FEV1, airway reversibility predict therapy response in young asthmatics
MedWire News: Pre-bronchodilation FEV1 and airway reversibility are significant predictors of response to anti-inflammatory treatment in young children with asthma, results from a small German study suggest.
Writing in the journal Current Medical Research and Opinion, Martin Christmann (Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt) and colleagues explain: “Currently available anti-inflammatory treatment for young children with asthma includes inhaled corticosteroids (ICSs) and the leukotriene receptor antagonist montelukast.”
To investigate potential predictors of response to anti-inflammatory therapy in young children with episodic asthma, the team studied data on 102 children, aged 4 to 7 years, with the respiratory condition who participated in an open-label, single-centre study.
At baseline, all the children underwent lung function tests and methacholine challenge, and their levels of total immunoglobulin E (IgE), cumulative specific IgE, and eosinophils were measured. They were also assessed for the presence of allergies and exposure to parental smoking.
In total, 45 children began to experience asthma symptoms during observation and were assigned to receive either the ICS fluticasone or montelukast for 6 weeks.
The researchers found that lung function improved to a similar extent after treatment in both groups of symptomatic children. Indeed, FEV1 improved from a mean of 90.2% before to 106.8% after treatment in the fluticasone group, and from 90.8% before to 103.7% after treatment in the montelukast group.
Analysis revealed that pre-bronchodilatory FEV1 and airway reversibility at the time of randomization were the only significant predictors of a favorable response to anti-inflammatory therapy. None of the biomarkers assessed were predictive of response to therapy.
Christmann and team conclude: “Despite the small sample size and the open-label design, the study suggests that the use of pre-bronchodilatory FEV1 and airway reversibility appears to be a good indicator of short-term anti-inflammatory therapy in young children with asthma.”
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By Mark Cowen