Loss of asthma control in inner city children with asthma after withdraw of asthma controller medication.
To determine what percentage of inner-city children with asthma would lose asthma control when taken off asthma controllers, a retrospective analysis was performed on inner-city asthmatic children who achieved asthma control in an asthma specific disease management program. Once disease control was achieved patients had stepwise reduction of asthma controllers based on the National Asthma Education and Prevention Program (NAEPP) Expert Review Panel (EPR) 2 guidelines. In patients who were taken off all controllers, probability of maintaining asthma control at the first visit after cessation of these medications was significantly lower compared to patients kept on inhaled corticosteroids. We conclude that cessation of asthma controllers in previously well controlled inner-city asthmatic children results in loss of asthma control in a significant number of these patients. Data support recommendations from national asthma guidelines to step down controller therapy, but clinical monitoring is important to reduce impairment due to loss of control.
Kwong
Kenny Y C
KY
Division of Allergy-Immunology, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California 90509, USA. kkwongusc@yahoo.com
Morphew
Tricia
T
Huynh
Peter
P
Scott
Lyne
L
Radjal
Nasser
N
Dale
Grace
G
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D017408:Guidelines as Topic; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D020024:Leukotriene Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D012189:Retrospective Studies; D012621:Seasons; D012737:Sex Factors; D016896:Treatment Outcome; D014505:Urban Population / Q000706:statistics & numerical data*; D028761:Withholding Treatment / Q000706:statistics & numerical data*
D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents; D020024:Leukotriene Antagonists