Asthma across the ages: Knowledge gaps in childhood asthma - 25/12/13

Doi : 10.1016/j.jaci.2013.10.018

Stanley J. Szefler, MD ^a,^⁎ , James F. Chmiel, MD, MPH ^b, Anne M. Fitzpatrick, PhD ^c, George Giacoia, MD ^d, Thomas P. Green, MD ^e, Daniel J. Jackson, MD ^f, Heber C. Nielsen, MD ^g, Wanda Phipatanakul, MD, MS ^h, Hengameh H. Raissy, PharmD ⁱ
^a Department of Pediatrics and Pharmacology, National Jewish Health, and the University of Colorado School of Medicine, Denver, Colo
^b University Hospitals Rainbow Babies and Children’s Hospital and Case Western Reserve University School of Medicine, Cleveland, Ohio
^c Emory University Department of Pediatrics and Children’s Healthcare of Atlanta Center for Developmental Lung Biology, Atlanta, Ga
^d National Institute of Child Health and Development, Bethesda, Md
^e Ann and Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Ill
^f Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
^g Floating Hospital for Children at Tufts Medical Center, Tufts University School of Medicine, Boston, Mass
^h Boston Children’s Hospital and Harvard Medical School, Boston, Mass
ⁱ Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, NM

^∗Corresponding author: Stanley J. Szefler, MD, Department of Pediatrics, National Jewish Health, 1400 Jackson St, Denver, CO 80206.

Abstract

The Eunice Kennedy Shriver National Institute of Child Health and Human Development convened an Asthma Group in response to the Best Pharmaceuticals for Children Act. The overall goal of the Best Pharmaceuticals for Children Act Program is to improve pediatric therapeutics through preclinical and clinical drug trials that lead to drug-labeling changes. Although significant advances have been made in the understanding and management of asthma in adults with appropriately labeled medications, less information is available on the management of asthma in children. Indeed, many medications are inadequately labeled for use in children. In general, the younger the child, the less information there is available to guide clinicians. Because asthma often begins in early childhood, it is incumbent on us to continue to address the primary questions raised in this review and carefully evaluate the medications used to manage asthma in children. Meanwhile, continued efforts should be made in defining effective strategies that reduce the risk of exacerbations. If the areas of defined need are addressed in the coming years, namely prevention of exacerbations and progression of disease, as well as primary intervention, we will see continuing reduction in asthma mortality and morbidity along with improved quality of life for children with asthma.

Le texte complet de cet article est disponible en PDF.

Key words : Asthma, asthma natural history, asthma progression, asthma biomarkers, childhood asthma, asthma pharmacotherapy

Abbreviations used : CO, EBC, Feno, HRV, RBM, RSV, SARP

Plan

Series editors: Donald Y. M. Leung, MD, PhD, and Dennis K. Ledford, MD

J.F.C. is supported by National Heart, Lung, and Blood Institute (NHLBI) AsthmaNet grant U10 HL098177 and CTSA award UL1TR000439. A.M.F. is supported by AsthmaNet grant U10 HL098103 and CTSA award UL1TR000454. D.J.J. was supported by the University of Wisconsin CTSA grant UL1TR000427 through the National Institutes of Health (NIH) National Center for Advancing Translational Sciences (NCATS). H.C.N. is supported by R21 HL097231. W.P. is supported by NHLBI AsthmaNet grant U10 HL098102. This work was conducted with the support of Harvard Catalyst/the Harvard Clinical and Translational Science Center (NIH Award no. UL1 RR 025758) and financial contributions from Harvard University and its affiliated academic health care centers. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University, and its affiliated academic health care centers; and the National Center for Research Resources or the NIH. H.H.R. is supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences of the NIH through grant no. UL1 TR000041 and NHLBI-funded Clinical Centers for the NHLBI AsthmaNet grant 5U10 HL098075-02. S.J.S. is supported by NHLBI AsthmaNet grant U10 HL098075 and supported in part by Colorado CTSA grant UL1 RR025780 from the NCRR/NIH and UL1 TR000154 from NIH/NCATS.