The burden of severe asthma in childhood and adolescence: results from the paediatric U-BIOPRED cohorts

Fleming, Louise and Murray, Clare and Bansal, Aruna T. and Hashimoto, Simone and Bisgaard, Hans and Bush, Andrew and Frey, Urs and Hedlin, Gunilla and Singer, Florian and Aalderen, Wim M. van and Vissing, Nadja H. and Zolkipli, Zaraquiza and Selby, Anna and Fowler, Stephen and Shaw, Dominick E. and Chung, Kian Fan and Sousa, Ana R. and Wagers, Scott and Corfield, Julie and Pandis, Ioannis and Rowe, Anthony and Formaggio, Elena and Sterk, Peter J. and Roberts, Graham (2015) The burden of severe asthma in childhood and adolescence: results from the paediatric U-BIOPRED cohorts. European Respiratory Journal, 46 (5). pp. 1322-1333. ISSN 1399-3003

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Abstract

U-BIOPRED aims to characterise paediatric and adult severe asthma using conventional and innovative systems biology approaches.

A total of 99 school-age children with severe asthma and 81 preschoolers with severe wheeze were compared with 49 school-age children with mild/moderate asthma and 53 preschoolers with mild/moderate wheeze in a cross-sectional study.

Despite high-dose treatment, the severe cohorts had more severe exacerbations compared with the mild/moderate ones (annual medians: school-aged 3.0 versus 1.1, preschool 3.9 versus 1.8; p<0.001). Exhaled tobacco exposure was common in the severe wheeze cohort. Almost all participants in each cohort were atopic and had a normal body mass index. Asthma-related quality of life, as assessed by the Paediatric Asthma Quality of Life Questionnaire (PAQLQ) and the Paediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ), was worse in the severe cohorts (mean±SE school-age PAQLQ: 4.77±0.15 versus 5.80±0.19; preschool PACQLQ: 4.27±0.18 versus 6.04±0.18; both p≤0.001); however, mild/moderate cohorts also had significant morbidity. Impaired quality of life was associated with poor control and airway obstruction. Otherwise, the severe and mild/moderate cohorts were clinically very similar.

Children with severe preschool wheeze or severe asthma are usually atopic and have impaired quality of life that is associated with poor control and airflow limitation: a very different phenotype from adult severe asthma. In-depth phenotyping of these children, integrating clinical data with high-dimensional biomarkers, may help to improve and tailor their clinical management.

Item Type: Article
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine
Identification Number: 10.1183/13993003.00780-2015
Depositing User: Eprints, Support
Date Deposited: 09 May 2017 09:02
Last Modified: 11 May 2017 10:29
URI: http://eprints.nottingham.ac.uk/id/eprint/42635

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