Trajectory of spirometric and exhaled nitric oxide measurements in Chinese schoolchildren with asthma

Leung, Ting Fan; Tang, Man; Leung, Agnes Sze Yin; Tam, Wilson W.S.; Sy, Hing Yee; Wong, Gary

doi:10.1111/pai.12836

Cited by 12 publications

(16 citation statements)

References 25 publications

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“…Included studies 11 observational studies with a total of 3720 participants were included [28][29][30][31][32][33][34][35][36][37]. Four studies were in children (n=787) [28,30,34,36] and seven in adults (n=2933) [29, 31-33, 35, 37, 38]. Asthma was physician-diagnosed in eight studies (n=1044) [28, 30-34, 36, 37] and self-reported in three studies (n=2676) [29,35,38].…”

Section: Observational Studiesmentioning

confidence: 99%

Does the use of inhaled corticosteroids in asthma benefit lung function in the long-term? A systematic review and meta-analysis

et al. 2021

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While asthma is known to be associated with an increased risk of progressive lung function impairments and fixed airflow obstruction, there is ongoing debate on whether inhaled corticosteroids (ICS) modify these long-term risks. Searches were performed of the PubMed, Embase and CENTRAL databases up to 22 July 2019 for studies with follow-up ≥1 year that investigated the effects of maintenance ICS on changes in lung function in asthma.Inclusion criteria were met by 13 randomised controlled trials (RCTs) (n=11 678) and 11 observational studies (n=3720). Median (interquartile range) follow-up was 1.0 (1–4) and 8.4 (3–28) years, respectively. In the RCTs, predominantly in individuals with mild asthma, ICS use was associated with improved pre-bronchodilator (BD) forced expiratory volume in 1 s (FEV1) across all age groups (2.22% predicted (95% CI 1.32–3.12), n=8332), with similar estimates of strength in association for children and adults. Improvements in post-BD FEV1 were observed in adults (1.54% (0.87–2.21), n=3970), but not in children (0.20% (−0.49–0.90), n=3924) (subgroup difference, p=0.006). Estimates were similar between smokers and nonsmokers. There were no RCT data on incidence of fixed airflow obstruction. In the observational studies, ICS use was associated with improved pre-BD FEV1 in children and adults. There were limited observational data for post-BD outcomes.In patients with mild asthma, maintenance ICS are associated with modest, age-dependent improvements in long-term lung function, representing an added benefit to the broader clinical actions of ICS in asthma. There is currently insufficient evidence to determine whether treatment reduces incidence of fixed airflow obstruction in later life.

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Section: Observational Studiesmentioning

confidence: 99%

Does the use of inhaled corticosteroids in asthma benefit lung function in the long-term? A systematic review and meta-analysis

et al. 2021

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“…Our sample is similar to that of a recent study in which 45.1% of children with asthma recruited in another local hospital in Hong Kong did not require ICS. 77 Our sample may therefore be representative of urban Asian families in general who are rearing children with a low severity of asthma. 78 Hence, we suggest that ACT integrated with asthma education could be universally adopted to help parents to improve their management of childhood asthma, regardless of the 6MFU, 6-mo follow-up after the intervention; AAQ-II, Acceptance and Action Questionnaire-II; Mdiff, difference in the estimated marginal means; -, not applicable.…”

Section: Days Per Week)mentioning

confidence: 99%

Acceptance and Commitment Therapy for Parental Management of Childhood Asthma: An RCT

et al. 2019

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BACKGROUND: Few trials have been conducted to address the psychological difficulties of parents in managing their child's asthma. Fostering parental psychological flexibility through Acceptance and Commitment Therapy (ACT) may help parents to accept these psychological difficulties and improve their management of childhood asthma. METHODS: In this randomized controlled trial, a 4-session, group-based ACT plus asthma education (ACT group) was compared with an asthma education talk plus 3 telephone followups (control group) to train parents of children diagnosed with asthma. The use of health care services due to asthma exacerbations in children and the psychological well-being of their parents were assessed before, immediately after, and at 6 months after the intervention. RESULTS: A total of 168 parents and their children aged 3 to 12 years with asthma were consecutively recruited in a public hospital in Hong Kong. When compared with the control group, children whose parents were in the ACT group made significantly fewer emergency department visits (adjusted 6-month incidence rate ratio = 0.20; confidence interval [CI] 0.08 to 0.53; P = .001) due to asthma exacerbations at 6 months postintervention. These parents also reported a decrease in psychological inflexibility (mean difference = 25.45; CI 27.71

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“…Several recent studies showed that high baseline FeNO was associated with reduced lung function growth in asthmatic children (47) and accelerated lung function decline in adults (48, 49). In the pediatric study from China 193 asthmatic children, mean age 9.7 years (SD 1.9 years) were followed for 5 years (47). One quarter had reduced lung function growth which was associated with lower baseline spirometry, higher FeNO and female sex.…”

Section: Introductionmentioning

confidence: 99%

The Role of FeNO in Predicting Asthma

Pijnenburg

2019

Front. Pediatr.

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Asthma-like symptoms like wheezing and dyspnea affect 1 in every 3 preschool children. An easily available biomarker that predicts later asthma or unfavorable lung growth in these children may be helpful in targeting the right child with the right drugs and avoiding exposure to potentially harmful drugs in others. The fraction of exhaled nitric oxide (FeNO) has been suggested as a marker of eosinophilic inflammation. FeNO can be measured in a standardized way from the age of 4 but several methods have been developed to measure FeNO also in younger children. Several studies have assessed the predictive value of FeNO in preschool wheezing children for asthma later in life. These studies have shown that FeNO may be helpful in defining different preschool wheezing phenotypes, and in assessing the risk of later asthma or impaired lung growth. However, data are conflicting on the added value over clinical parameters. In two studies in school children, high FeNO was predictive for asthma development during follow up and also predicted lower lung function growth. In school children with respiratory symptoms suggestive of asthma, particularly in atopic children, FeNO has diagnostic value for an asthma diagnosis, mostly for ruling in asthma. There are not enough data to assess if FeNO has a predictive value for lung development in school children.

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Trajectory of spirometric and exhaled nitric oxide measurements in Chinese schoolchildren with asthma

Abstract: Asthmatic children have annual decline in FVC and increase in FEV /FVC and FEF . Their lung function trajectory is influenced by gender, ICS treatment, BMI, and asthma exacerbations. IL33 and GSDMB may be candidate genes for their lung function growth.

Cited by 12 publications

References 25 publications

Does the use of inhaled corticosteroids in asthma benefit lung function in the long-term? A systematic review and meta-analysis

Does the use of inhaled corticosteroids in asthma benefit lung function in the long-term? A systematic review and meta-analysis

Acceptance and Commitment Therapy for Parental Management of Childhood Asthma: An RCT

The Role of FeNO in Predicting Asthma

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