Abstract
Globally, asthma is one of the most common chronic conditions that affect individuals of all ages. When poorly controlled, it negatively impacts patient's ability to enjoy life and work. At the population level, effective use of recommended strategies in children and adults can reduce symptom burden, improve quality of life and significantly reduce the risk of exacerbation, decline of lung function and asthma-related death. Inhaled corticosteroid as the initial maintenance therapy, ideally started within 2 years of symptom onset, is highly effective in both children and adults and across various degrees of asthma severity. If asthma is not controlled, the choice of subsequent add-on therapies differs between children and adults. Evidence supporting pharmacological approach to asthma management, especially for those with more severe disease, is more robust in adults compared to children. This is, in part, due to various challenges in the diagnosis of asthma, in the recruitment into clinical trials and in the lack of objective outcomes in children, especially those in the preschool age group. Nevertheless, where evidence is emerging for younger children, it seems to mirror the observations in adults. Clinicians need to develop strategies to implement guideline-based recommendations while taking into consideration individual variations in asthma clinical phenotypes, pathophysiology and treatment responses at different ages.
Highlights
Asthma BurdenAsthma is a chronic inflammatory disease of the airways with typical symptoms of wheezing, breathlessness and cough and variable airflow obstruction
The most striking asthma phenotype is found in young children who present with wheezing attacks associated with viral infection, rhinovirus infection, often with no symptoms between attacks
This review summarizes evidence about differences in the approaches to asthma treatments in adults and children as currently recommended in commonly used asthma guidelines [12, 13] (Table 1)
Summary
Asthma is a chronic inflammatory disease of the airways with typical symptoms of wheezing, breathlessness and cough and variable airflow obstruction. The WHO estimates that some 235 million people currently suffer from asthma [1] and it is the commonest chronic disease of children worldwide. With appropriate management most people with asthma can enjoy excellent symptom control and a good quality of life [1]. Reduction of future risk in terms of asthma attacks, and prevention of decline in lung function are recognized as the key goals of asthma management (Figure 1). These goals are relevant to all patients with asthma irrespective of age. Pharmacological therapies are the main tools for controlling asthma but non-pharmacological interventions such as allergen or
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