Anas Al-Turki1,2, Ann Salvator3, Shasha Bai4,3, Shahid I Sheikh1,2. 1. Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA. 2. Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA. 3. Biostatistics Resource at Nationwide Children's Hospital, Nationwide Children's Hospital, Columbus, Ohio, USA. 4. Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, Ohio, USA.
Abstract
Background: Childhood asthma carries significant morbidity. Aim/ Objectives: Aim of the study was to compare efficacy of 2 commonly used therapies for asthma control in children with asthma. Methods: This was a 1-year, prospective cohort study at a tertiary care children's hospital. Patients were referred by their primary care physicians (PCPs) for asthma control. All patients were on low-dose inhaled corticosteroids (ICSs) at baseline. They were either switched to medium-dose ICS (ICS group) or medium-dose ICS and long-acting beta agonist (ICS+LABA group). Results were compared over time and between both groups. Results: Our cohort included 163 children (ages 2-18 years) with mean age of 5.62 ± 3.61 years. Mean Asthma Control Test (ACT) score at baseline was 15.9 ± 5.4. Mean ACT and percent predicted forced expiratory volume in one second improved (P < 0.0001 for both) in both groups. Median emergency department visits, short courses of oral steroids, and unscheduled PCP visits for acute asthma significantly decreased (P < 0.001 for all) in both groups. Similarly, days/month with wheezing, nighttime cough, and missed school days significantly decreased in both groups (P < 0.001 for all). Patients in ICS group were more likely to fail to achieve asthma control compared to patients in ICS+LABA group. Conclusion: Our study suggests that in children with uncontrolled asthma on low-dose ICS, switching to either medium-dose ICS or medium-dose ICS+LABA resulted in better symptom control, ACT improvement, and less asthma exacerbations over time. ICS+LABA had the additional benefit of less risk of treatment failure when compared to medium-dose ICS.
Background: Childhood asthma carries significant morbidity. Aim/ Objectives: Aim of the study was to compare efficacy of 2 commonly used therapies for asthma control in children with asthma. Methods: This was a 1-year, prospective cohort study at a tertiary care children's hospital. Patients were referred by their primary care physicians (PCPs) for asthma control. All patients were on low-dose inhaled corticosteroids (ICSs) at baseline. They were either switched to medium-dose ICS (ICS group) or medium-dose ICS and long-acting beta agonist (ICS+LABA group). Results were compared over time and between both groups. Results: Our cohort included 163 children (ages 2-18 years) with mean age of 5.62 ± 3.61 years. Mean Asthma Control Test (ACT) score at baseline was 15.9 ± 5.4. Mean ACT and percent predicted forced expiratory volume in one second improved (P < 0.0001 for both) in both groups. Median emergency department visits, short courses of oral steroids, and unscheduled PCP visits for acute asthma significantly decreased (P < 0.001 for all) in both groups. Similarly, days/month with wheezing, nighttime cough, and missed school days significantly decreased in both groups (P < 0.001 for all). Patients in ICS group were more likely to fail to achieve asthma control compared to patients in ICS+LABA group. Conclusion: Our study suggests that in children with uncontrolled asthma on low-dose ICS, switching to either medium-dose ICS or medium-dose ICS+LABA resulted in better symptom control, ACT improvement, and less asthma exacerbations over time. ICS+LABA had the additional benefit of less risk of treatment failure when compared to medium-dose ICS.
Authors: J Mark FitzGerald; Louis-Philipe Boulet; R Andrew McIvor; Sabrina Zimmerman; Kenneth R Chapman Journal: Can Respir J Date: 2006 Jul-Aug Impact factor: 2.409
Authors: Fernando D Martinez; Vernon M Chinchilli; Wayne J Morgan; Susan J Boehmer; Robert F Lemanske; David T Mauger; Robert C Strunk; Stanley J Szefler; Robert S Zeiger; Leonard B Bacharier; Elizabeth Bade; Ronina A Covar; Noah J Friedman; Theresa W Guilbert; Hengameh Heidarian-Raissy; H William Kelly; Jonathan Malka-Rais; Michael H Mellon; Christine A Sorkness; Lynn Taussig Journal: Lancet Date: 2011-02-14 Impact factor: 79.321
Authors: Hans Bisgaard; Pascal Le Roux; Ditlef Bjåmer; Andrzej Dymek; Jan H Vermeulen; Christer Hultquist Journal: Chest Date: 2006-12 Impact factor: 9.410
Authors: Eric D Bateman; Helen K Reddel; Paul M O'Byrne; Peter J Barnes; Nanshan Zhong; Christina Keen; Carin Jorup; Rosa Lamarca; Agnieszka Siwek-Posluszna; J Mark FitzGerald Journal: N Engl J Med Date: 2018-05-17 Impact factor: 91.245
Authors: Nick P Adams; Janine C Bestall; Paul Jones; Toby J Lasserson; Benedict Griffiths; Christopher J Cates Journal: Cochrane Database Syst Rev Date: 2008-10-08
Authors: David A Stempel; Ibrahim H Raphiou; Kenneth M Kral; Anne M Yeakey; Amanda H Emmett; Charlene M Prazma; Kathleen S Buaron; Steven J Pascoe Journal: N Engl J Med Date: 2016-03-06 Impact factor: 91.245