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."
-end-
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:

Insomnia prevalent in patients with asthma
A team of researchers from the University of Pittsburgh has found that insomnia is highly prevalent in adults with asthma and is also associated with worse asthma control, depression and anxiety symptoms and other quality of life and health issues.
Test used to diagnose asthma may not be accurate
A new study urges caution in the use of the mannitol challenge test for asthma in non-clinical settings.
Turning off asthma attacks
Working with human immune cells in the laboratory, Johns Hopkins researchers report they have identified a critical cellular 'off' switch for the inflammatory immune response that contributes to lung-constricting asthma attacks.
Access to asthma meds, plus flu vaccines, keep kids with asthma healthy
Kids need flu shots to prevent asthma flares, and medications available in school to keep 86 percent in class, according to two studies being presented at the American College of Allergy, Asthma and Immunology Annual Scientific Meeting.
Discovery could lead to better asthma treatment
Scientists have made a discovery that could lead to improved treatment for asthma sufferers.
Do asthma and COPD truly exist?
Defining a patient's symptoms using the historical diagnostic labels of asthma and chronic obstructive pulmonary disease (COPD) is an outdated approach to understanding an individual's condition, according to experts writing in the European Respiratory Journal today.
Asthma in many adolescents is not an allergic disease
New research indicates that asthma in many adolescents is not likely to involve inflammation of the airways and therefore should not be considered an allergic disease.
First classification of severe asthma
Severe asthma can have a devastating effect on sufferers, affecting their ability to work or go to school and to lead normal lives.
Exploring 'clinical conundrum' of asthma-COPD overlap in nonsmokers with chronic asthma
Researchers may be closer to finding the mechanism responsible for loss of lung elastic recoil and airflow limitation in nonsmokers with chronic asthma.
Asthma app helps control asthma: Alerts allergists when sufferers need assistance
New study in Annals of Allergy, Asthma and Immunology shows how an app directly connecting an allergist and an asthma sufferer can provide necessary intervention when asthma isn't under control.

Related Asthma Reading:

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

Digital Manipulation
Technology has reshaped our lives in amazing ways. But at what cost? This hour, TED speakers reveal how what we see, read, believe — even how we vote — can be manipulated by the technology we use. Guests include journalist Carole Cadwalladr, consumer advocate Finn Myrstad, writer and marketing professor Scott Galloway, behavioral designer Nir Eyal, and computer graphics researcher Doug Roble.
Now Playing: Science for the People

#529 Do You Really Want to Find Out Who's Your Daddy?
At least some of you by now have probably spit into a tube and mailed it off to find out who your closest relatives are, where you might be from, and what terrible diseases might await you. But what exactly did you find out? And what did you give away? In this live panel at Awesome Con we bring in science writer Tina Saey to talk about all her DNA testing, and bioethicist Debra Mathews, to determine whether Tina should have done it at all. Related links: What FamilyTreeDNA sharing genetic data with police means for you Crime solvers embraced...