Retrospective, observational study of different medication regimens and outcome in children with cough variant asthma

IF 3.1 4区 医学 Q3 IMMUNOLOGY Immunity, Inflammation and Disease Pub Date : 2024-08-07 DOI:10.1002/iid3.1357
Nannan Lou, Xiang Ma, Qingxin Luo, Xiaoling Wei, Yun Zhang, Jing Guo, Jing Wang, Zhongtao Gai
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Abstract

Objective

This retrospective longitudinal cohort study aimed to explore the best therapeutic regimen and treatment duration of cough variant asthma (CVA) in children.

Methods

A total of 314 children with CVA were divided into receive inhaled corticosteroids (ICS) combined with long-acting beta2-agonist (LABA) group, ICS combined with leukotriene receptor antagonists (LTRA) group, ICS monotherapy group and LTRA monotherapy group. All clinical data were statistically analyzed. Logistic regression model was used to compare the advantages and disadvantages of different treatment schemes at each follow-up time point and the best treatment scheme. The Cox proportional hazard regression model based on inverse probability weighting was used to compare the effects of different medication regimens on adverse outcomes with asthma recurrence or progression as the end point.

Results

(1) After comprehensive analysis, ICS + LABA group was the preferred control regimen for CVA within 8 weeks. After 8 weeks of diagnosis, the efficacy of ICS group or LTRA group was comparable to that of ICS + LABA group and ICS + LTRA group. (2) The ICS + LABA group showed a significant improvement in cough at an early stage, particularly at 4 weeks; the symptoms of ICS + LTRA and ICS groups were significantly improved at 36 weeks. The LTRA group alone showed significant improvement at 20 weeks.

Conclusion

ICS + LABA, ICS + LTRA, ICS alone and LTRA alone can effectively treat CVA. ICS + LABA could improve the symptoms most quickly within 8 weeks after CVA diagnosis, followed by ICS + LATR group. After 8 weeks, it can be reduced to ICS alone to control CVA for at least 36 weeks based on the remission of symptoms in children.

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对咳嗽变异性哮喘患儿不同用药方案和疗效的回顾性观察研究。
目的这项回顾性纵向队列研究旨在探讨儿童咳嗽变异性哮喘(CVA)的最佳治疗方案和治疗时间:共有314名CVA患儿被分为接受吸入皮质激素(ICS)联合长效β2-受体激动剂(LABA)组、ICS联合白三烯受体拮抗剂(LTRA)组、ICS单药治疗组和LTRA单药治疗组。所有临床数据均经过统计学分析。采用 Logistic 回归模型比较各随访时间点不同治疗方案的优劣以及最佳治疗方案。以哮喘复发或进展为终点,采用基于逆概率加权的 Cox 比例危险回归模型比较不同用药方案对不良结局的影响。结果:(1)经综合分析,ICS + LABA 组是 8 周内 CVA 的首选控制方案。确诊 8 周后,ICS 组或 LTRA 组的疗效与 ICS + LABA 组和 ICS + LTRA 组相当。(2)ICS + LABA 组在早期,尤其是 4 周时咳嗽症状有明显改善;ICS + LTRA 组和 ICS 组在 36 周时症状有明显改善。结论:结论:ICS + LABA、ICS + LTRA、单用 ICS 和单用 LTRA 可有效治疗 CVA。在确诊 CVA 后的 8 周内,ICS + LABA 能最快改善症状,其次是 ICS + LATR 组。8 周后,根据儿童症状的缓解情况,可减为单用 ICS 控制 CVA 至少 36 周。
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来源期刊
Immunity, Inflammation and Disease
Immunity, Inflammation and Disease Medicine-Immunology and Allergy
CiteScore
3.60
自引率
0.00%
发文量
146
审稿时长
8 weeks
期刊介绍: Immunity, Inflammation and Disease is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research across the broad field of immunology. Immunity, Inflammation and Disease gives rapid consideration to papers in all areas of clinical and basic research. The journal is indexed in Medline and the Science Citation Index Expanded (part of Web of Science), among others. It welcomes original work that enhances the understanding of immunology in areas including: • cellular and molecular immunology • clinical immunology • allergy • immunochemistry • immunogenetics • immune signalling • immune development • imaging • mathematical modelling • autoimmunity • transplantation immunology • cancer immunology
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