Management and treatment of bronchial asthma in adults and children on the basis of new guidelines

REVIEW ARTICLE

Management and treatment of bronchial asthma in adults and children on the basis of new guidelines

Anna Książkiewicz 1 , Edyta Kwilosz 1 , Rafał Fornal 2 , Ewa Dworzańska 3

1. Zakład Pielęgniarstwa, Państwowa Wyższa Szkoła Zawodowa w Krośnie,
2. Oddział Dziecięcy Wojewódzkiego Szpitala Podkarpackiego w Krośnie,
3. Klinika Neurologii Dziecięcej, Uniwersytet Medyczny w Lublinie,

Published: 2020-07-22
DOI: 10.5604/01.3001.0014.3290
GICID: 01.3001.0014.3290
Available language versions: en pl
Issue: Postepy Hig Med Dosw 2020; 74 : 283-300

 

Abstract

Bronchial asthma is the most common chronic disease in children and adults under 40 years of age. Characteristic symptoms include wheezing, shortness of breath, tightness of the chest and a cough varying in time and intensity. The disease usually begins in childhood and lasts a lifetime, with periods of exacerbation and remission. Asthma can occur at any age, but in approximately 80% of cases the first asthma attack occurs before the age of 5. Over the past several years, progress in the diagnosis and monitoring of patients with asthma has been made. In addition to the long-established objective assessment methods, such as functional tests, rapid asthma control questionnaires recommended for use in daily practice and noninvasive methods for assessing inflammation have been introduced. The availability of these methods and their degree of use in routine practice are variable. Taking careful history with the child and parents is very important. A detailed history is the first and primary step of asthma recognition. While in the case of adults, the observation period and available methods usually allow us to make reliable diagnosis of the disease, in younger children the diagnosis is associated with difficulties resulting from the inability to use some diagnostic tools. The paper discusses the currently available diagnostic methods and those used for monitoring the disease, especially the most current ones used in the youngest children. Medications used in asthma treatment have been characterized, including new therapeutic options, especially biological treatment. Particular attention was paid to the education of the patient and caregivers, which, apart from well-established treatment, determines good asthma control.

