
  • Discrepancies exist between subjective and objective measures of asthma control.

Purpose of the Study:

  • To compare the Global Initiative for Asthma criteria (GINAc) and the Asthma Control Test (ACT) in assessing pediatric asthma control.
  • To evaluate the utility of lung function (LF) tests, including spirometry and bronchodilator response (BDR), in identifying uncontrolled asthma.
  • To explore the role of LF tests in conjunction with questionnaires for a comprehensive asthma assessment.

Main Methods:

  • A study involving 149 children on inhaled corticosteroids.
  • Assessment of asthma control using GINAc and ACT questionnaires.
  • Performance of spirometry and bronchodilator response (BDR) tests.

Main Results:

  • GINAc identified significantly more children with uncontrolled asthma (65.8%) compared to ACT (25.9%).
  • Abnormal lung function was more prevalent in GINAc-defined uncontrolled asthma.
  • Bronchodilator response was also more frequent in GINAc-defined uncontrolled asthma and ACT-defined uncontrolled asthma.

Conclusions:

  • GINAc appears more sensitive than ACT in detecting uncontrolled asthma in children.
  • Spirometry and BDR may complement asthma control questionnaires, particularly for identifying controlled cases with subclinical abnormalities.
  • Integrating LF tests could refine the assessment of asthma control and guide treatment adjustments.

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