Asthma in children with sickle cell disease

Willen, Shaina M.; Rodeghier, Mark; DeBaun, Michael R.

doi:10.1097/mop.0000000000000756

Cited by 18 publications

(20 citation statements)

References 62 publications

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“…Consistent with what has been reported, we find that chronic complications that are not specific to SCD, but are much more common in persons with the condition, such as chronic pain, cardio-vascular conditions including pulmonary hypertension and renal disease are more prevalent at older ages in SCD patients [19,21,25]. Similar to what is seen in persons without SCD, the prevalence of asthma is common in all age groups [21,26]. Importantly, our data call attention to the high prevalence of several complications which were historically not considered as common issues for SCD patients, but have later been confirmed in studies.…”

Section: Plos Onesupporting

confidence: 89%

Prevalence of comorbidities associated with sickle cell disease among non-elderly individuals with commercial insurance–A retrospective cohort study

Ramsey

Bender

et al. 2022

PLoS ONE

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Sickle cell disease (SCD) is a severe monogenic disease associated with high morbidity and mortality and a disproportionate burden on Black communities. Few population-based studies have examined the prevalence of comorbidities among persons with SCD. We estimated the prevalence of comorbidities experienced by individuals with SCD enrolled in employer-based health insurance plans in the US over their non-elderly lifetimes (0–64 years of age) with a retrospective cohort design using Truven Health MarketScan commercial claims data from 2007–2018. ICD-9/10 codes were used to identify individuals with SCD using a previously published algorithm. For this cohort, comorbidities associated with SCD were identified across 3 age categories (<18, 18–45, 46–64 years-old), based on the CMS Chronic Comorbidities Warehouse or SCD-specific diagnosis codes, when applicable. The total number of SCD patients available for analysis in each age category was 7,502 (<18 years), 10,183 (18–45 years) and 4,459 (46–64 years). Across all ages, vaso-occlusive pain, infections (non-specific), and fever were the most common comorbidities. Vaso-occlusive pain and infection were the most prevalent conditions for persons age <18- and 18–45-year-olds, while in the 46–54-year-old age group, infection and cardiovascular including pulmonary hypertension were most prevalent. Compared to persons <18 years old, the prevalence of vaso-occlusive pain, fever, and acute chest syndrome claims declined in older populations. The comorbidity burden of SCD is significant across all age groups. SCD patients experience comorbidities of age such as chronic pain, cardio-vascular conditions including pulmonary hypertension and renal disease at far higher rates than the general population. Novel disease modifying therapies in development have the potential to significantly reduce the comorbidity burden of SCD.

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Section: Plos Onesupporting

confidence: 89%

Prevalence of comorbidities associated with sickle cell disease among non-elderly individuals with commercial insurance–A retrospective cohort study

Ramsey

Bender

et al. 2022

PLoS ONE

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“…Asthma is a common comorbidity for children with sickle cell disease (SCD), 1 which affects an estimated 100 000 persons in the United States 2 . A diagnosis of asthma is associated with an increased risk of adverse events such as hospitalizations for vaso‐occlusive pain episodes (VOEs) 3 and acute chest syndrome, 4 as well as premature mortality when compared to children with SCD who do not have asthma 3,5 . Current evidence‐based guidelines from the National Heart, Lung, and Blood Institute (NHLBI) 6 and the American Society of Hematology (ASH) 7 do not recommend routine screening with pulmonary function tests (PFTs) in asymptomatic patients with SCD.…”

Section: Introductionmentioning

confidence: 99%

“…Sadreameli and colleagues 14 discovered an increase in lung disease detection, pulmonary referrals and visits in children with SCD when asthma screening questionnaires and spirometry were administered in a pediatric hematology and infusion clinic. Irrespective of asthma, children with SCD may also present with asthma‐like symptoms (eg, cough, wheezing, shortness of breath, airway hyperresponsiveness, chest pain) and abnormal lung function, further contributing to morbidity and premature mortality 4 . Markedly, other pulmonary conditions, such as obstructive sleep apnea, pulmonary hypertension, 4,15 exercise‐induced dyspnea, and obstructive and restrictive lung disease 15 are also common.…”

