Control of asthma in children: still unacceptable? A French cross-sectional study

Blic, J. de; Boucot, I.; Pribil, C.; Robert, Jacques; Huas, Dominique; Marguet, Christophe

doi:10.1016/j.rmed.2009.03.006

Cited by 48 publications

(38 citation statements)

References 34 publications

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“…In contrast, such a severe allergic profile has not yet been clearly individualised as a risk group in problematic severe asthma either in previous cohorts [15,17] or in recent guidelines [2]. A polysensitisation to three or more allergens has nevertheless been associated with severe [22,23] or uncontrolled asthma [24]. This is in accordance with recent findings, which defined a specific phenotype of severe asthma in children with multiple sensitisations not only to inhaled but also to food allergens [25].…”

Section: Discussionmentioning

confidence: 63%

Add-on omalizumab in children with severe allergic asthma: a 1-year real life survey

et al. 2013

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Omalizumab has been shown to reduce exacerbation rates in moderate to severe allergic asthma. Our aim was to evaluate omalizumab efficacy and safety in a real-life setting in severe asthmatic children.104 children (aged 6-18 years), followed up in paediatric pulmonary tertiary care centres, were included at the beginning of omalizumab treatment. Asthma control levels, exacerbations, inhaled corticosteroid dose, lung function and adverse events were evaluated over 1 year.Children were characterised by allergic sensitisation to three or more allergens (66%), high IgE levels (mean 1125 kU?L -1 ), high rate of exacerbations (4.4 per year) and healthcare use during the previous year, and high inhaled corticosteroid dose (mean 703 mg equivalent fluticasone per day). Asthma control levels defined as good, partial or poor, improved from 0%, 18% and 82% at entry to 53%, 30% and 17% at week 20, and to 67%, 25% and 8% at week 52, respectively (p,0.0001). Exacerbation and hospitalisation rates dropped by 72% and 88.5%, respectively. At 12 months, forced expiratory volume in 1 s improved by 4.9% (p50.023), and inhaled corticosteroid dose decreased by 30% (p,0.001). Six patients stopped omalizumab for related significant adverse events.Omalizumab improved asthma control in children with severe allergic asthma and was generally well tolerated. The observed benefit was greater than that reported in clinical trials. @ERSpublications Omalizumab improves asthma control in children with severe allergic asthma and is generally well tolerated

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Section: Discussionmentioning

confidence: 63%

Add-on omalizumab in children with severe allergic asthma: a 1-year real life survey

et al. 2013

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“…The lack of asthma control in children and adolescents has been highlighted previously [5,9]. Poorly controlled asthma represents a heavy socioeconomic burden on society [28,29].…”

Section: Discussionmentioning

confidence: 99%

“…Asthma control is defined as the extent to which the various manifestations of asthma are reduced or removed by treatment [3]. Poor assessment of asthma control results in suboptimal treatment; good asthma control is associated with improved quality of life and reduced healthcare utilisation [4][5][6][7].…”

mentioning

confidence: 99%

“…Despite widespread availability of effective therapies, asthma control often falls short of guideline standards; this may be due to overestimation of asthma control by both physicians and parents coupled with low expectations of achievable control [9]. Suboptimal asthma control in children and adolescents has been indicated by several surveys [5,[10][11][12][13][14]. For example, parents from the UK, Germany and Spain considered their child's/adolescent's asthma to be well controlled, but also reported visiting the emergency department within the previous 3 months [14].…”

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confidence: 99%

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Parent misperception of control in childhood/adolescent asthma: the Room to Breathe survey

Carroll

Wildhaber²,

Brand³

2011

European Respiratory Journal

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“…Poor asthma control, as measured by the ACT, C-ACT or ACQ, is associated with reduced lung function, increased risk of exacerbations and elevated exhaled nitric oxide fraction, and is lower in children not regularly using inhaled corticosteroid maintenance therapy [17,18,[23][24][25][26][27]. Children with asthma and allergic rhinitis have poorer asthma control and a higher risk of exacerbations than those without allergic rhinitis [28,29].…”

Section: Composite Asthma Control Scoresmentioning

confidence: 99%

Monitoring asthma in childhood: symptoms, exacerbations and quality of life

et al. 2015

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Monitoring asthma in children in clinical practice is primarily performed by reviewing disease activity (daytime and night-time symptoms, use of reliever medication, exacerbations requiring frequent use of reliever medication and urgent visits to the healthcare professional) and the impact of the disease on children's daily activities, including sports and play, in a clinical interview. In such an interview, most task force members also discuss adherence to maintenance therapy and the patients' (and parents') views and beliefs on the goals of treatment and the amount of treatment required to achieve those goals. Composite asthma control and quality of life measures, although potentially useful in research, have limited value in clinical practice because they have a short recall window and do not cover the entire spectrum of asthma control. Telemonitoring of children with asthma cannot replace face-to-face follow-up and monitoring because there is no evidence that it is associated with improved health outcomes. @ERSpublications To monitor asthma control in children interviewing the child and parents is preferred over composite control scores http://ow.ly/JbqnR

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Control of asthma in children: still unacceptable? A French cross-sectional study

Cited by 48 publications

References 34 publications

Add-on omalizumab in children with severe allergic asthma: a 1-year real life survey

Add-on omalizumab in children with severe allergic asthma: a 1-year real life survey

Parent misperception of control in childhood/adolescent asthma: the Room to Breathe survey

Monitoring asthma in childhood: symptoms, exacerbations and quality of life

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