Fainardi Valentina, Caffarelli Carlo, Deolmi Michela, Zambelli Giulia, Palazzolo Elisabetta, Scavone Sara, Bergamini Barbara Maria, Bertelli Luca, Biserna Loretta, Bottau Paolo, Corinaldesi Elena, De Paulis Nicoletta, Di Palmo Emanuela, Dondi Arianna, Gallucci Marcella, Guidi Battista, Lombardi Francesca, Magistrali Maria Sole, Marastoni Elisabetta, Pastorelli Silvia, Piccorossi Alessandra, Poloni Maurizio, Tagliati Sylvie, Vaienti Francesca, Gregori Giuseppe, Sacchetti Roberto, Antodaro Francesco, Bergomi Andrea, Reggiani Lamberto, De Fanti Alessandro, Marchetti Federico, Grandinetti Roberto, Mussi Nicole, Ricci Giampaolo, Esposito Susanna
Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.
Paediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy.
J Clin Med. 2023 Aug 23;12(17):5467. doi: 10.3390/jcm12175467.
Asthma is the most frequent chronic disease of childhood, affecting up to 20% of children worldwide. The main guidelines on asthma maintenance therapy in pediatrics suggest different approaches and describe different stages of asthma to determine the most appropriate treatment. This project aims to summarize the most recent evidence regarding maintenance therapy for asthma in children and adolescents. A multidisciplinary panel of experts was asked clinical questions regarding the treatment of children and adolescents with asthma. Overall, 10 clinical questions were addressed, and the search strategy included accessing electronic databases and a manual search of gray literature published in the last 25 years. After data extraction and narrative synthesis of results, recommendations were developed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) methodology. Results showed that the choice of medication depends on the severity of the child's asthma, phenotype, age, preference, and individual factors. In addition to medications, the identification of comorbidities and modifiable factors is crucial to obtaining good control. Asthma in children is heterogeneous, and its evolution varies over time. Since most recommendations for asthma management in childhood are extrapolated from clinical studies performed in adults, more clinical trials specifically designed for young children should be conducted.
哮喘是儿童最常见的慢性疾病，全球多达20%的儿童受其影响。儿科哮喘维持治疗的主要指南提出了不同的方法，并描述了哮喘的不同阶段，以确定最合适的治疗方案。本项目旨在总结有关儿童和青少年哮喘维持治疗的最新证据。一个多学科专家小组被问及有关哮喘儿童和青少年治疗的临床问题。总体而言，共提出了10个临床问题，检索策略包括检索电子数据库以及人工检索过去25年发表的灰色文献。在数据提取和结果叙述性综合之后，使用推荐分级、评估、制定和评价（GRADE）方法制定了建议。结果表明，药物的选择取决于儿童哮喘的严重程度、表型、年龄、偏好和个体因素。除药物治疗外，识别合并症和可改变因素对于实现良好控制至关重要。儿童哮喘具有异质性，其演变随时间而变化。由于大多数儿童哮喘管理的建议是从成人临床研究中推断出来的，因此应该开展更多专门针对幼儿的临床试验。
