Use of asthma medications in African American children with sickle cell
disease: a single center experience
- Allison Jue,
- Lucia mirea,
- Alyssa McGary,
- Sophia Williams
Abstract
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Objective: To investigate use of asthma controller medications
and their effect on lung function in pediatric patients with SCD.
Methods: Retrospective study in pediatric patients of African
American ethnicity with SCD treated at PCH between 2014-2021.
Associations of asthma controller medications with changes in lung
symptoms (cough, wheeze, chest pain, shortness of breath with exercise,
sleep disturbance), Acute Chest Syndrome (ACS), and percent predicted
spirometry (FEV 1, FVC, FEV 1/FVC, FEF
25%-75%)) were examined (Fisher exact, Wilcoxon rank
sum) separately in SCD patients with and without asthma.
Results: Of the total 98 SCD patients, 28 (29%) had an asthma
diagnosis. Asthma controller medications were prescribed to 20 (71% of
28) with asthma and 37 (53% of 70) without asthma. Patients with vs
without asthma were more likely to receive combined medications (55% vs
8.1%), but less ICS alone (35% vs 48 %) or LTRA alone (10% vs 43%)
(p<0.0003). Medication use vs non-use improved cough (38% vs
9%, P=0.006) and shortness of breath with exercise (32% vs 12%,
P=0.03) in SCD patients without asthma, but these were non-significant
in asthmatics. Medications also improved the mean percent change in both
non-asthmatics FEV 1 (10.2 vs -3.2; P<0.0001),
FVC (8.8 vs -0.7; P=0.002), and FEF 25%-75%, (17.6 vs
-9.7; P=0.0005), and asthmatics FEV 1 (16.4 vs -5.2;
P=0.001), FVC (13.7 vs -3.8; P=0.0009), and FEF
25%-75%, (26.1 vs -5.0; P=0.02). Conclusion:
These findings, demonstrating improved lung function with asthma
controller medications in pediatric patients with SCD, irrespective of
an asthma diagnosis, holds great promise for this undertreated
population.15 Jun 2024Submitted to Pediatric Pulmonology 18 Jun 2024Submission Checks Completed
18 Jun 2024Assigned to Editor
18 Jun 2024Review(s) Completed, Editorial Evaluation Pending
15 Jul 2024Reviewer(s) Assigned
07 Sep 2024Editorial Decision: Revise Major