References

  • 1. Akdis C.A., Akdis M.: Mechanisms of allergen-specific immunotherapyand immune tolerance to allergens. World Allergy Organ.J., 2015; 8: 17
    Google Scholar
  • 2. Anderson H.R., Bland J.M., Patel S., Peckham C.: The natural history ofasthma in childhood. J. Epidemiol. Community Health, 1986; 40: 121–129
    Google Scholar
  • 3. Asamoah F., Kakourou A., Dhami S., Lau S., Agache I., MuraroA., Roberts G., Akdis C., Bonini M., Cavkaytar O., Flood B., IzuharaK., Jutel M., Kalayci Ö. i wsp.: Allergen immunotherapy for allergicasthma: A systematic overview of systematic reviews. Clin. Transl.Allergy, 2017; 7: 25
    Google Scholar
  • 4. Baddar S., Jayakrishnan B., Al-Rawas O.A.: Asthma control: Importanceof compliance and inhaler technique assessments. J. Asthma,2014; 51: 429–434
    Google Scholar
  • 5. Barnes P.J.: Theophylline. Am. J. Respir. Crit. Care Med., 2013;188: 901–906
    Google Scholar
  • 6. Becker A.B.: Asthma in the preschool child: Still a rose by anyother name? J. Allergy Clin. Immunol., 2008; 122: 1136–1137
    Google Scholar
  • 7. Becker A.: Leukotriene receptor antagonists: Efficacy and safetyin children with asthma. Pediatr. Pulmonol., 2000; 30: 183–186
    Google Scholar
  • 8. Bodajko-Grochowska A., Bednarek A., Markut-Miotła E., DerewieckiT., Emeryk A.: Stan wiedzy pielęgniarek na temat aerozoloterapiiu dzieci z astmą. Alerg. Astma Immunol., 2015; 20: 199–207
    Google Scholar
  • 9. Buczyłko K.: Znaczenie redukcji narażenia na alergeny sezonowew leczeniu alergii. Alerg. Astma Immunol., 2011; 16: 17–23
    Google Scholar
  • 10. Castro M., Corren J., Pavord I.D., Maspero J., Wenzel S., Rabe K.F.,Busse W.W., Ford L., Sher L., FitzGerald J.M., Katelaris C., Tohda Y.,Zhang B., Staudinger H., Pirozzi G. i wsp.: Dupilumab efficacy andsafety in moderate to severe uncontrolled asthma. N. Engl. J. Med.,2018; 378: 2486–2496
    Google Scholar
  • 11. Castro M., Zangrilli J., Wechsler M.E., Bateman E.D, Brusselle G.G,Bardin P., Murphy K., Maspero J.F, O`Brien C., Korn S.: Reslizumabfor inadequately controlled asthma with elevated blood eosinophilcounts: Results from two multicentre, parallel, double-blind, randomised,placebo-controlled, phase 3 trials. Lancet Respir. Med.,2015; 3: 355–366
    Google Scholar
  • 12. Castro-Rodríguez J.A., Holberg C.J., Wright A.L., Martinez F.D.:A clinical index to define risk of asthma in young children with recurrentwheezing. Am. J. Respir. Crit. Care Med., 2000; 162: 1403–1406
    Google Scholar
  • 13. Castro-Rodriguez J.A., Rodrigo G.J.: The role of inhaled corticosteriodsand montelukast in children with mild-moderate asthma:Results of a systematic review with meta-analysis. Arch. Dis. Child.,2010, 95: 365–370
    Google Scholar
  • 14. Caudri D., Wijga A., A Schipper C.M., Hoekstra M., Postma D.S.,Koppelman G.H., Brunekreef B., Smit H.A., de Jonqste J.C.: Predictingthe long-term prognosis of children with symptoms suggestive ofasthma at preschool age. J. Allergy Clin. Immunol., 2009; 124: 903–910
    Google Scholar
  • 15. Cockle S.M., Stynes G., Gunsoy N.B., Parks D., Alfonso-CristanchoR., Wex J., Bradford E.S., Albers F.C., Willson J.: Comparative effectivenessof mepolizumab and omalizumab in severe asthma: An indirecttreatment comparison. Respir. Med., 2017; 123: 140–148
    Google Scholar
  • 16. Corren J.: Asthma phenotypes and endotypes: An evolving paradigmfor classification. Discov. Med., 2013; 15: 243–249
    Google Scholar
  • 17. Damps-Konstańska I.: Kwalifikacja chorych na astmę ciężką doleczenia omalizumabem – przewodnik dla lekarza. Alerg. Astma Immunol.,2015; 20: 215–217
    Google Scholar
  • 18. Dusser D., Montani D., Chanez P., de Blic J., Delacourt C., DeschildreA., Devillier P., Didier A., Leroyer C., Marguet C., Martinat Y.,Piquet J., Raherison C., Serrier P., Tillie-Leblond I. i wsp.: Mild asthma:An expert review on epidemiology, clinical characteristics and treatmentrecommendations. Allergy, 2007; 62: 591–604
    Google Scholar
  • 19. Eid N., Yandell B., Howell L., Eddy M., Sheikh S.: Can peak expiratoryflow predict airflow obstruction in children with asthma?Pediatrics, 2000; 105: 354–358
