Jianguo Hong1, Yixiao Bao2,3, Aihuan Chen4, Changchong Li5, Li Xiang6, Chuanhe Liu7, Zhimin Chen8, Deyu Zhao9, Zhou Fu10, Yunxiao Shang11. 1. a Department of Pediatrics , Shanghai General Hospital, Shanghai Jiaotong University , Shanghai , China. 2. b National Children's Medical Center, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai , China. 3. c Department of Pediatrics , Shanghai EverBetter Pubin Children's Hospital , Shanghai , China. 4. d Department of Pediatrics , The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease , Guangzhou , China. 5. e Department of Pediatrics , the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University , Wenzhou , China. 6. f Department of Allergy , Beijing Children's Hospital, Capital Medical University , Beijing , China. 7. g Department of Pediatrics , Capital Institute of Pediatrics , Beijing , China. 8. h Department of Respiratory Diseases , the Children's Hospital, Zhejiang University School of Medicine , Hangzhou , China. 9. i Department of Respiratory Diseases , Children's Hospital of Nanjing Medical University , Nanjing , China. 10. j Department of Respiratory Diseases , Children's Hospital of Chongqing Medical University , Chongqing , China. 11. k Department of Pediatrics , Shengjing Hospital of China Medical University , Shenyang , China.
Abstract
OBJECTIVE: With increased industrialization and urbanization in China, pediatric asthma is becoming more prevalent. Despite a growing body of evidence, there remains a significant unmet need for adequate management of childhood asthma. The Subspecialty Group of Respiratory Diseases of the Society of Pediatrics, the Chinese Medical Association, and the editorial board of the Chinese Journal of Pediatrics have recently updated the "Guidelines for diagnosis and optimal management of asthma in children," first published in 2008. METHODS: This article reviews the major updates to the guidelines and covers the main recommendations for diagnosis, assessment, and treatment of pediatric asthma in China. Key regional data on epidemiology, clinical features, disease burden, knowledge among children and parents, and risk factors including pollution are provided to contextualize the recommendations. RESULTS: The major updates to the guidelines include: (1) A more practical definition of asthma; (2) assessment of asthma control that takes into account both current symptom control and future risk; (3) classification based on disease severity that corresponds with treatment step; (4) differentiation between difficult-to-treat and poorly controlled asthma; (5) an open-ended approach to pharmacological management; and (6) allergen immunotherapy (AIT) in mild- to moderate-persistent asthma. CONCLUSIONS: The updated "Guidelines for the diagnosis and optimal management of asthma in children (2016)" combine the latest national and international clinical evidence and experience to provide practical and reliable recommendations to Chinese clinicians.
OBJECTIVE: With increased industrialization and urbanization in China, pediatric asthma is becoming more prevalent. Despite a growing body of evidence, there remains a significant unmet need for adequate management of childhood asthma. The Subspecialty Group of Respiratory Diseases of the Society of Pediatrics, the Chinese Medical Association, and the editorial board of the Chinese Journal of Pediatrics have recently updated the "Guidelines for diagnosis and optimal management of asthma in children," first published in 2008. METHODS: This article reviews the major updates to the guidelines and covers the main recommendations for diagnosis, assessment, and treatment of pediatric asthma in China. Key regional data on epidemiology, clinical features, disease burden, knowledge among children and parents, and risk factors including pollution are provided to contextualize the recommendations. RESULTS: The major updates to the guidelines include: (1) A more practical definition of asthma; (2) assessment of asthma control that takes into account both current symptom control and future risk; (3) classification based on disease severity that corresponds with treatment step; (4) differentiation between difficult-to-treat and poorly controlled asthma; (5) an open-ended approach to pharmacological management; and (6) allergen immunotherapy (AIT) in mild- to moderate-persistent asthma. CONCLUSIONS: The updated "Guidelines for the diagnosis and optimal management of asthma in children (2016)" combine the latest national and international clinical evidence and experience to provide practical and reliable recommendations to Chinese clinicians.