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Small Airway Dysfunction and Prior Exacerbations are Common in Primarily Well-Controlled Pediatric Asthma
Preethi Balagani1, Yela Jung2, Sarah S Field3
1University of California, Irvine, Department of Allergy and Immunology, Orange, CA.
Summary
Many children with mild asthma have small airway dysfunction (SAD) or a history of exacerbations, yet often receive inadequate treatment. Identifying these risk factors is crucial for better asthma management in pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Asthma Research
- Respiratory Medicine
Background:
- Current asthma guidelines are effective, but many children still experience poor asthma control.
- Failure to identify small airway dysfunction (SAD) may contribute to poor control, as SAD is a known exacerbation risk factor.
Purpose of the Study:
- To assess the prevalence of SAD using oscillometry in children with asthma.
- To determine the association between SAD, prior exacerbations, and current therapy patterns.
- To evaluate if SAD and/or prior exacerbations align with current asthma treatment guidelines.
Main Methods:
- A retrospective, cross-sectional analysis of 53 children (ages 2-7) with mild, well-controlled asthma.
- Small airway dysfunction (SAD) was identified using the C100 Airwave Oscillometer.
- High-risk status was defined by SAD and/or more than one exacerbation in the prior 12 months.
Main Results:
- Nearly half (49.1%) of the children had SAD, and 43.3% had prior exacerbations.
- A significant majority (74.0%) met the criteria for high-risk status.
- Only 41% of high-risk children were receiving appropriate therapy (step 2 or higher).
Conclusions:
- Small airway dysfunction and prior exacerbations are common in young children with mild asthma.
- These biomarkers identify a phenotype at risk for future exacerbations that is often unrecognized.
- Current therapy patterns do not adequately address the identified risks in this pediatric asthma population.
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