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The influence of inhaled corticosteroid discontinuation in children with well-controlled asthma.

Abstract Asthma is a chronic inflammatory disease that requires adherence to both preventative and therapeutic interventions in disease management. Children with asthma are likely to discontinue inhaled corticosteroids (ICS), especially when symptoms are under control. We aimed to investigate the impact of ICS adherence in children whose symptoms were under control.The study is cohort study; 35 children with controlled asthma that had undergone 3 years of follow-up were included. Serum eosinophil count, serum total IgE (tIgE), and lung function (FEV1, FEV1/FVC, PEF, FEF20-75%, and PC20) were evaluated at the beginning and end of the follow-up.At baseline, patients in both the adherent and nonadherent groups were similar. After 3 years, the nonadherent group who had discontinued ICS had a decrease in FEV1 (P < .05), FEV1/FVC (P < .05), PEF (P < .05), and FEF20-75% (P < .05). The nonadherent group had no significant improvement in PC20 compared with their values at the beginning of the follow-up, whereas the adherent group had improvement in PC20. Furthermore, there was an increase in serum eosinophil (P < .001) and tIgE (P < .05) in the nonadherent compared with the adherent group.Despite good asthma control, airway hyperresponsiveness (AHR) was detected in a large proportion of children with asthma. ICS discontinuation affected lung function, serum eosinophil count, tIgE, and AHR. Adequate adherence is important in asthma management. The benefits of ICS and the influence of drug discontinuation despite good asthma control may encourage better adherence from patients.
PMID
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Authors

Mayor MeshTerms

Medication Adherence

Keywords
Journal Title medicine
Publication Year Start




PMID- 28858095
OWN - NLM
STAT- MEDLINE
DA  - 20170831
DCOM- 20170911
LR  - 20170912
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 35
DP  - 2017 Sep
TI  - The influence of inhaled corticosteroid discontinuation in children with
      well-controlled asthma.
PG  - e7848
LID - 10.1097/MD.0000000000007848 [doi]
AB  - Asthma is a chronic inflammatory disease that requires adherence to both
      preventative and therapeutic interventions in disease management. Children with
      asthma are likely to discontinue inhaled corticosteroids (ICS), especially when
      symptoms are under control. We aimed to investigate the impact of ICS adherence
      in children whose symptoms were under control.The study is cohort study; 35
      children with controlled asthma that had undergone 3 years of follow-up were
      included. Serum eosinophil count, serum total IgE (tIgE), and lung function
      (FEV1, FEV1/FVC, PEF, FEF20-75%, and PC20) were evaluated at the beginning and
      end of the follow-up.At baseline, patients in both the adherent and nonadherent
      groups were similar. After 3 years, the nonadherent group who had discontinued
      ICS had a decrease in FEV1 (P &lt; .05), FEV1/FVC (P &lt; .05), PEF (P &lt; .05), and
      FEF20-75% (P &lt; .05). The nonadherent group had no significant improvement in PC20
      compared with their values at the beginning of the follow-up, whereas the
      adherent group had improvement in PC20. Furthermore, there was an increase in
      serum eosinophil (P &lt; .001) and tIgE (P &lt; .05) in the nonadherent compared with
      the adherent group.Despite good asthma control, airway hyperresponsiveness (AHR) 
      was detected in a large proportion of children with asthma. ICS discontinuation
      affected lung function, serum eosinophil count, tIgE, and AHR. Adequate adherence
      is important in asthma management. The benefits of ICS and the influence of drug 
      discontinuation despite good asthma control may encourage better adherence from
      patients.
FAU - Zheng, Shengkun
AU  - Zheng S
AD  - Department of Pediatrics, The Second Affiliated Hospital &amp; Yuying Children's
      Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China.
FAU - Yu, Qiying
AU  - Yu Q
FAU - Zeng, Xiangyan
AU  - Zeng X
FAU - Sun, Wangming
AU  - Sun W
FAU - Sun, Yan
AU  - Sun Y
FAU - Li, Mengrong
AU  - Li M
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Adrenal Cortex Hormones)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - AIM
SB  - IM
MH  - Administration, Inhalation
MH  - Adrenal Cortex Hormones/*administration &amp; dosage
MH  - Asthma/blood/*drug therapy/physiopathology
MH  - Child
MH  - Cohort Studies
MH  - Drug Administration Schedule
MH  - Female
MH  - Humans
MH  - Immunoglobulin E/blood
MH  - Leukocyte Count
MH  - Male
MH  - *Medication Adherence
MH  - Respiratory Function Tests
MH  - Retrospective Studies
PMC - PMC5585489
EDAT- 2017/09/01 06:00
MHDA- 2017/09/12 06:00
CRDT- 2017/09/01 06:00
AID - 10.1097/MD.0000000000007848 [doi]
AID - 00005792-201709010-00019 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Sep;96(35):e7848. doi: 10.1097/MD.0000000000007848.