Can early intervention in pediatric asthma improve long‐term outcomes? A question that needs an answer

Abstract

Objective Although many children with asthma do not experience persistence into adulthood, recent studies have suggested that poorly controlled asthma in childhood may be associated with significant airflow obstruction in adulthood. However, data regarding disease progression are lacking, and clinicians are not yet able to predict the course of a child's asthma. The goal of this article was to assess the current understanding of childhood asthma treatment and progression and to highlight gaps in information that remain. Data Sources Nonsystematic PubMed literature search and authors’ expertise. Study Selection Articles were selected at the authors’ discretion based on areas of interest in childhood asthma treatment and progression into adulthood. Results Uncontrolled asthma in early childhood can potentially have lasting effects on lung development, but it is unclear whether traditional interventions in very young children preserve lung function. Although not all children respond to standard interventions, certain asthma phenotypes have been identified that can help to understand which children may respond to a particular treatment. Conclusion Clinicians should monitor children's asthma control and pulmonary function over time to assess the long‐term impact of an intervention and to minimize the effect of uncontrolled asthma, especially exacerbations, on lung development. New biologic therapies have shown promise in treating adults with severe, uncontrolled asthma, and some of these therapies are approved in the United States for children as young as age 6. However, knowledge gaps regarding the efficacy and safety of these treatments in younger children hamper our understanding of their effect on long‐term outcomes.

Role of montelukast in multitrigger wheezers attending chest clinic in Punjab, India

“…Treatment for multitrigger wheezing in young children is required to improve the quality of life but it is not known if this control will also prevent airway structural changes. Although excellent review by Lanz et al states that effective management of childhood asthma could potentially slow the trajectory of FEV 1 decline in adulthood and ultimately lessen the risk of fixed airflow obstruction 16 …”

“…No patient developed any neuropsychiatric symptoms and montelukast was not stopped in any child due to any side effect. tentially slow the trajectory of FEV 1 decline in adulthood and ultimately lessen the risk of fixed airflow obstruction 16. T A B L E 3 Control of symptoms in children on Montelukast in relation to various parameters (n = 139) *p < .05 significant.…”

Evaluating documentation of social history in paediatric medical notes at a regional paediatric centre – a quality improvement initiative

“…Though tobacco use in adolescence and in adulthood has declined in recent years, there has been a startling jump in e-cigarette use in adolescence [ 21 ]. Maternal smoking may result in reduced lung function in adulthood, and exposure to parental smoking can trigger respiratory infection during the childhood years [ 22 ].…”

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“…Водночас основними біомаркерами БА є еозинофіли периферичної крові. Еозинофіли являють собою насамперед тканинні клітини, що ускладнює вивчення їх функціональних особли востей [10]. Крім того, рівень циркулюючих еозинофілів залежить від добового ритму секре ції гідрокортизону, а також пов'язаний із певни ми циркадіадними ритмами, максимум якого припадає на нічний час, мінімум -на ранковий.…”