BMJ Open (Jul 2021)
Management of asthma in childhood: study protocol of a systematic evidence update by the Paediatric Asthma in Real Life (PeARL) Think Tank
- Jonathan Grigg,
- Heather J Zar,
- David Price,
- Andrew Bentley,
- Aziz Sheikh,
- Michael Miligkos,
- Giuseppe De Carlo,
- Peter N Le Souëf,
- Tim Felton,
- Graham Roberts,
- Jose A Castro-Rodriguez,
- Stephen Turner,
- Alexander G Mathioudakis,
- Gioulinta S Alimani,
- Georgios A Mathioudakis,
- Effie Papageorgiou,
- Nikolaos G Papadopoulos,
- Apostolos Beloukas,
- Ioanna Tsiligianni,
- Despo Ierodiakonou,
- Tuomas Jartti,
- A Deschildre,
- Wojciech Feleszko,
- Matteo Bonini,
- Clare Murray,
- Adnan Custovic,
- Mário Morais-Almeida,
- Wanda Phipatanakul,
- Mika J Mäkelä,
- Gunilla Hedlin,
- Robert F Lemanske,
- Paraskevi Xepapadaki,
- James E Gern,
- Cristina Boccabella,
- Francine Monique Ducharme,
- Omer Kalayci,
- Antonio Nieto Garcia,
- Ioana Octavia Agache,
- Leonard Bacharier,
- Timothy Craig,
- Zuzana Diamant,
- Elham M Hossny,
- Alan Kaplan,
- Paolo Matricardi,
- Marina Mitrogiorgou,
- Karthik Nagaraju,
- Helena Pité,
- Paulo M C Pitrez,
- Petr Pohunek,
- Susanne Vijverberg,
- Tonya A Winders,
- Gary WK Wong
Affiliations
- Jonathan Grigg
- 6 Centre for Child Health, Blizard Institute, Queen Mary University of London, London, UK, London, UK
- Heather J Zar
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- David Price
- Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK
- Andrew Bentley
- Respiratory Medicine Research Group, School of Translational Medicine, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK
- Aziz Sheikh
- Usher Institute, University of Edinburgh College of Medicine and Veterinary Medicine, Edinburgh, UK
- Michael Miligkos
- First Department of Pediatrics, Aghia Sofia Childrens Hospital, University of Athens, Athens, Attica, Greece
- Giuseppe De Carlo
- Allergy and Airway Diseases Patients Associations, European Federation of Pharmaceutical Industries and Associations, Brussels, Belgium
- Peter N Le Souëf
- School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
- Tim Felton
- Division of Infection, Immunity and Respiratory Medicine, The University of Manchester, Manchester, UK
- Graham Roberts
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
- Jose A Castro-Rodriguez
- Department of Pediatrics, Pontifical Universidad Catolica de Chile, Santiago, Chile
- Stephen Turner
- NHS Grampian, Aberdeen, UK
- Alexander G Mathioudakis
- Immunity and Respiratory Medicine, The University of Manchester, Manchester, UK
- Gioulinta S Alimani
- Athens Breath Centre, Athens, Greece
- Georgios A Mathioudakis
- Athens Breath Centre, Athens, Greece
- Effie Papageorgiou
- Department of Biomedical Sciences, University of West Attica, Egaleo, Attica, Greece
- Nikolaos G Papadopoulos
- Division of Infection, Immunity and Respiratory Medicine, The University of Manchester, Manchester, UK
- Apostolos Beloukas
- Department of Biomedical Sciences, University of West Attica, Egaleo, Attica, Greece
- Ioanna Tsiligianni
- Department of Social Medicine, Faculty of Medicine, University of Crete, Rethimno, Greece
- Despo Ierodiakonou
- Department of Social Medicine, Faculty of Medicine, University of Crete, Rethimno, Greece
- Tuomas Jartti
- Department of Paediatrics, University of Turku, Turku, Finland
- A Deschildre
- Unité de Pneumologie et Allergologie Pédiatriques, Hôpital Jeanne de Flandre, CHU Lille, Lille, Hauts-de-France, France
- Wojciech Feleszko
- Department of Pediatric Pulmonology and Allergy, Medical University of Warsaw, Warszawa, Poland
- Matteo Bonini
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Lazio, Italy
- Clare Murray
- Division of Immunology, Immunity to Infection and Respiratory Medicine (DIIIRM), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Adnan Custovic
- National Heart and Lung Institute, Imperial College London, London, UK
- Mário Morais-Almeida
- Allergy Center, Hospital CUF Descobertas, Lisboa, Portugal
- Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, Massachusetts, USA
- Mika J Mäkelä
- Department of Allergy, University of Helsinki, Helsinki, Uusimaa, Finland
- Gunilla Hedlin
- Department of Womens and Childrens Health, Karolinska Institute, Stockholm, Stockholm, Sweden
- Robert F Lemanske
- Department of Pediatrics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Paraskevi Xepapadaki
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Attica, Greece
- James E Gern
