Chest
Original ResearchAsthmaPredictors of Symptoms Are Different From Predictors of Severe Exacerbations From Asthma in Children
Section snippets
Design
We conducted an analysis using data from the Childhood Asthma Management Program (CAMP), a multicenter trial of 1,041 children with mild to moderate persistent asthma between the ages of 5 and 12 years who were randomly assigned to receive budesonide, nedocromil, or placebo.20 Details of the CAMP protocol have been previously published.20 The institutional review board at each of the eight participating institutions approved the study, and parents or guardians of the subjects gave informed
Results
Of the 1,041 subjects in the trial, 1,019 met our inclusion criteria for having completed daily diary cards regularly. As shown in Table 1, the subjects in the budesonide group were less likely to have persistent symptoms. In the budesonide group, 26% (78) of subjects had persistent symptoms compared with 37% (115) in the nedocromil group and 44% (179) in the placebo group (P < .0001). Forty percent (197) of subjects who had a history of previous ED visit or hospitalization visit had persistent
Discussion
Our study suggests that experiencing persistent symptoms from asthma is closely associated with having severe exacerbations from asthma. The following predictors of experiencing persistent symptoms are similar to the predictors of experiencing severe exacerbations: (1) treatment with inhaled corticosteroids is protective against experiencing persistent symptoms and severe exacerbations, (2) lower lnPC20 is associated with both persistent symptoms and severe exacerbations, and (3) lower FEV1/FVC
Acknowledgments
Author contributions: Dr Wu: contributed to study design, data analysis, and manuscript preparation.
Dr Tantisira: contributed to study design and manuscript preparation.
Dr Li: contributed to data analysis and manuscript revision.
Ms Schuemann: contributed to data analysis and manuscript revision.
Dr Weiss: contributed to study design and manuscript preparation.
Dr Fuhlbrigge: contributed to study design and manuscript preparation.
Funding/Support: The Childhood Asthma Management Program (CAMP) is
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Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).
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A complete list of participants is located in e-Appendix 1.