Cargando…

Difficult vs. Severe Asthma: Definition and Limits of Asthma Control in the Pediatric Population

Evaluating the degree of disease control is pivotal when assessing a patient with asthma. Asthma control is defined as the degree to which manifestations of the disease are reduced or removed by therapy. Two domains of asthma control are identified in the guidelines: symptom control and future risk...

Descripción completa

Detalles Bibliográficos
Autores principales: Licari, Amelia, Brambilla, Ilaria, Marseglia, Alessia, De Filippo, Maria, Paganelli, Valeria, Marseglia, Gian L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6018103/
https://www.ncbi.nlm.nih.gov/pubmed/29971223
http://dx.doi.org/10.3389/fped.2018.00170
_version_ 1783334881746485248
author Licari, Amelia
Brambilla, Ilaria
Marseglia, Alessia
De Filippo, Maria
Paganelli, Valeria
Marseglia, Gian L.
author_facet Licari, Amelia
Brambilla, Ilaria
Marseglia, Alessia
De Filippo, Maria
Paganelli, Valeria
Marseglia, Gian L.
author_sort Licari, Amelia
collection PubMed
description Evaluating the degree of disease control is pivotal when assessing a patient with asthma. Asthma control is defined as the degree to which manifestations of the disease are reduced or removed by therapy. Two domains of asthma control are identified in the guidelines: symptom control and future risk of poor asthma outcomes, including asthma attacks, accelerated decline in lung function, or treatment-related side effects. Over the past decade, the definition and the tools of asthma control have been substantially implemented so that the majority of children with asthma have their disease well controlled with standard therapies. However, a small subset of asthmatic children still requires maximal therapy to achieve or maintain symptom control and experience considerable morbidity. Childhood uncontrolled asthma is a heterogeneous group and represents a clinical and therapeutic challenge requiring a multidisciplinary systematic assessment. The identification of the factors that may contribute to the gain or loss of control in asthma is essential in differentiating children with difficult-to-treat asthma from those with severe asthma that is resistant to traditional therapies. The aim of this review is to focus on current concept of asthma control, describing monitoring tools currently used to assess asthma control in clinical practice and research, and evaluating comorbidities and modifiable and non-modifiable factors associated with uncontrolled asthma in children, with particular reference to severe asthma.
format Online
Article
Text
id pubmed-6018103
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-60181032018-07-03 Difficult vs. Severe Asthma: Definition and Limits of Asthma Control in the Pediatric Population Licari, Amelia Brambilla, Ilaria Marseglia, Alessia De Filippo, Maria Paganelli, Valeria Marseglia, Gian L. Front Pediatr Pediatrics Evaluating the degree of disease control is pivotal when assessing a patient with asthma. Asthma control is defined as the degree to which manifestations of the disease are reduced or removed by therapy. Two domains of asthma control are identified in the guidelines: symptom control and future risk of poor asthma outcomes, including asthma attacks, accelerated decline in lung function, or treatment-related side effects. Over the past decade, the definition and the tools of asthma control have been substantially implemented so that the majority of children with asthma have their disease well controlled with standard therapies. However, a small subset of asthmatic children still requires maximal therapy to achieve or maintain symptom control and experience considerable morbidity. Childhood uncontrolled asthma is a heterogeneous group and represents a clinical and therapeutic challenge requiring a multidisciplinary systematic assessment. The identification of the factors that may contribute to the gain or loss of control in asthma is essential in differentiating children with difficult-to-treat asthma from those with severe asthma that is resistant to traditional therapies. The aim of this review is to focus on current concept of asthma control, describing monitoring tools currently used to assess asthma control in clinical practice and research, and evaluating comorbidities and modifiable and non-modifiable factors associated with uncontrolled asthma in children, with particular reference to severe asthma. Frontiers Media S.A. 2018-06-19 /pmc/articles/PMC6018103/ /pubmed/29971223 http://dx.doi.org/10.3389/fped.2018.00170 Text en Copyright © 2018 Licari, Brambilla, Marseglia, De Filippo, Paganelli and Marseglia. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Licari, Amelia
Brambilla, Ilaria
Marseglia, Alessia
De Filippo, Maria
Paganelli, Valeria
Marseglia, Gian L.
Difficult vs. Severe Asthma: Definition and Limits of Asthma Control in the Pediatric Population
title Difficult vs. Severe Asthma: Definition and Limits of Asthma Control in the Pediatric Population
title_full Difficult vs. Severe Asthma: Definition and Limits of Asthma Control in the Pediatric Population
title_fullStr Difficult vs. Severe Asthma: Definition and Limits of Asthma Control in the Pediatric Population
title_full_unstemmed Difficult vs. Severe Asthma: Definition and Limits of Asthma Control in the Pediatric Population
title_short Difficult vs. Severe Asthma: Definition and Limits of Asthma Control in the Pediatric Population
title_sort difficult vs. severe asthma: definition and limits of asthma control in the pediatric population
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6018103/
https://www.ncbi.nlm.nih.gov/pubmed/29971223
http://dx.doi.org/10.3389/fped.2018.00170
work_keys_str_mv AT licariamelia difficultvssevereasthmadefinitionandlimitsofasthmacontrolinthepediatricpopulation
AT brambillailaria difficultvssevereasthmadefinitionandlimitsofasthmacontrolinthepediatricpopulation
AT marsegliaalessia difficultvssevereasthmadefinitionandlimitsofasthmacontrolinthepediatricpopulation
AT defilippomaria difficultvssevereasthmadefinitionandlimitsofasthmacontrolinthepediatricpopulation
AT paganellivaleria difficultvssevereasthmadefinitionandlimitsofasthmacontrolinthepediatricpopulation
AT marsegliagianl difficultvssevereasthmadefinitionandlimitsofasthmacontrolinthepediatricpopulation