- Department of Pediatrics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Cristina Boccabella
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Lazio, Italy
- Francine Monique Ducharme
- Departments of Pediatrics and of Social and Preventive Medicine, Centre hospitalier universitaire (CHU) Sainte-Justine, University of Montreal, Montreal, Québec, Canada
- Omer Kalayci
- Pediatric Allergy and Asthma Unit, Hacettepe Universitesi, Ankara, Turkey
- Antonio Nieto Garcia
- Pulmonology and Allergy Unity, La Fe University and Polytechnic Hospital, Valencia, Comunidad Valenciana, Spain
- Ioana Octavia Agache
- Allergy and Clinical Immunology, Transylvania University, Brasov, Romania
- Leonard Bacharier
- Department of Allergy, Immunology, and Pulmonary Medicine, University of Washington, Seattle, Washington, USA
- Timothy Craig
- Allergy, Asthma and Immunology, Penn State University, Hershey, Pennsylvania, USA
- Zuzana Diamant
- Department of Respiratory Medicine and Allergology, Institute for Clinical Science, Skane University Hospital Lund Hematological Clinic, Lund, Skåne, Sweden
- Elham M Hossny
- Pediatric Allergy and Immunology Unit, Ain Shams University, Cairo, Egypt
- Alan Kaplan
- Family Physician, Airways Group of Canada, University of Toronto, Toronto, Ontario, Canada
- Paolo Matricardi
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine, Charité - University Medicine, Berlin, Germany
- Marina Mitrogiorgou
- Third Department of Paediatrics, National and Kapodistrian University of Athens School of Health Sciences, Athens, Greece
- Karthik Nagaraju
- Allergy & Asthma, VN, Chennai, India
- Helena Pité
- Allergy Center, Hospital CUF Descobertas, Lisboa, Portugal
- Paulo M C Pitrez
- Laboratory of Respiratory Physiology, Infant Center, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
- Petr Pohunek
- Paediatric Department, Motol University Hospital, Praha, Czech Republic
- Susanne Vijverberg
- Department of Respiratory Medicine and Department of Pediatric Pulmonology, University of Amsterdam, Amsterdam, Netherlands
- Tonya A Winders
- Allergy & Asthma, Global Patient Platform, Virginia, Virginia, USA
- Gary WK Wong
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
- DOI
- https://doi.org/10.1136/bmjopen-2020-048338
- Journal volume & issue
-
Vol. 11,
no. 7
Abstract
Introduction Clinical recommendations for childhood asthma are often based on data extrapolated from studies conducted in adults, despite significant differences in mechanisms and response to treatments. The Paediatric Asthma in Real Life (PeARL) Think Tank aspires to develop recommendations based on the best available evidence from studies in children. An overview of systematic reviews (SRs) on paediatric asthma maintenance management and an SR of treatments for acute asthma attacks in children, requiring an emergency presentation with/without hospital admission will be conducted.Methods and analysis Standard methodology recommended by Cochrane will be followed. Maintenance pharmacotherapy of childhood asthma will be evaluated in an overview of SRs published after 2005 and including clinical trials or real-life studies. For evaluating pharmacotherapy of acute asthma attacks leading to an emergency presentation with/without hospital admission, we opted to conduct de novo synthesis in the absence of adequate up-to-date published SRs. For the SR of acute asthma pharmacotherapy, we will consider eligible SRs, clinical trials or real-life studies without time restrictions. Our evidence updates will be based on broad searches of Pubmed/Medline and the Cochrane Library. We will use A MeaSurement Tool to Assess systematic Reviews, V.2, Cochrane risk of bias 2 and REal Life EVidence AssessmeNt Tool to evaluate the methodological quality of SRs, controlled clinical trials and real-life studies, respectively.Next, we will further assess interventions for acute severe asthma attacks with positive clinical results in meta-analyses. We will include both controlled clinical trials and observational studies and will assess their quality using the previously mentioned tools. We will employ random effect models for conducting meta-analyses, and Grading of Recommendations Assessment, Development and Evaluation methodology to assess certainty in the body of evidence.Ethics and dissemination Ethics approval is not required for SRs. Our findings will be published in peer reviewed journals and will inform clinical recommendations being developed by the PeARL Think Tank.PROSPERO registration numbers CRD42020132990, CRD42020171624.
