There have been no investigations of longitudinal asthma trajectories based on asthma exacerbation frequency and medications required for asthma control in children.
To investigate the longitudinal asthma trajectories based on the exacerbation frequency throughout childhood and asthma medication ranks.
A total of 531 children aged 7-10 years were enrolled from the Korean childhood asthma study (KAS). Required asthma medications for control of asthma from 6 to 12 years of age asthma exacerbation from birth to 12 years of age were obtained from the Korean National Health Insurance System database. Longitudinal asthma trajectories were identified based on the asthma exacerbation frequency and asthma medication ranks.
Four asthma clusters were identified: lesser exacerbation with low-step treatment (8.1%), lesser exacerbations with middle-step treatment (30.7%), highly frequent exacerbations in early childhood with small-airway dysfunction (5.7%), and frequent exacerbations with high-step treatment (55.6%). The frequent exacerbations with high-step treatment cluster was characterized by a high prevalence of the male, increased blood eosinophil (%) with fractional exhaled nitric oxide, and high prevalence of comorbidities. The highly frequent exacerbation in early childhood with small-airway dysfunction cluster was characterized by recurrent wheeze in preschool-age with high prevalence of acute bronchiolitis in infancy and a higher number of family members with small-airway dysfunction at school-age.
The present study identified four longitudinal asthma trajectories based on the frequency of asthma exacerbation and asthma medication ranks. These results would be helpful in understanding the heterogeneities and pathophysiologies of childhood asthma.
Copyright © 2023. Published by Elsevier Inc.