    Google Scholar
  • 20. Emeryk A., Bartkowiak-Emeryk M., Bodajko-Grochowska A.: Inhalatorysuchego proszku – jak ważna jest edukacja chorego? Alergia,2013; 3: 17–21
    Google Scholar
  • 21. Emeryk A., Kurzawa R., Bręborowicz A.: Aerozoloterapia choróbukładu oddechowego u dzieci. Elsevier Urban & Partner, Wrocław2007
    Google Scholar
  • 22. Emeryk A., Pirożyński M.: Nowe inhalatory suchego proszku.Pneumonol. Alergol. Pol., 2015; 83: 83–87
    Google Scholar
  • 23. Emeryk A., Pirożyński M., Bodasiński J., Dniec Z., FlorkiewiczE., Gradoń L., Kurzawa R., Małaczyńska T., Mazurek H., SiergiejkoZ., Sosnowski T., Taff J.: Nebulizacja: czym, jak, dla kogo, kiedy? PolskiKonsensus Nebulizacyjny. Med. Prakt. Pneumon, 2013; 1: 1–12
    Google Scholar
  • 24. European Community Respiratory Health Survey: Variationsin the prevalence of respiratory symptoms, self-reported asthmaattacks, and use of asthma medication in the European CommunityRespiratory Health Survey (ECRHS). Eur. Respir. J., 1996; 9: 687–695
    Google Scholar
  • 25. FitzGerald J.M., Bleecker E.R., Menzies-Gow A., Zangrilli J.G.,Hirsch I., Metcalfe P., Newbold P., Goldman M.: Predictors of enhancedresponse with benralizumab for patients with severe asthma:Pooled analysis of the SIROCCO and CALIMA studies. Lancet Respir.Med., 2018; 6: 51–64
    Google Scholar
  • 26. Fornal R., Kurzawa R., Błażowski Ł., Sak I.: Nieżyt nosa – najważniejszefenotypy i endotypy oraz zasady leczenia. Alerg. AstmaImmunol., 2015; 20: 242–252
    Google Scholar
  • 27. Fornal R., Kurzawa R., Błażowski Ł., Widerska-Kurzawa A.: Postępowaniez dzieckiem do ukończenia 5 roku życia z zaostrzeniemastmy oskrzelowej. Analiza Przypadków w Pediatrii. PZWL, 4/2015
    Google Scholar
  • 28. Global Initiative for Asthma. Global Strategy for Asthma Managementand Prevention, 2019. www.ginasthma.org
    Google Scholar
  • 29. Global Initiative for Asthma. Global Strategy for the Diagnosisand Management of Asthma in Children 5 Years and Younger, 2009.www.ginasthma.org
    Google Scholar
  • 30. Guilbert T.W., Morgan W.J., Krawiec M., Lemanske R.F. Jr, SorknessC., Szefler S.J., Larsen G., Spahn J.D., Zeiger R.S., Heldt G., StrunkR.C., Bacharier L.B., Bloomberg G.R., Chinchilli V.M., Boehmer S.J.i wsp.: The prevention of early asthma in kids study: Design, rationaleand methods for the childhood. asthma research and educationnetwork. Control Clin. Trials, 2004; 25: 286–310
    Google Scholar
  • 31. Holt P.G., Rowe J., Kusel M., Parsons F., Hollams E.M., Bosco A.,McKenna K., Subrata L., de Klerk N., Serralha M., Holt B.J., Zhang G.,Loh R., Ahlstedt S., Sly P.D.: Toward improved prediction of risk foratopy and asthma among preschoolers: A prospective cohort study.J. Allergy Clin. Immunol., 2010; 125: 653–659
    Google Scholar
  • 32. Hutchinson J.: On the capacity of the lungs, and on the respiratoryfunctions, with a view of establishing a precise and easymethod of detecting disease by the spirometer. Med. Chir. Trans.,1846; 29: 137–252
    Google Scholar
  • 33. Ibrahim M., Verma R., Garcia-Contreras L.: Inhalation drug deliverydevices: Technology update. Med. Devices, 2015; 8: 131–139
    Google Scholar
  • 34. Jutel M: Rozpoznawanie chorób alergicznych w podstawowejopiece zdrowotnej. Podsumowanie zaleceń grupy ekspertów EuropeanAcademy of Allergy and Clinical Immunology 2014. Med.Prakt., 2014; : 60–68
    Google Scholar
  • 35. Karolewicz B., Pluta J., Haznar D.: Nebulizacja jako metoda podawanialeków. Farm. Pol., 2009; 65: 291–304
    Google Scholar
  • 36. Killian K.J., Watson R., Otis J., St Amand T.A., O’Byrne P.M.: Symptomperception during acute bronchoconstriction. Am. J. Respir. Crit.Care Med., 2000; 162: 490–496
    Google Scholar
  • 37. Kowalski M.L.: Dobór chorych do immunoterapii. W: Immunoterapiaalergenowa, red.: M.L. Kowalski, B. Rogala. Mediton, Łódź2012: 69–80
    Google Scholar
  • 38. Kroczyńska-Bednarek J., Grzelewska-Rzymowska I.: Przydatnośćtestów nadreaktywności oskrzeli w diagnostyce i terapii chorób obturacyjnych.Terapia, 2008; 16: 35–40
