PubMed · 9363119
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1996. Asthma.. https://pubmed.ncbi.nlm.nih.gov/9363119/
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We evaluated the reproducibility of home spirometry in 110 children aged 5-10 years with newly diagnosed asthma according to the criteria proposed by the American Thoracic Society (level of reproducibility < or = 5%). Flow-volume spirometry was performed in the clinic. Spirometric values were then monitored twice daily at home for 24 days (mean), using a novel device, the Vitalograph(R) Data Storage Spirometer (Vitalograph, Ltd., Buckingham, UK). During this period, the mean (SD) compliance in performing the spirometric tests was 94% (7). In the whole study population, the mean (SD) percentage of reproducible spirometric measurements was 77% (17), although there was wide individual variation (range, 21-100%). In the 5-6-year age group (n = 51), the mean (SD) percentage of reproducible spirometric values was 72.8% (18.6), in the 7-8-year group (n = 38) 77.1% (13.8), and in the 9-10-year group (n = 21) 84. 5% (13.7) analysis of variance, P = 0.02). We conclude that most of the children aged 5-10 years could perform reproducible spirometric tests during home monitoring, although there was wide individual variation. Younger children were less likely to perform reproducible tests than older children. However, a considerable proportion of the measurements (23%) did not meet the criteria of acceptable reproducibility. In order to improve the quality of home monitoring, nonreproducible measurements should be excluded from the calculations.
Asthma in adults is generally recognized as a chronic inflammatory airway disease, although this association is less well established in childhood asthma. Thus, recent asthma guidelines have emphasized that asthma treatment should be directed toward the underlying inflammatory aspects of the disease. The prevalence of asthma and resultant hospitalizations and deaths have increased or remained stable over the past 10 years in the United States. In part, this appears to be caused by shortcomings of available antiasthma therapeutic agents. Because these trends are particularly troublesome in children and young adults, there is a need for effective anti-inflammatory therapies that are safe and tolerable. The leukotrienes are a family of lipid mediators that appear to play an important role in the symptomology and pathogenesis of asthma. The results of clinical trials in adults with asthma demonstrated that antileukotriene drugs such as zafirlukast, montelukast, and zileuton improve pulmonary function, decrease asthma symptoms, and decrease the concomitant use of other antiasthma drugs. Most antileukotriene agents are orally bioavailable and well tolerated, offering the potential for improved patient compliance. Montelukast and zafirlukast have received approval for use in pediatric asthma patients, and approval of zafirlukast in this patient population is pending.
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