Current Allergy and Asthma Reports

, Volume 13, Issue 5, pp 421–426

Will Symptom-Based Therapy Be Effective for Treating Asthma in Children?

  • Marianne Nuijsink
  • Johan C. De Jongste
  • Mariëlle W. Pijnenburg
ASTHMA (WJ CALHOUN AND SP PETERS, SECTION EDITORS)

DOI: 10.1007/s11882-013-0364-x

Cite this article as:
Nuijsink, M., De Jongste, J.C. & Pijnenburg, M.W. Curr Allergy Asthma Rep (2013) 13: 421. doi:10.1007/s11882-013-0364-x

Abstract

Traditionally, symptoms are important patient-oriented outcomes in asthma treatment, and assessment of symptoms is an essential component of assessing asthma control. However, variable airways obstruction, airways hyperresponsiveness and chronic inflammation are key components of the asthma syndrome, and correlations among these hallmarks and symptoms are weak or even absent. Therefore, it might be questioned if symptom-based therapy is effective for treating asthma in (all) children. To date, there is no firm indication that monitoring asthma based on repetitive lung function measurement or markers of airway inflammation is superior to monitoring based on symptoms only. In the majority of patients, symptom-based asthma management may well be sufficient, and in preschool children, symptoms are presently the only feasible outcome. Nevertheless, there is some evidence that selected groups might benefit from an approach that takes into account individual phenotypic characteristics. In patients with poor perception, those with a discordant phenotype and those with persistent severe asthma, considering lung function, airways hyperresponsiveness and inflammatory markers in treatment decisions might improve outcomes.

Keywords

AsthmaChildrenSymptomsAsthma controlAsthma control questionnaireAsthma control testChildhood asthma control testLung functionAirwaysSymptom-based therapyHyperresponsivenessExacerbationsSputum eosinophilsExhaled nitric oxideMonitoringExhaled breath

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Marianne Nuijsink
    • 1
  • Johan C. De Jongste
    • 2
  • Mariëlle W. Pijnenburg
    • 2
  1. 1.Department of PaediatricsJuliana Children’s HospitalThe HagueThe Netherlands
  2. 2.Department of Paediatrics/Paediatric Respiratory MedicineErasmus University Medical Centre RotterdamRotterdamThe Netherlands