The Measurement of Asthma and Allergic Rhinitis Control in Children and Adolescents.

Maria Tosca,Amelia Licari,Paolo Del Barba,Giorgio Ciprandi

doi:10.3390/children7050043

Abstract

Asthma and allergic rhinitis (AR) are frequently associated. The objective of the treatment of asthma and AR should be the control of symptoms and disease progression. Therefore, the combined measurement of disease control is desirable. In this regard, a questionnaire able to together assess asthma and AR control has been validated: the CARAT (Control of Allergic Rhinitis and Asthma Test). A further pediatric version (CARATkids) has been generated. The current real-world study used different disease control measures in children and adolescents with asthma and rhinitis. A total of 138 children and adolescents were recruited at three allergy centers. CARAT, CARATkids, ACT (Asthma Control Test), cACT (children ACT), GINA (Global Initiative for Asthma) disease control classification, VAS (Visual Analog Scale) for asthma and nasal symptoms, and lung function were used in all subjects. There was a predominance of males (67.4%) and asthma was well-controlled (according to GINA classification) in about half the subjects. In children, the median CARAT and cACT values were 5 and 22 respectively. In adolescents, the median CARAT and ACT values were 23 for both tests. There were significant differences between CARAT and ACT (p = 0.035) as well as between CARATkids and cACT (p = 0.0001). However, the tests’ outcomes were different as assessed in different domains. CARAT and CARATkids are disease-control measurements that give additional information to other tests, therefore, these different questionnaires to measure disease control complement each other.

Highlights

It is well known that allergic rhinitis (AR) is a relevant risk factor for asthma exacerbations [1]
The inclusion criteria were: (i) age between 5 and 17 years; (ii) a documented asthma diagnosis, based on the history of intermittent wheezing, breathlessness, cough, and chest tightness in combination with reversibility to bronchodilators and/or positive response to bronchial methacholine challenge; and (iii) diagnosis of AR according to validated criteria [1]
This study evaluated different methods to assess asthma control, including GINA asthma grading, ACT, Visual Analog Scale (VAS), and CARAT

Summary

Introduction

AR and asthma are closely associated both from a pathophysiological and a clinical point of view [2] In this regard, a functional link has been described between nasal airflow and bronchial airflow [3] as well as a close association between upper and lower airway inflammation [4]. A functional link has been described between nasal airflow and bronchial airflow [3] as well as a close association between upper and lower airway inflammation [4] These concepts support the unbreakable relationship between the upper and lower airways, in health as well as in disease. As upper and lower airway diseases share the same pathophysiological features, their management and treatment should be integrated In this regard, disease control is the shared goal for both AR and Asthma. Asthma control has been defined by the GINA (Global Initiative for Asthma) guidelines [5]

Methods

Discussion

Conclusion