July 25, 2016
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One-third of pediatric asthma patients experience exacerbations

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A more focused treatment approach for the 34.4% of children with asthma who experience recurrent exacerbations may provide more meaningful control for this population, according to recent study data.

“Despite improvements in asthma management and advances in therapeutics, there has not been a reduction in the reported incidence of exacerbations in pediatric asthma,” Robert Y. Suruki, ScD, head of epidemiology and real world data sciences for immunology at UCB Biosciences, and colleagues wrote. “Previously reported findings from controlled clinical trials indicate that asthma exacerbations in children, as well as in adults, are predictive of future exacerbations. However, data from randomized controlled trials are often not representative of real-world clinical practice.”

To assess the type and frequency of exacerbations in children with asthma, the researchers conducted a study including records on 734,114 patients (58.5% males) obtained from the U.S. Clinformatics DataMart Multiplan database. In addition to an association between age group or gender with exacerbation frequency, the researchers sought a link between exacerbation recurrence and seasonal trends.

Patients aged 1 to 17 years with a recorded asthma diagnosis who received treatment between 2004 and 2012 were included in the analysis. Dates of asthma diagnoses were recorded, and exacerbations were examined for a 12-month period. Asthma-related hospitalization, in which a systemic corticosteroid was used, or an ED visit was considered an exacerbation.

During follow-up, the researchers wrote that 34.4% of patients experienced at least one exacerbation. Incidence increased from 28.9% in 2004 to 36.3% in 2012. The average yearly exacerbation frequency in the cohort was 1.4 events per patient, and systemic corticosteroid use defined 85.8% of exacerbations. In addition, younger age correlated strongly with asthma-related hospitalizations, and the researchers observed a consistent trend of increased incidence of exacerbation in the fall and early winter.

“We propose that a more targeted treatment approach with particular focus on those who have a history of recurrent exacerbations, together with improved treatment engagement of patients and their parents or guardians, in combination with the prescription of effective controller medications, could result in meaningful improvements in asthma control in children,” the researchers wrote. – by Kate Sherrer

 

Disclosure: Suruki reports being employed by and holding stock in GlaxoSmithKline during the study period. Please see the full study for a list of all other authors’ relevant financial disclosures.