Journal of Clinical Medicine (Aug 2023)
Maintenance Therapy for Children and Adolescents with Asthma: Guidelines and Recommendations from the Emilia-Romagna Asthma (ERA) Study Group
- Valentina Fainardi,
- Carlo Caffarelli,
- Michela Deolmi,
- Giulia Zambelli,
- Elisabetta Palazzolo,
- Sara Scavone,
- Barbara Maria Bergamini,
- Luca Bertelli,
- Loretta Biserna,
- Paolo Bottau,
- Elena Corinaldesi,
- Nicoletta De Paulis,
- Emanuela Di Palmo,
- Arianna Dondi,
- Marcella Gallucci,
- Battista Guidi,
- Francesca Lombardi,
- Maria Sole Magistrali,
- Elisabetta Marastoni,
- Silvia Pastorelli,
- Alessandra Piccorossi,
- Maurizio Poloni,
- Sylvie Tagliati,
- Francesca Vaienti,
- Giuseppe Gregori,
- Roberto Sacchetti,
- Francesco Antodaro,
- Andrea Bergomi,
- Lamberto Reggiani,
- Alessandro De Fanti,
- Federico Marchetti,
- Roberto Grandinetti,
- Nicole Mussi,
- Giampaolo Ricci,
- Susanna Esposito
Affiliations
- Valentina Fainardi
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Carlo Caffarelli
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Michela Deolmi
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Giulia Zambelli
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Elisabetta Palazzolo
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Sara Scavone
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Barbara Maria Bergamini
- Paediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Luca Bertelli
- Pediatric Clinic, Scientific Institute for Research and Healthcare (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Loretta Biserna
- Paediatrics and Neonatology Unit, Ravenna Hospital, Azienda Unità Sanitaria Locale (AUSL) Romagna, 48121 Ravenna, Italy
- Paolo Bottau
- Paediatrics Unit, Imola Hospital, 40026 Imola, Italy
- Elena Corinaldesi
- Paediatric Unit, Carpi Hospital, 41012 Carpi, Italy
- Nicoletta De Paulis
- Paediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Emanuela Di Palmo
- Pediatric Clinic, Scientific Institute for Research and Healthcare (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Arianna Dondi
- Pediatric Clinic, Scientific Institute for Research and Healthcare (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Marcella Gallucci
- Pediatric Clinic, Scientific Institute for Research and Healthcare (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Battista Guidi
- Hospital and Territorial Paediatrics Unit, 41026 Pavullo, Italy
- Francesca Lombardi
- Paediatrics Unit, Maggiore Hospital, 40133 Bologna, Italy
- Maria Sole Magistrali
- Paediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Elisabetta Marastoni
- Paediatrics Unit, Santa Maria Nuova Hospital, Azienda Unità Sanitaria Locale (AUSL)-Scientific Institute for Research and Healthcare (IRCCS) of Reggio Emilia, 42123 Reggio Emilia, Italy
- Silvia Pastorelli
- Paediatrics Unit, Sassuolo Hospital, 41049 Sassuolo, Italy
- Alessandra Piccorossi
- Paediatrics and Paediatric Intensive Care Unit, Cesena Hospital, Azienda Unità Sanitaria Locale (AUSL) Romagna, 47521 Cesena, Italy
- Maurizio Poloni
- Paediatrics Unit, Rimini Hospital, Azienda Unità Sanitaria Locale (AUSL) Romagna, 47921 Rimini, Italy
- Sylvie Tagliati
- Paediatric Clinic, Ferrara Hospital, 44124 Ferrara, Italy
- Francesca Vaienti
- Paediatrics Unit, G.B. Morgagni Pierantoni Hospital, Azienda Unità Sanitaria Locale (AUSL) Romagna, 47121 Forlì, Italy
- Giuseppe Gregori
- Primary Care Pediatricians, Azienda Unità Sanitaria Locale (AUSL) Piacenza, 29121 Piacenza, Italy
- Roberto Sacchetti
- Primary Care Pediatricians, Azienda Unità Sanitaria Locale (AUSL) Piacenza, 29121 Piacenza, Italy
- Francesco Antodaro
- Primary Care Pediatricians, Azienda Unità Sanitaria Locale (AUSL) Modena, 41125 Modena, Italy
- Andrea Bergomi
- Primary Care Pediatricians, Azienda Unità Sanitaria Locale (AUSL) Modena, 41125 Modena, Italy
- Lamberto Reggiani
- Primary Care Pediatricians, Azienda Unità Sanitaria Locale (AUSL) Imola, 40026 Imola, Italy
- Alessandro De Fanti
- Paediatrics Unit, Santa Maria Nuova Hospital, Azienda Unità Sanitaria Locale (AUSL)-Scientific Institute for Research and Healthcare (IRCCS) of Reggio Emilia, 42123 Reggio Emilia, Italy
- Federico Marchetti
- Paediatrics and Neonatology Unit, Ravenna Hospital, Azienda Unità Sanitaria Locale (AUSL) Romagna, 48121 Ravenna, Italy
- Roberto Grandinetti
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Nicole Mussi
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Giampaolo Ricci
- Pediatric Clinic, Scientific Institute for Research and Healthcare (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- DOI
- https://doi.org/10.3390/jcm12175467
- Journal volume & issue
-
Vol. 12,
no. 17
p. 5467
Abstract
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.
Keywords
- asthma
- inhaled corticosteroid
- long-acting beta agonist
- oral corticosteroids
- pediatric pulmonology
- short-acting beta agonist