Çocuklarda Ağır Astım, Biyolojik Tedaviler ve Covid-19 Pandemisinde Güncel Yaklaşımlar

Yıl 2021, Cilt: 15 Sayı: 2, 168 - 173, 30.03.2021

Ayşegül Ertuğrul , İlknur Bostancı

https://doi.org/10.12956/tchd.758127

Cited By: 2

Öz

Astım, çocukluk çağında gözlenen en sık kronik hastalıktır. Ağır astım, çocuklarda daha nadir görülen bir durumdur. Ağır astımda farklı mekanizmalar rol oynadığı için farklı fenotipler söz konusu olup tedavi hastaya göre kişiselleştirilmelidir. Hastanın ağır astım fenotipine katkıda bulunan faktörlerin değerlendirilmesi sonucunda, tip 2 astım olduğu belirlenen hastalara biyolojik tedavilerin uygulaması günümüzde ağır astım tedavisi yönetiminde önemli bir gelişme sağlamıştır. COVID-19 pandemisi sırasında güncel rehberler, biyolojik ajan uygunluk kriterlerini karşılayan ve bu tedavilerin etkili olduğu hastalarda biyolojik tedavilerin uygulanmasına devam edilmesini önermektedir. Aktif SARS-CoV-2 enfeksiyonu durumunda klinik düzelme sağlanana kadar biyolojik tedavi durdurulmalıdır.

Anahtar Kelimeler

ağır astım, biyolojikler, ÇOCUK, COVID-19

Destekleyen Kurum

YOK

Proje Numarası

YOK

Teşekkür

-

Severe Asthma, Bıological Treatments in Chıldren And Current Approaches In the COVID-19 Pandemic

Öz

Asthma is the most common chronic disease observed in children. Severe asthma is a relatively rare condition in children. As different mechanisms play role in severe asthma, there are different phenotypes and treatment should be individualized. The utilization of biological treatments to patients identified to have type 2 asthma, according to the evaluation of the factors that contribute to the patient’s asthma phenotype, has led to a significant improvement in the management of severe asthma treatment today. During the COVID-19 pandemic, current guidelines recommend continuing the biological treatments to the patients meeting biological agent usage criteria and to whom these treatments are effective. In case of active SARS‐CoV‐2 infection, biological therapy should be stopped until clinical improvement is achieved.

