Aiming for optimal asthma control in children as soon as they are diagnosed appears to be a promising strategy for stopping the disease in its tracks, an international expert says.
The research presented by Francine Ducharme, a Professor of Paediatrics at the University of Montreal in Canada, retrospectively studied almost 120,000 children under the age of five with asthma who were born in four Canadian provinces between 1990 and 2013.
Preschool asthma was defined by one hospitalisation or two medical visits within a two-year period for asthma. Remission was assumed after two years without any asthma-related drug claims, medical visit or hospitalisation.
Asthma control in the 2 years following diagnosis was measured on the 4-level Pediatric Pharmacoepidemiology Asthma Control Index (PPACI).
The research team pinpointed a window of opportunity after diagnosis to implement targeted strategies that could have an impact on long-term outcomes.
| PPACI
2 years post-dx |
Adjusted HR *(95% CI) |
| Controlled throughout | reference |
| Improving control | 0.80 (0.68, 0.95) |
| Varying control | 0.59 (0.52, 0.68) |
| Worsening control | 0.50 (0.42, 0.59) |
| Out of control throughout | 0.31 (0.27, 0.36) |
*Adjusted for demographic and disease characteristics (3 provinces)
“Asthma control achieved in the 24 months following diagnosis in preschoolers is a major determinant of both remission and recurrence,” Professor Ducharme told the conference during a TSANZ late breaking abstract session on Monday.
This finding was irrespective of the child and their early disease characteristics.
“The worse the control, the lowest the likelihood of remission,” she said.