BACKGROUND: Children with severe/difficult-to-treat asthma experience high morbidity including frequent severe exacerbations. More knowledge is required to identify predictors of these exacerbations to reduce their occurrence. OBJECTIVE: To investigate the risk of future severe exacerbations (FSEs) in children with severe/difficult-to-treat asthma and recent severe exacerbations (RSEs). METHODS: We analyzed the occurrence and association of RSE (defined as 1 or more corticosteroid bursts during the 3 months before each of 3 annual visits) and FSE (defined as 1 or more corticosteroid bursts 6 or 12 months later) in children age 6 to 11 years in The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens 3-year observational study. Repeated measures logistic regression analysis assessed the risk of FSE adjusted for demographics and clinical variables. RESULTS: In a multivariable model, FSE at 6 months was most strongly predicted by RSE (odds ratio [OR], 3.08; 95% CI, 2.21-4.28) and having 3 to 4 allergic triggers (OR, 2.05; 95% CI, 1.31-3.20). Race (OR, 1.77; 95% CI, 1.25-2.51) and being very poorly controlled according to the impairment component of the National Heart, Lung, and Blood Institute guidelines (OR, 1.59; 95% CI, 1.14-2.23) also significantly predicted FSE. CONCLUSION: Recent severe asthma exacerbations are an important independent predictor of FSE in children with severe/difficult-to-treat asthma and should be considered when establishing asthma management plans.
BACKGROUND:Children with severe/difficult-to-treat asthma experience high morbidity including frequent severe exacerbations. More knowledge is required to identify predictors of these exacerbations to reduce their occurrence. OBJECTIVE: To investigate the risk of future severe exacerbations (FSEs) in children with severe/difficult-to-treat asthma and recent severe exacerbations (RSEs). METHODS: We analyzed the occurrence and association of RSE (defined as 1 or more corticosteroid bursts during the 3 months before each of 3 annual visits) and FSE (defined as 1 or more corticosteroid bursts 6 or 12 months later) in children age 6 to 11 years in The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens 3-year observational study. Repeated measures logistic regression analysis assessed the risk of FSE adjusted for demographics and clinical variables. RESULTS: In a multivariable model, FSE at 6 months was most strongly predicted by RSE (odds ratio [OR], 3.08; 95% CI, 2.21-4.28) and having 3 to 4 allergic triggers (OR, 2.05; 95% CI, 1.31-3.20). Race (OR, 1.77; 95% CI, 1.25-2.51) and being very poorly controlled according to the impairment component of the National Heart, Lung, and Blood Institute guidelines (OR, 1.59; 95% CI, 1.14-2.23) also significantly predicted FSE. CONCLUSION: Recent severe asthma exacerbations are an important independent predictor of FSE in children with severe/difficult-to-treat asthma and should be considered when establishing asthma management plans.
Authors: Paul E Moore; Jason T Poston; Debra Boyer; Emily Barsky; Jonathan Gaffin; Kathleen B Boyne; Kristie R Ross; Laura Beth Mann Dosier; Timothy J Vece; Alicia M Casey; Sebastian K Welsh; J Wells Logan; Edward G Shepherd; Pelton A Phinzy; Howard B Panitch; Christina M Papantonakis; Eric D Austin; Amir B Orandi; Maleewan Kitcharoensakkul; Mark K Abe; Amjad Horani; Jordan S Rettig; Jessica Pittman Journal: Ann Am Thorac Soc Date: 2017-08
Authors: Nadia N Hansel; Elizabeth C Matsui; Robert Rusher; Meredith C McCormack; Jean Curtin-Brosnan; Roger D Peng; Derek Mazique; Patrick N Breysse; Gregory B Diette Journal: J Asthma Date: 2011-08-23 Impact factor: 2.515
Authors: Wilson Quezada; Eun Soo Kwak; Joan Reibman; Linda Rogers; John Mastronarde; William G Teague; Christine Wei; Janet T Holbrook; Emily DiMango Journal: Ann Allergy Asthma Immunol Date: 2015-12-19 Impact factor: 6.347
Authors: Stephen J Teach; Peter J Gergen; Stanley J Szefler; Herman E Mitchell; Agustin Calatroni; Jeremy Wildfire; Gordon R Bloomberg; Carolyn M Kercsmar; Andrew H Liu; Melanie M Makhija; Elizabeth Matsui; Wayne Morgan; George O'Connor; William W Busse Journal: J Allergy Clin Immunol Date: 2015-03-18 Impact factor: 10.793