Section: Introductionmentioning

confidence: 99%

“…Irrespective of asthma, children with SCD may also present with asthma‐like symptoms (eg, cough, wheezing, shortness of breath, airway hyperresponsiveness, chest pain) and abnormal lung function, further contributing to morbidity and premature mortality 4 . Markedly, other pulmonary conditions, such as obstructive sleep apnea, pulmonary hypertension, 4,15 exercise‐induced dyspnea, and obstructive and restrictive lung disease 15 are also common. These conditions further highlight the need for pulmonary care.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility and preliminary outcomes of an integrated pediatric sickle cell disease and pulmonary care clinic for children with sickle cell disease

Black

Ezmigna

Wallace-Farquharson

et al. 2020

Pediatric Blood & Cancer

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Background: In children with sickle cell disease (SCD), comorbid asthma is associated with increased disease severity and morbidity, but it remains underdiagnosed and optimal management paradigms are not well defined. The purpose of this study was to determine the feasibility and preliminary outcomes of an integrated pediatric SCD and pulmonary care clinic in children with SCD. Methods: We implemented a pre-post quality improvement (QI) project in our pediatric hematology clinic between 2017 and 2019. Guided by the chronic care model, patients who were ages 2-18 years, diagnosed with SCD and suspected pulmonary comorbidities, received care in an interdisciplinary clinic. We examined feasibility and compared clinical outcomes to 24 months prior (2015-2017) to the implementation of the integrated care model. Results: Twenty-four patients were included in the QI project: 88% (n = 21) received pulmonary function testing, 92% (n = 22) were diagnosed with asthma, and 33% (n = 8) with obstructive sleep apnea. Adherence to pulmonary appointments was increased by 81% (mean difference [MD] = 1.3, 95% confidence interval [CI] = 0.71-1.92; P < .001). Unplanned acute health care utilization was reduced by 59% (MD = 2.9, 95% CI = 1.14-4.69; P < .01) and packed red blood cell transfusion was reduced by 81% (MD = 1.38, 95% CI = 0.71-2.04; P < .001). Conclusion: Asthma is prevalent in children with SCD, and interdisciplinary clinics can improve access to subspecialty pulmonary care and reduce unplanned acute care. Additional patients and a longer follow-up period are required to determine the true treatment effect.

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“…The underlying disorder that may develop in adult and pediatric patients is asthma. Their first asthmatic exposure can be terrifying, for some children with asthma: intense wheezing, a tight chest, and shortness of breath can easily catch their active, young bodies off balance [2]. Childhood asthma, also referred to as pediatric asthma, is known as one of the most prevalent yet difficult to diagnose, which causes severe diseases in infants.…”

Section: Introductionmentioning

confidence: 99%

Novel pediatric suspension of nanoparticulate zafirlukast for the treatment of asthma: Assessment and evaluation in animal model

Yao

2021

Micro & Nano Letters

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The aim of the present study was to formulate the novel pediatric suspension containing nanoparticulate Zafirlukast (ZFR) for the treatment of pediatric asthma. The ZFR loaded nanoparticles (NPs) were formulated by ionotropic external gelation method using tripolyphosphate (TPP) and Tween 80. NPs were characterized for drug loading, encapsulation efficiency, surface morphology, saturation solubility, particle size, zeta potential and polydispersity index (PDI). The optimized NP formulation was used for the development of suspension. The suspensions were characterized for pH, viscosity, sedimentation volume, dissolution and drug content. The encapsulation efficiency of NPs was found between 93.24% and 98.57% with drug loading in the range of 26.50-35.90%. All formulations were found of nanosized in nature (150-220 nm) with zeta potential (19.18-21.41 mV). PDI of all NP formulations was found less than 0.3. The NPs were spherical and smooth in nature. The saturation solubility of ZFR was enhanced nearly 16 times as compared to pure ZFR. The optimized suspension showed almost 100% ZFR release within the period of 30 min. The reduction in lung resistance (RI) was found nearly four fold as compared to the control group animals. The study supported the efficacy of suspension containing nanoparticulate ZFR in asthmatic animals.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Asthma in children with sickle cell disease

Cited by 18 publications

References 62 publications

Prevalence of comorbidities associated with sickle cell disease among non-elderly individuals with commercial insurance–A retrospective cohort study

Prevalence of comorbidities associated with sickle cell disease among non-elderly individuals with commercial insurance–A retrospective cohort study

Feasibility and preliminary outcomes of an integrated pediatric sickle cell disease and pulmonary care clinic for children with sickle cell disease

Novel pediatric suspension of nanoparticulate zafirlukast for the treatment of asthma: Assessment and evaluation in animal model

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