Demographic and clinical characteristics of children and adolescents with severe or difficult-to-treat asthma.
BACKGROUND
Young patients with severe or difficult-to-treat asthma are an understudied population.


OBJECTIVE
To assess age-associated and gender-associated differences in children and adolescents in the observational study, The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens.


METHODS
Cross-sectional baseline data for patients greater than or equal to 6 years and less than or equal to 17 years (n = 1261) were stratified by age group (6-8, 9-11, 12-14, and 15-17 years). The chi(2) test for categorical variables and analysis of variance for continuous variables were used to identify differences among age groups, stratified by gender.


RESULTS
Most patients had moderate (55%) or severe (41%) asthma by physician assessment. Of those using greater than or equal to 3 long-term controllers (62%), 53% of children (6-11 years) and 44% of adolescents (12-17 years) reported an oral corticosteroid burst and 25% and 19%, respectively, had an emergency department visit in the previous 3 months; 10% and 15%, respectively, reported past intubation. In females, weight for age ranged between the 67th and 70th percentiles; height for age was between the 42nd and 54th percentiles (P < .01 among age groups). Lung function was lower in adolescents than children: prebronchodilator percent predicted forced expiratory volume in 1 second (FEV(1))/forced vital capacity was 0.92 (6-8 years) and 0.83 (15-17 years), P less than .05, in males; and 0.94 (6-8 years) and 0.87 (15-17 years), P less than .05, in females.


CONCLUSIONS
Children and adolescents demonstrated high rates of health care use and loss of lung function, despite using multiple long-term controllers.


CONCLUSIONS
Asthma treatments that prevent loss of lung function and reduce health care resource use are needed in young patients with severe or difficult-to-treat asthma.
Chipps
Bradley E
BE
Capital Allergy and Respiratory Disease Center, Sacramento, CA 95819, USA. BChipps@capitalallergy.com
Szefler
Stanley J
SJ
Simons
F Estelle R
FE
Haselkorn
Tmirah
T
Mink
David R
DR
Deniz
Yamo
Y
Lee
June H
JH
D000293:Adolescent; D000367:Age Factors; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000453:epidemiology*; D002648:Child; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D012737:Sex Factors; D013147:Spirometry
D018927:Anti-Asthmatic Agents; D007073:Immunoglobulin E