Managing Asthma in Pregnancy (MAP) trial: FENO levels and childhood asthma

Morten, Matthew; Collison, Adam; Murphy, Vanessa E.; Barker, Daniel; Oldmeadow, Christopher; Attia, John; Meredith, Joseph; Powell, Heather; Robinson, Paul D.; Sly, Peter D.; Gibson, Peter G.; Mattes, Joërg

doi:10.1016/j.jaci.2018.02.039

Cited by 69 publications

(45 citation statements)

References 24 publications

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“…Tegethoff et al have studied 4083 mother-child pairs from the Danish National Birth Cohort and found that ICS for asthma treatment during pregnancy (n � 1231; 79.9% budesonide, 17.6% fluticasone, 5.4% beclomethasone, and 0.9% other or unspecified glucocorticoids) is not associated with offspring disease risk in most categories, except for offspring endocrine, metabolic, and nutritional disorders [22]. However, Mortenet al have indicated that fraction of exhaled nitric oxide-(FENO-) guided asthma management during pregnancy reduces doctor-diagnosed asthma in the offspring at the stage of preschool, partly mediated through alterations in use and dosing of ICS during the trial of managing asthma in pregnancy [23].…”

Section: Glucocorticoids Among Glucocorticoids Inhalationmentioning

confidence: 99%

Asthma in Pregnancy: Pathophysiology, Diagnosis, Whole-Course Management, and Medication Safety

Wang

Huang

2020

Canadian Respiratory Journal

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Asthma in pregnancy is a health issue of great concern. Physiological changes and drug compliance during pregnancy can affect asthma control in varying degrees, and the control level of asthma and the side effects of asthma medications are closely related to the adverse perinatal outcomes of mother and fetus. is article provides an update on the available literature regarding the alleviating or aggravating mechanism of asthma in pregnancy, diagnosis, disease assessment, and systematic management, to provide a new guidance for physician, obstetric joint doctor, and health care practitioner.

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Section: Glucocorticoids Among Glucocorticoids Inhalationmentioning

confidence: 99%

Asthma in Pregnancy: Pathophysiology, Diagnosis, Whole-Course Management, and Medication Safety

Wang

Huang

2020

Canadian Respiratory Journal

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“…For some comparisons, data from the ongoing prospective birth cohort study Growing into Asthma (GIA) [15] were used. These children were born to asthmatic mothers who participated in the Management of Asthma in Pregnancy (MAP) study [16].…”

Section: Control Cohortmentioning

confidence: 99%

Clinical and lung function outcomes in a cohort of children with severe asthma

et al. 2020

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Background: Uncontrolled severe asthma in children is burdensome and challenging to manage. This study aims to describe outcomes in children with uncontrolled severe asthma managed in a nurse-led severe asthma clinic (SAC). Methods: This retrospective analysis uses data collected from children referred by a paediatric respiratory specialist to a nurse-led SAC for uncontrolled severe asthma between 2014 and 2019. The pre-clinical assessments included a home visit to assess modifiable factors that could be addressed to improve control. A comprehensive lung function analysis was conducted at each visit. Interventions were personalised and included biologic agents. Statistical analysis was performed using nonparametric, two-tailed Mann-Whitney U-test, the parametric Student's t-test, or analysis of variance (ANOVA) as appropriate. Results: Twenty-three children with a median age of 12 years were seen once, and 16 were followed up. Compared to a non-asthmatic (NA) and asthmatic (A) age-matched cohort, children with severe asthma (SA) had a lower FEV1, and FVC% predicted before and after bronchodilator inhalation, and a higher mean Lung Clearance Index [LCI] (10.5 [SA] versus 7.3 [NA] versus 7.6 [A], p = 0.003). Almost 80% of children with SA had an abnormal LCI, and 48% had a reduced FEV1% at the first SAC visit. Asthma control and FEV1% predicted significantly improved at a follow-up visit, while LCI remained abnormal in the majority of children (83%). Conclusion: Over time, many children with severe asthma showed improved clinical outcomes and lung function while lung ventilation inhomogeneities persisted. Future appropriately controlled studies are required to determine if a nurse-led multidisciplinary SAC is associated with better outcomes.

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“…It may be necessary to ‘think outside the box’, not only in terms of risk factors for the causation of asthma, but also in the types of novel primary and secondary prevention strategies that are developed, and the research methodology used to provide the evidence base for their implementation . Pregnancy and early childhood are key areas of focus, especially given the success of FeNO‐guided ICS‐LABA therapy during pregnancy and subsequent reductions in childhood asthma …”

Section: Disclosure Statementmentioning

confidence: 99%

“…11 Pregnancy and early childhood are key areas of focus, especially given the success of FeNO-guided ICS-LABA therapy during pregnancy and subsequent reductions in childhood asthma. 12 A crucial discovery has been understanding the molecular mechanism of viral susceptibility in asthma. A defect in epithelial antiviral immunity makes patients with asthma subject to severe exacerbations after what are otherwise trivial picornavirus infections.…”

mentioning

confidence: 99%