Asthma Rx in Kids: A 5-Question Quiz

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Telemedicine, add-on tiotropium, and more-than-doubled ICS are 3 interventions evaluated in recent studies of school-aged children and those even younger. Do you remember reading them? Try this short test of your literature scanning skills; details on each of the studies are available at the end. 

Question 1 

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Answer: A. True

Children who received a combination of telemedicine support and school-based medication therapy were half as likely to need an emergency room or hospital visit for their asthma (7%) as the control group (15%).¹

Question 2

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Answer: D. 63% vs placebo

In children aged 1 to 5 years with persistent asthma poorly controlled on inhaled corticosteroids, addition of once daily tiotropium (2.5 µg, or 5 µg,) was associated with up to 63% decreased risk of asthma exacerbation vs placebo. Adverse events were mild-to-moderate and none led to treatment discontinuation.²

Question 3 

Maintenance therapy with inhaled corticosteroids (ICS) is only partly effective in preventing asthma exacerbations and guidelines recommend a short-term increased ICS dose for early signs of loss of asthma control. Evidence suggest that doubling the ICS dose, however, may not be enough to prevent an exacerbation and may not reduce the need for rescue oral corticosteroids or occurrence of adverse events. 

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Answer: E. B (quadrupled dose in teens/adults) and C (quintupled dose in school-aged children)

Two recent studies looked at quadrupling the ICS dose to assess impact on teens/adults (in the UK) and quintupling the dose in school-aged children (in the US). In the first study there was a 19% lower risk of time to first exacerbation in the quadrupling vs non-quadrupling group (p=0.002); in the second study quintupling ICS dose upon deterioration in asthma control did not improve asthma control and may affect growth.³

Question 4

One in six children with asthma end up in the ED, and one in 20 are hospitalized for asthma each year. 

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Answer: D. Hospitalizations for children with asthma fell from nearly 10% in 2003 to ~5% in 2013.⁴

Question 5

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Answer: A. Compared to never use of hormone replacement therapy, current use of HRT was associated with a 48% (not a 25%) increased risk in new-onset asthma. The rest of the reported results are true.⁵

References:

This quiz is based on articles that previously appeared on Patient Care. For more information on the studies, please visit the following:

1. Novel School-based Asthma Program Cuts ER Visits in Half

2. Safety of Tiotropium in Children with Persistant Asthma 

3. How to Prevent Asthma Exacerbations: Is More ICS Better?

4. Prevalence of Childhood Asthma Trending Downward

5. Asthma and Being Female