    Google Scholar
  • 39. Kruszewski J., Kowalski M. (red).: Standardy w alergologii. StanowiskaPanelów Eksperckich Polskiego Towarzystwa Alergologicznego.Część I, wyd. II. Medycyna Praktyczna. Kraków 2010: 111–127
    Google Scholar
  • 40. Kurukulaaratchy R.J., Matthews S., Holgate S.T., Arshad S.H.:Predicting persistent disease among children who wheeze duringearly life. Eur. Respir. J., 2003; 22: 767–771
    Google Scholar
  • 41. Kuruvilla M.E., Lee F.E., Lee G.B.: Understanding asthma phenotypes,endotypes, and mechanisms of disease. Clin. Rev. AllergyImmunol., 2019; 56: 219–233
    Google Scholar
  • 42. Langier K., Czarny-Działak M.: Knowledge of parents or guardiansabout children’s bronchial asthma. Participation of a nursein health education of parents or guardians and a sick child. Stud.Med., 2013; 29: 171–176
    Google Scholar
  • 43. Lannerö E., Wickman M., Pershagen G., Nordvall L.: Maternalsmoking during pregnancy increases the risk of recurrent wheezingduring the first years of life (BAMSE). Respir. Res., 2006; 7: 3
    Google Scholar
  • 44. Leonardi N.A., Spycher B.D., Strippoli M.P., Frey U., SilvermanM., Kuehni C.E.: Validation of the asthma predictive index and comparisonwith simpler clinical prediction rules. J. Allergy Clin. Immunol.,2011; 127: 1466–1472
    Google Scholar
  • 45. Litonjua A.A., Carey V.J., Burge H.A., Weiss S.T., Gold D.R.: Parentalhistory and the risk for childhood asthma. Does mother confermore risk than father? Am. J. Respir. Crit. Care Med., 1998; 158:176–181
    Google Scholar
  • 46. Liu A.H., Zeiger R., Sorkness C., Mahr T., Ostrom N., Burgess S.,Rosenzweig J.C., Manjunath R.: Development and cross-sectionalvalidation of the childhood asthma control test. J. Allergy Clin. Immunol.,2007; 119: 817–825
    Google Scholar
  • 47. Liu A.H., Zeiger R.S., Sorkness C.A., Ostrom N.K., Chipps B.E.,Rosa K., Watson M.E, Kaplan M.S, Meurer J.R., Mahr T.A., Blaiss M.S.,Piault-Louis E., McDonald J.: The childhood asthma control test:Retrospective determination and clinical validation of a cut pointto identify children with very poorly controlled asthma. J. AllergyClin. Immunol., 2010; 126: 267–273
    Google Scholar
  • 48. Mastrorilli C., Cardinale F., Giannetti A., Caffarelli C.: Pollenfoodallergy syndrome: A not so rare disease in childhood. Medicina,2019; 55: E641
    Google Scholar
  • 49. Mierzejewska A., Jodłowska M., Kućko A., Rybak K., SołtysiakM., Sroka S., Kalicki B.: Przydatność określania stężenia tlenku azotuw wydychanym powietrzu w ocenie stopnia ciężkości astmy u dzieci.Pediatr. Med. Rodz., 2015; 11: 186–196
    Google Scholar
  • 50. Nachef Z., Krishnan A., Mashtare T., Zhuang T., Mador M.J.: Omalizumabversus Mepolizumab as add-on therapy in asthma patientsnot well controlled on at least an inhaled corticosteroid: A networkmeta-analysis. J. Asthma, 2018; 55: 89–100
    Google Scholar
  • 51. Nathan R.A., Sorkness C.A., Kosinski M., Schatz M., Li J.T., MarcusP., Murray J.J., Pendergraft T.B.: Development of the asthmacontrol test: A survey for assessing asthma control. J. Allergy Clin.Immunol., 2004; 113: 59–65
    Google Scholar
  • 52. O’Byrne P.M., Bisgaard H., Godard P.P., Pistolesi M., PalmqvistM., Zhu Y., Ekström T., Bateman E.D.: Budesonide/formoterol combinationtherapy as both maintenance and reliever medication inasthma. Am. J. Respir. Crit. Care Med., 2005; 171: 129–136
    Google Scholar
  • 53. Panaszek B., Szmagierewski W.: Źródła alergenów reagującychkrzyżowo i ich znaczenie kliniczne. Alergia, 2010; 4: 32–38
    Google Scholar
  • 54. Pirożyński M.: Praktyczne aspekty nebulizacji. α- medica. Press,Bielsko-Biała 2013
    Google Scholar
  • 55. Rabe K.F., Atienza T., Magyar P., Larsson P., Jorup C., Lalloo U.G.:Effect of budesonide in combination with formoterol for relievertherapy in asthma exacerbations: A randomised controlled, double–blind study. Lancet, 2006; 368: 744–753
    Google Scholar
  • 56. Rabe K.F., Pizzichini E., Ställberg B., Romero S., Balanzat A.M.,Atienza T., Lier P.A., Jorup C.: Budesonide/formoterol in a singleinhaler for maintenance and relief in mild-to-moderate asthma:A randomized, double blind trial. Chest, 2006; 129: 246–256
