Nav: Home

Hard-to-control asthma has distinct features, study shows

October 05, 2016

Bronchodilator responsiveness, nasal inflammation and allergy were among the most significant baseline features that distinguished hard-to-control asthma in inner-city children and adolescents. These characteristics identified patients whose asthma did not improve throughout the year, despite adherence to the most intensive treatment based on national guidelines. Patients with hard-to-control asthma also had exacerbations peaking in the spring and fall, and more nighttime symptoms in the fall and winter. These findings from the Inner City Asthma Consortium study, funded by the National Institutes of Health (NIH), were published in the Journal of Allergy and Clinical Immunology.

"Our study found striking differences in how children with asthma respond to treatment, and these were associated with clinical factors that can be identified from the start," said Jacqueline Pongracic, MD, lead author, Head of Allergy and Immunology Division at Ann & Robert H. Lurie Children's Hospital of Chicago and Professor of Pediatrics and Medicine at Northwestern University Feinberg School of Medicine. "Being able to predict whether a child's asthma will be easy or difficult to control will help us provide a more personalized treatment approach."

The study included 619 patients with asthma, 6 to 17 years old, from nine urban communities across the country, representing mainly African American and Latino populations. All children underwent standardized assessment and bimonthly guideline-based management visits over the course of one year. Researchers examined 44 clinical features in a broad range of domains that were previously reported as potentially contributing to asthma severity and response to treatment.

"One of the novel aspects of our study is that we evaluated children with asthma over an entire year, which allowed us to more accurately characterize their disease," said Pongracic. The study found that children with hard-to-control asthma were twice as responsive to a bronchodilator, compared to the easy-to-control asthma group. Results also demonstrated that nasal inflammation is a key factor affecting response to asthma therapy, reinforcing recommendations that nasal symptoms should be treated as part of asthma management. Allergy, especially to mold, was also an important feature of hard-to-control asthma.

While children with easy-to-control asthma were able to progressively taper their medication requirements over the year, the hard-to-control asthma group could not, showing no improvement in lung function and seasonal worsening in symptoms. Adherence to asthma therapy was comparable in both groups.

"Our findings emphasize the unique nature of hard-to-control asthma in children," said Pongracic. "Performing selected key assessments early on may help identify which children are likely to need higher doses of daily medications and to benefit from management by a pediatric allergist or asthma specialist."
Research at Ann & Robert H. Lurie Children's Hospital of Chicago is conducted through the Stanley Manne Children's Research Institute. The Manne Research Institute is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge.

Lurie Children's is ranked as one of the nation's top children's hospitals in the U.S. News & World Report. It is the pediatric training ground for Northwestern University Feinberg School of Medicine. Last year, the hospital served more than 173,000 children from 50 states and 48 countries.

Ann & Robert H. Lurie Children's Hospital of Chicago

Related Asthma Articles:

Physics vs. asthma
A research team from the MIPT Center for Molecular Mechanisms of Aging and Age-Related Diseases has collaborated with colleagues from the U.S., Canada, France, and Germany to determine the spatial structure of the CysLT1 receptor.
New knowledge on the development of asthma
Researchers at Karolinska Institutet in Sweden have studied which genes are expressed in overactive immune cells in mice with asthma-like inflammation of the airways.
Eating fish may help prevent asthma
A scientist from James Cook University in Australia says an innovative study has revealed new evidence that eating fish can help prevent asthma.
Academic performance of urban children with asthma worse than peers without asthma
A new study published in Annals of Allergy, Asthma and Immunology shows urban children with poorly controlled asthma, particularly those who are ethnic minorities, also suffer academically.
Asthma Controller Step Down Yardstick -- treatment guidance for when asthma improves
The focus for asthma treatment is often stepping up treatment, but clinicians need to know how to step down therapy when symptoms improve.
More Asthma News and Asthma Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Erasing The Stigma
Many of us either cope with mental illness or know someone who does. But we still have a hard time talking about it. This hour, TED speakers explore ways to push past — and even erase — the stigma. Guests include musician and comedian Jordan Raskopoulos, neuroscientist and psychiatrist Thomas Insel, psychiatrist Dixon Chibanda, anxiety and depression researcher Olivia Remes, and entrepreneur Sangu Delle.
Now Playing: Science for the People

#537 Science Journalism, Hold the Hype
Everyone's seen a piece of science getting over-exaggerated in the media. Most people would be quick to blame journalists and big media for getting in wrong. In many cases, you'd be right. But there's other sources of hype in science journalism. and one of them can be found in the humble, and little-known press release. We're talking with Chris Chambers about doing science about science journalism, and where the hype creeps in. Related links: The association between exaggeration in health related science news and academic press releases: retrospective observational study Claims of causality in health news: a randomised trial This...