Difficult and Severe Asthma in Children

Porcaro, Federica; Ullmann, Nicola; Allegorico, Annalisa; Marco, A. Di; Cutrera, Renato

doi:10.3390/children7120286

Cited by 16 publications

(14 citation statements)

References 88 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cough may often be the only first symptom of mild bronchial asthma. This is clinically important because undiagnosed or poorly treated asthma can have serious consequences [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…Children are exposed to constant contact with various sensitizing factors that aggravate the course of the disease and provoke the onset of possible symptoms. Asthma attacks can be triggered by infections, dust, psychological and physical stress, or excessive exercise [ 27 ]. In our study, environmental risk factors, such as the presence of pets and exposure to tobacco smoke, were not observed to affect the prevalence of bronchial asthma.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Respiratory Symptoms, Allergies, and Environmental Exposures in Children with and without Asthma

Wypych-Ślusarska

Grot

Maria

et al. 2022

IJERPH

View full text Add to dashboard Cite

Background: Epidemiological data concerning the level of asthma morbidity indicate that in Poland, asthma is diagnosed in 5–10% of the pediatric population. Aim The purpose of this study was to compare the prevalence of respiratory symptoms and allergies in a group of children with and without asthma and to evaluate the association between exposure to environmental factors and the prevalence of bronchial asthma in a pediatric population. Material and Methods: A cross-sectional study was conducted on a group of 995 children attending primary schools in the province of Silesia in 2018–2019. The research tool was an anonymous questionnaire developed based on the form used in The International Study of Asthma and Allergies in Childhood (ISAAC). Children’s health status, the prevalence of bronchial asthma, and the performance of allergic skin tests were assessed based on parents’ indications in a questionnaire. Environmental exposures such as mold and dampness in apartments or ETS were similarly assessed. Analyses were performed using Statistica 13.0; p < 0.05. Results: A total of 88 subjects (8.8%) suffered from bronchial asthma. Parents of children with asthma, compared to parents of children without the disease, were more likely to rate their children’s health as rather good (43.2% vs. 38.0%) or average (21.6% vs. 3.1%). All analyzed respiratory symptoms, as well as allergies, were statistically more frequent in children with bronchial asthma. Conclusions: The parent’s subjective assessment of the child’s health varied significantly according to the asthma diagnosis. Asthma is also associated with other diseases: allergic reactions to pollen, house dust, hay fever, and AD (atopic dermatitis) were statistically significantly more frequent among children diagnosed with bronchial asthma.

show abstract

“…Cough may often be the only first symptom of mild bronchial asthma. This is clinically important because undiagnosed or poorly treated asthma can have serious consequences [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Respiratory Symptoms, Allergies, and Environmental Exposures in Children with and without Asthma

Wypych-Ślusarska

Grot

Maria

et al. 2022

IJERPH

View full text Add to dashboard Cite

show abstract

“…Patients that need to be moved to GINA steps 4 and 5 care have to be referred to a tertiary center for a specialist evaluation first to confirm the diagnosis and subsequently to identify the best personalized treatment (7). In the beginning, it is very important to distinguish between "difficult to treat asthma, " due to modifiable factors, and true "therapy-resistant asthma, " which is unresponsive to standard medications (16,17). Although a concomitance between these two conditions cannot always be excluded, uncontrolled asthma is frequently caused by treatmentrelated issues such as poor adherence to medication, inadequate or inappropriate inhalation technique (18,19), and persistent exposure to adverse environmental factors (smoke, irritants, allergens, etc.)…”

Section: Step-by-step Diagnosismentioning

confidence: 99%

Severe Pediatric Asthma Therapy: Mepolizumab

et al. 2022

Self Cite

View full text Add to dashboard Cite

There is a growing need for advanced treatment in children with persistent and severe asthma symptoms. As a matter of fact, between 2 and 5% of asthmatic children experience repeated hospitalizations and poor quality of life despite optimized treatment with inhaled glucocorticoid plus a second controller. In this scenario, mepolizumab, a humanized monoclonal antibody, has proven to be effective in controlling eosinophil proliferation by targeting interleukin-5 (IL-5), a key mediator of eosinophil activation pathways. Mepolizumab is approved since 2015 for adults at a monthly dose of 100 mg subcutaneously and it has been approved for patients ≥ 6 years of age in 2019. Especially in children aged 6 to 11 years, mepolizumab showed a greater bioavailability, with comparable pharmacodynamics parameters as in the adult population. The recommended dose of 40 mg every 4 weeks for children aged 6 through 11 years, and 100 mg for patients ≥ 12 years provides appropriate concentration and proved similar therapeutic effects as in the adult study group. A marked reduction in eosinophil counts clinically reflects a significant improvement in asthma control as demonstrated by validated questionnaires, reduction of exacerbation rates, and the number of hospitalizations. Finally, mepolizumab provides a safety and tolerability profile similar to that observed in adults with adverse events mostly of mild or moderate severity. The most common adverse events were headache and injection-site reaction. In conclusion, mepolizumab can be considered a safe and targeted step-up therapy for severe asthma with an eosinophilic phenotype in children and adolescents.

show abstract

“…New treatment options for asthma are indeed strongly needed in children or adolescents with asthma, especially those with moderate or severe symptoms ( 15 ). In the last decade, several pediatric studies have evaluated the use of tiotropium bromide as an add-on to ICS maintenance therapy, with or without leukotriene receptor antagonist (LTRA) or LABA.…”

Section: Introductionmentioning

confidence: 99%

Update on Long-Acting Anticholinergics in Children and Adolescents With Difficult and Severe Asthma

et al. 2022

View full text Add to dashboard Cite

Tiotropium bromide is the only long-acting muscarinic antagonist (LAMA) approved for treatment of patients aged ≥6 years old who have symptoms of uncontrolled asthma. Results from several clinical trials have found that once-daily inhaled tiotropium bromide is safe and efficacious in 6- to 17-year-olds with symptomatic asthma despite treatment with inhaled corticosteroids, with or without other medications. There are still few available studies investigating the impact of tiotropium bromide treatment in preschool children with suboptimal control. In this narrative review, we summarize the pharmacological effects of the LAMA tiotropium bromide, provide an overview about current asthma studies at different pediatric ages, and describe future research needs.

show abstract

Difficult and Severe Asthma in Children

Cited by 16 publications

References 88 publications

Respiratory Symptoms, Allergies, and Environmental Exposures in Children with and without Asthma

Respiratory Symptoms, Allergies, and Environmental Exposures in Children with and without Asthma

Severe Pediatric Asthma Therapy: Mepolizumab

Update on Long-Acting Anticholinergics in Children and Adolescents With Difficult and Severe Asthma

Contact Info

Product

Resources

About