Childhood Asthma Control Test and airway inflammation evaluation in asthmatic children.
BACKGROUND
The Childhood Asthma Control Test (C-ACT) has been proposed as a tool in assessing the level of disease control in asthmatic children. To evaluate the position of C-ACT in the clinical management of asthmatic children, in relationship to the level of airway inflammation as assessed by fractional exhaled nitric oxide (FeNO) and with lung function.


METHODS
A total of 200 asthmatic children were included in the study: 47 children with newly diagnosed asthma ('New') and without any regular controller therapy; and 153 children with previously diagnosed asthma, treated according to GINA guidelines, and evaluated during a scheduled follow-up visit ('Follow-up'). Childhood Asthma Control Test, FeNO and lung function [forced expiratory volume 1 (FEV1) and forced vital capacity (FVC)] were evaluated.


RESULTS
In New vs Follow-up participants, C-ACT score (P < 0.001), FVC (P < 0.005) and FEV1 (P < 0.05) were significantly lower, and FeNO (P = 0.011) were significantly higher. In New, but not in Follow-up participants, significant correlations were observed between C-ACT score and FeNO (r = -0.51; P < 0.001), FEV1 (r = 0.34; P = 0.022) and FEV1/FVC (r = 0.32; P = 0.03). This lack of correlation in Follow-up visits seemed attributable to dissociation between inadequately controlled asthma by C-ACT ratings with normalization of other measures such as FeNO levels.


CONCLUSIONS
This study confirms and expands the concept that C-ACT is complementary to, but not a substitute for, other markers of disease control in asthmatic children, especially in the context of follow-up visits.
Piacentini
G L
GL
Clinica Pediatrica Università di Verona, Verona, Italy.
Peroni
D G
DG
Bodini
A
A
Bonafiglia
E
E
Rigotti
E
E
Baraldi
E
E
Liu
A H
AH
Boner
A L
AL
D001249:Asthma / Q000175:diagnosis* / Q000473:pathology; D002648:Child; D005541:Forced Expiratory Volume; D006801:Humans; D007249:Inflammation / Q000175:diagnosis*; D012129:Respiratory Function Tests / Q000379:methods*; D012130:Respiratory Hypersensitivity / Q000473:pathology; D014797:Vital Capacity