    Google Scholar
  • 57. Reddel H.K., Busse W.W., Pedersen S., Tan W.C., Chen Y.Z., JorupC., Lythgoe D., O’Byrne P.: Should recommendations about startinginhaled corticosteroid treatment for mild asthma be based onsymptom frequency: A post-hoc efficacy analysis of the START study.Lancet, 2017; 389: 157–166
    Google Scholar
  • 58. Román-Rodríguez M., Metting E., Gacía-Pardo M., Kocks J., vander Molen T.: Wrong inhalation technique is associated to poor asthmaclinical outcomes. Is there room for improvement? Curr. Opin.Pulm. Med., 2019; 25: 18–26
    Google Scholar
  • 59. Rozporządzenie Ministra Zdrowia z dnia 28 lutego 2017 r. DziennikUstaw Rzeczypospolitej Polskiej, Warszawa, dnia 8 marca 2017r. Poz. 497
    Google Scholar
  • 60. Sakula A.: A history of asthma. The Fitz Patrick lecture 1987. J.R. Coll. Physicians Lond., 1988; 22: 36–44
    Google Scholar
  • 61. Samoliński B.: ECAP Epidemiologia chorób alergicznych w Polsce:Raport z badań przeprowadzonych w latach 2006-2008 w oparciuo metodologię ECRHS II i ISAAC. Oficyna Wydawnicza WarszawskiegoUniwersytetu Medycznego, Warszawa 2009
    Google Scholar
  • 62. Savenije O.E., Granell R., Caudri D., Koppelman G.H., Smit H.A.,Wijga A., de Jongste J.C., Brunekreef B., Sterne J.A., Postma D.S.,Henderson J., Kerkhof M.: Comparison of childhood wheezing phenotypesin 2 birth cohorts: ALSPAC and PIAMA. J. Allergy Clin. Immunol.,2011; 127: 1505–1512
    Google Scholar
  • 63. Shedd G.C., Blenis R.C.: Tiotropium for asthma: A summary ofcurrent guidelines and a case study. J. Am. Assoc. Nurse Pract., 2018;30: 460–463
    Google Scholar
  • 64. Sheikh A., Strachan D.P.: The hygiene theory: Fact or fiction?Curr. Opin. Otolaryngol. Head Neck Surg., 2004; 12: 232–236
    Google Scholar
  • 65. Sozańska E., Barczyk A., Biedroń-Machura M., Pierzchała W.:Przydatność badania plwociny indukowanej w diagnostyce niektórychprzewlekłych chorób zapalnych układu oddechowego. Pneumonol.Alergol. Pol., 2009; 77: 349–356
    Google Scholar
  • 66. Szefler S.J., Baker J.W., Uryniak T., Goldman M., Silkoff P.E.: Comparativestudy of budesonide inhalation suspension and montelukastin young children with mild persistent asthma. J. Allergy Clin.Immunol., 2007; 120: 1043–1050
    Google Scholar
  • 67. Tasche M.J., Uijen J.H., Bernsen R.M., de Jongste J.C., van derWouden J.C.: Inhaled disodium cromoglycate (DSCG) as maintenancetherapy in children with asthma: A systematic review. Thorax,2000: 55: 913–920
    Google Scholar
  • 68. The International Study of Asthma and Allergies in Childhood(ISAAC) Steering Committee: Worldwide variation in prevalence ofsymptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema.Lancet, 1998; 351: 1225–1232
    Google Scholar
  • 69. Wadsworth S.J., Sin D.D., Dorscheid D.R.: Clinical update on theuse of biomarkers of airway inflammation in the management ofasthma. J. Asthma Allergy, 2011; 4: 77–86
    Google Scholar
  • 70. Wilson A.M.: The role of antihistamines in asthma management.Treat. Respir. Med., 2006; 5: 149–158
    Google Scholar
  • 71. Wojsyk-Banaszak I., Bręborowicz A.: Metody badań czynnościowychukładu oddechowego u dzieci w wieku przedszkolnym.Pneumonol. Alergol. Pol., 2010; 78: 216–223
    Google Scholar
  • 72. Yamauchi K., Ogasawara M.: The role of histamine in the pathophysiologyof asthma and the clinical efficacy of antihistamines inasthma therapy. Int. J. Mol. Sci., 2019; 20: E1733
    Google Scholar
  • 73. Ye Q., He X.O., D’Urzo A.: A review on the safety and efficacy of inhaledcorticosteroids in the management of asthma. Pulm. Ther., 2017; 3: 1–18
    Google Scholar
  • 74. Zhang J., Paré P.D., Sandford A.J.: Recent advances in asthmagenetics. Respir. Res., 2008; 9: 4
    Google Scholar
  • 75. Ziętkowski Z., Ziętkowska E., Bodzenta-Łukaszyk A.: Kliniczne znaczeniepomiarów stężenia tlenku azotu w powietrzu wydychanym w chorobachukładu oddechowego. Alerg. Astma Immunol., 2009; 14: 215–222
    Google Scholar

Full text

Skip to content