The influence of inhaled corticosteroid discontinuation in children with well-controlled asthma

Abstract

Asthma is a chronic inflammatory disease that requires adherence to both preventative and therapeutic interventions in disease management. Children with asthma are likely to discontinue inhaled corticosteroids (ICS), especially when symptoms are under control. We aimed to investigate the impact of ICS adherence in children whose symptoms were under control.The study is cohort study; 35 children with controlled asthma that had undergone 3 years of follow-up were included. Serum eosinophil count, serum total IgE (tIgE), and lung function (FEV1, FEV1/FVC, PEF, FEF20–75%, and PC20) were evaluated at the beginning and end of the follow-up.At baseline, patients in both the adherent and nonadherent groups were similar. After 3 years, the nonadherent group who had discontinued ICS had a decrease in FEV1 (P < .05), FEV1/FVC (P < .05), PEF (P < .05), and FEF20–75% (P < .05). The nonadherent group had no significant improvement in PC20 compared with their values at the beginning of the follow-up, whereas the adherent group had improvement in PC20. Furthermore, there was an increase in serum eosinophil (P < .001) and tIgE (P < .05) in the nonadherent compared with the adherent group.Despite good asthma control, airway hyperresponsiveness (AHR) was detected in a large proportion of children with asthma. ICS discontinuation affected lung function, serum eosinophil count, tIgE, and AHR. Adequate adherence is important in asthma management. The benefits of ICS and the influence of drug discontinuation despite good asthma control may encourage better adherence from patients.

A Long-Term Follow-up Study of Asthmatic Children Discontinued Allergen-Specific Immunotherapy

“…AIT is an effective therapy that can improve allergic response by modifying the underlying disease, and HDM AIT has been incorporated in the GINA recommendations as an add-on treatment for HDM allergic asthma 2020. 1 At least 3 years of treatment is required to obtain the long-term benefits and disease-modifying effects of AIT. 4 A previous study found that 85% of allergic asthmatic children had controlled asthma after 3-year course of SCIT.…”

“…The global prevalence of asthma ranges from 1 to 22% of the population in different countries. 1 Allergic asthma often commences in childhood and is associated with a past and/or family history of allergic disease such as eczema and allergic rhinitis. Allergens, especially house dust mites (HDMs), are the main environmental risk factors for developing asthma in children.…”

The skin prick test response after allergen immunotherapy in different levels of tIgE children with mite sensitive Asthma/Rhinitis in South China

“…24 There was no statistical difference in lung function parameters, which may be attributed to the control of asthma in most children before AIT, but PC20 significantly improved after AIT as we found in another article. 25 In this study, we analyzed the relationship between serum parameters before AIT and AIT efficacy, which provided a reference for selecting the appropriate patients for AIT. However, it is not clear whether serum parameters after AIT is related to the clinical symptoms.…”

Medication Adherence in Children with Asthma

“…Followed up over 3 years, the non-adherent children showed a significant deterioration in each of these markers compared with the adherent children. 23 In this study, adherence was graded using parents self reporting and prescription pick up rates.…”