Prediction of asthma control and treatment changes in obstructive asthmatic children

Abstract

Background usefulness of lung function (LF) over clinical evaluation is not well established in asthmatic children follow-up. Objectives To determine factors associated with change in treatment and in the level of asthma control in asthmatic children. Methods Prospective study in asthmatic children referred for LF (including capillary PO 2 , baseline and post- bronchodilator spirometry)(V1) and assessed for clinical asthma features (P/C: partially or totally controlled; NC: not controlled) at V1 and few weeks later (V2). Results 55 asthmatic children (57 children included at V1) were seen with a median [Q1;Q3] delay of 2 [1.1;2.8] months. In 52 children at V1, 22 (42%) had a prescription or an increase in inhaled treatment, and 11 (21%) took a short course of oral corticosteroids (OCS). In a generalized logistic regression to estimate the change in inhaled or OCS treatment versus no change, high dose of inhaled CS at V1 was associated with less change in inhaled treatment (OR [95%CI] 0.04 [0.0;0.32]; p=0.003), and a PcaO2 ≥-2 z score was associated with lesser prescription of OCS (OR [95%CI] 0.03 [0.003;0.22]; p=0.001). In a logistic model predicting asthma control at V2, the only independent explaining factor was the level of asthma control at V1 (adjusted OR [95%CI] 19.3 [2.26;165.6]; p=0.01). Conclusion Clinical and LF indices are complementary in predicting asthma outcome.