https://doi.org/10.4081/monaldi.2023.2701

Global Initiative for Asthma (GINA) guideline: achieving optimal asthma control in children aged 6-11 years

Early Access
Submitted: July 5, 2023
Accepted: August 28, 2023
Published: September 7, 2023
Asthma exacerbation, pediatric asthma, GINA guidelines, long-acting beta agonist, leukotriene receptor inhibitor
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Authors

Danish Abdul Aziz
drdanishaziz@gmail.com
https://orcid.org/0000-0001-5402-8488
Department of Paediatrics and Child Health, Aga Khan University Hospital, Karachi, Pakistan.
Muhammad Aqib Sajjad
https://orcid.org/0000-0002-6948-5072
Department of Paediatrics and Child Health, Aga Khan University Hospital, Karachi, Pakistan.
Ameema Asad
Department of Paediatrics and Child Health, Aga Khan University Hospital, Karachi, Pakistan.

The Global Initiative for Asthma (GINA) 2021 guidelines for asthma have been set forth with some alterations in Step 3, for children from 6-11-year-old age group. The low dose LABA-ICS, very low dose formoterol-ICS, medium dose ICS and ICS-LTRA combination were recommended in the guideline. We organized this study to draw an effective comparison between these three combinations of controller therapies in pediatric population. A retrospective study was conducted at the Aga Khan University Hospital, Karachi, Pakistan which enrolled 114 children aged 6-11 years old, from July 2021 to December 2022. These children were admitted with asthma exacerbations and were discharged on controller medications as per GINA guidelines on step 3 for control of asthma for 3 months. They were then followed for re-admission within 30 days of discharge, number of ER visits with asthma exacerbations for 1 year, number of admissions with asthma including HDU and PICU admissions, length of stay per admission for all admissions in subsequent one year. The pulmonary function test was done at 1 week follow-up in clinic after discharge and at 3 months visit post discharge. A total of 114 pediatric patients from age 6-11-year-old, were enrolled in the study period out of which 36 (31.57%), 33(28.9%) and 34 (29.82%) patients were categorized into ICS-LABA, ICS and ICS-LTRA groups respectively. ER visits were significantly low in ICS-LABA group followed by ICS-LRTA group and then ICS group (1.75±0.96 vs 2.93±1.412 vs 3.11±1.21, p<0.001). Similar statistically significant results were observed on average number of admissions per year (1.52±1.02 vs 1.96±0.84 vs 2.06±1.07, p=0.047) and number of patients needing PICU (13.88% vs 26.47% vs 39.39%, p=0.034) in these groups respectively. ICS- LABA group patients had the best values of FEV1 and FEV1/FVC ratio after pulmonary function tests at 3 months follow-up followed by ICS-LTRA and ICS group. Amongst the three options regimens for children managed at step 3 on GINA 2021 guidelines, ICS-LABA therapy helps attain optimal patient outcomes and lung functions in children with asthma followed by ICS-LTRA and ICS group respectively.

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Ethics Approval

The study was approved by the Institutional Review Board of the Aga Khan University Hospital, Karachi

How to Cite

Aziz, Danish Abdul, Muhammad Aqib Sajjad, and Ameema Asad. 2023. “Global Initiative for Asthma (GINA) Guideline: Achieving Optimal Asthma Control in Children Aged 6-11 Years”. Monaldi Archives for Chest Disease, September. https://doi.org/10.4081/monaldi.2023.2701.
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