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Asthma Severity and the Controller Prescription in Children at 12 Tertiary Hospitals

Authors
Suh, Dong InYang, Hyeon JongKim, Bong-SeongShin, Youn HoLee, So-YeonPark, GeunhwaKim, Woo KyungKim, Hyo-BinBaek, HeysungKim, Ja-KyoungKim, Jin-TackLim, Dae Hyun
Issue Date
Jan-2017
Publisher
대한천식알레르기학회
Keywords
Asthma; child; guideline; Leukotriene antagonists; Republic of Korea
Citation
Allergy, Asthma & Immunology Research, v.9, no.1, pp 52 - 60
Pages
9
Journal Title
Allergy, Asthma & Immunology Research
Volume
9
Number
1
Start Page
52
End Page
60
URI
https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/7900
DOI
10.4168/aair.2017.9.1.52
ISSN
2092-7355
2092-7363
Abstract
Purpose: Guidelines need to be tailored to where they are applied. We aimed to describe the distinctive asthma severity profile and the pattern of controller prescription in Korean children. Methods: Twelve pediatric allergists from tertiary medical centers reviewed medical records of all asthmatic children who visited their clinics between September 1 and November 30 of 2013. Controller prescriptions were re-classified into 4 categories, then the prevalence of each asthma severity category and the controller prescription patterns according to asthma severity assessed by a Western (Global Initiative for Asthma, GINA) and an Asia-Pacific (Japanese Pediatric GuideLine, JPGL) guideline were evaluated. Results: A total of 840 cases were reviewed. Both GINA and JPGL revealed that 328 (39.0%) and 249 (29.6%) subjects had intermittent asthma whereas 24 (2.9%) and 21 (2.5%) subjects had severe persistent asthma, respectively. Although higher category controllers tended to be prescribed to those who had more severe asthma, there was much overlap in categories of prescribed controllers between groups with regard to asthma severities. Leukotriene receptor antagonists (LTRA) was the most frequently prescribed as a single controller (40%) or as an add-on medication (19%) in the group of asthmatic children <6 years. Conclusions: Korean children have distinctive patterns of asthma severity and management strategies with a lower prevalence of severe asthma and a preference toward LTRA rather than low dose inhaled corticosteroids (ICS) alone or add-on long-acting beta-agonist (LABA) in the group of <6 year-old asthmatics that has not been predicted in Western countries. Thus, strategies tailored to regional situations need to be developed and recommended.
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