Anahtar Kelimeler

severe asthma, biologicals, child, COVID-19

Proje Numarası

YOK

Kaynakça

• 1. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1211-1259. doi:10.1016/S0140-6736(17)32154-2
• 2. National Survey of Children's Health. NSCH 2011/12. Data query from the Child and Adolescent Health Measurement Initiative, Data Resource Center for Child and Adolescent Health website. Available from: https://www.childhealthdata.org/learn-about-the-nsch/NSCH. Aaccessed 23 June 2020.
• 3. Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview Survey, 2016. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. Available from: https://www.cdc.gov/nchs/nhis/methods.htm. Aaccessed 23 June 2020.
• 4. Ahmed H, Turner S. Severe asthma in children-a review of definitions, epidemiology, and treatment options in 2019. Pediatr Pulmonol. 2019;54(6):778‐787. doi:10.1002/ppul.24317
• 5. Fleming L, Murray C, Bansal AT, Hashimoto S, Bisgaard H, Bush A, et al. The burden of severe asthma in childhood and adolescence: results from the paediatric U‐BIOPRED cohorts. EurRespir J. 2015;46:1322‐1333.doi:10.1183/13993003.00780-2015
• 6. Selby L, Saglani S. Severe asthma in children: therapeutic considerations. Curr Opin Allergy Clin Immunol. 2019;19(2):132-140. doi:10.1097/ACI.0000000000000521
• 7. Chung KF, Wenzel SE, Brozek JL, Bush A, Castro M, Sterk PJ, et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J. 2014 Feb;43(2):343-73. doi: 10.1183/09031936.00202013.
• 8. 2020 GINA Maın Report. 2020 GINA Report, Global Strategy for Asthma Management and Prevention. Available from: https://ginasthma.org/gina-reports/. Aaccessed 23 June 2020.
• 9. Diffucult-to-treat and severe asthma in adolescent and adult patients Diagnosis and Management. GINA 2019. Available from: https://ginasthma.org/severeasthma/. Aaccessed 23 June 2020.
• 10. Nordlund B, Melen E, Schultz ES, Gronlund H, Hedlin G, Kull I. Prevalence of severe childhood asthma according to the WHO. Respir Med. 2014;108:1234‐1237. doi:10.1016/j.rmed.2014.05.015
• 11. Lang A, Carlsen KH, Haaland G, Devulapalli CS, Munthe-Kaas M, Mowinckel P, et al. Severe asthma in childhood: assessed in 10 year olds in a birth cohort study. Allergy. 2008 Aug;63(8):1054-60. doi: 10.1111/j.1398-9995.2008.01672.x.
• 12. Teague WG, Phillips BR, Fahy JV, Wenzel SE, Fitzpatrick AM, Moore WC, et al. Baseline Features of the Severe Asthma Research Program (SARP III) Cohort: Differences with Age. J Allergy Clin Immunol Pract. 2018;6(2):545-554.e4. doi:10.1016/j.jaip.2017.05.032
• 13. Barsky EE, Giancola LM, Baxi SN, Gaffin JM. A Practical Approach to Severe Asthma in Children. Ann Am Thorac Soc. 2018;15(4):399-408. doi:10.1513/Annals ATS.201708-637FR.
• 14. Anderson GP. Endotyping asthma: new insights in to key pathogenic mechanisms in a complex, heterogeneous disease. Lancet. 2008;372(9643):1107-1119. doi:10.1016/S0140-6736(08)61452-X
• 15. Chung KF, Adcock IM. Precision medicine for the discovery of treatable mechanisms in severe asthma. Allergy. 2019;74(9):1649-1659. doi:10.1111/all.13771
• 16. Can D. Can Phenotypes be Recognized? İzmir Dr. Behçet Uz Çocuk Hast. Dergisi 2019;9(3):167-174 doi:10.5222/buchd.2019.40327.
• 17. Agache I. Severe asthma phenotypes and endotypes. Semin Immunol. 2019;46:101301. doi:10.1016/j.smim.2019.101301
• 18. Lötvall J, Akdis CA, Bacharier LB, Bjermer L, Casale TB, Custovic A,et al. Asthma endotypes: a new approach to classification of disease entities within the asthma syndrome. J Allergy Clin Immunol. 2011;127(2):355-360. doi:10.1016/j.jaci.2010.11.037
• 19. Pongracic JA, Krouse RZ, Babineau DC, oratti EM, Cohen RT, Wood RA, et al. Distinguishing characteristics of difficult-to-control asthma in inner-city children and adolescents. J Allergy Clin Immunol. 2016;138(4):1030-1041. doi:10.1016/j.jaci.2016.06.059
• 20. Liu AH, Babineau DC, Krouse RZ, Zoratti EM, Pongracic JA, O'Connor GT,et al. Pathways through which asthma risk factors contribute to asthma severity in inner-city children. J Allergy Clin Immunol. 2016;138(4):1042-1050. doi:10.1016/j.jaci.2016.06.060
• 21. Agache I, Akdis C, Akdis M, Canonica GW, Casale T, Chivato T, et al. EAACI Biologicals Guidelines - Recommendations for severe asthma [published online ahead of print, 2020 Jun 2]. Allergy. 2020;10.1111/all.14425. doi:10.1111/all.14425.
• 22. Israel E, Reddel HK. Severe and Difficult-to-Treat Asthma in Adults. N Engl J Med. 2017;377(10):965-976. doi:10.1056/NEJMra1608969
• 23. Morais-Almeida M, Aguiar R, Martin B, Ansotegui IJ, Ebisawa M, Arruda LK,et al. COVID-19, asthma, and biologic therapies: What we need to know [published online ahead of print, 2020 May 16]. World Allergy Organ J. 2020;13(5):100126. doi:10.1016/j.waojou.2020.100126
• 24. Halpin DMG, Faner R, Sibila O, Badia JR, Agusti A. Do chronic respiratory diseases or their treatment affect the risk of SARS-CoV-2 infection?. Lancet Respir Med. 2020;8(5):436-438. doi:10.1016/S2213-2600(20)30167-3
• 25. Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y,et al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan [published online ahead of print, 2020 Apr 12]. J Allergy Clin Immunol. 2020;S0091-6749(20)30495-4. doi:10.1016/j.jaci.2020.04.006
• 26. Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 — COVID-NET, 14 States, March 1–30, 2020Weekly / April 17, 2020 / 69(15);458–464. On April 8, 2020, this report was posted online as an MMWR Early Release. Available from: https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm. Aaccessed 23 June 2020.
• 27. Vultaggio A, Agache I, Akdis CA, Akdis M, Bavbek S, Bossios A,et al. Considerations on Biologicals for Patients with allergic disease in times of the COVID-19 pandemic: an EAACI Statement [published online ahead of print, 2020 Jun 5]. Allergy. 2020;10.1111/all.14407. doi:10.1111/all.14407
• 28. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi:10.1016/S0140-6736(20)30183-5
• 29. Sabogal Piñeros YS, Bal SM, Dijkhuis A, Majoor CJ, Dierdorp BS, Dekker T,et al. Eosinophils capture viruses, a capacity that is defective in asthma. Allergy. 2019;74(10):1898-1909. doi:10.1111/all.13802
• 30. COVID-19: GINA Answers to Frequently Asked Questions on asthma Management Release date: March 25, 2020 Follow GINA at @ginasthma. Available from: https://ginasthma.org/wp-content/uploads/2020/03/Final-COVID-19-answers-to-frequent-questions-25.3.2020-1.pdf. Aaccessed 23 June 2020.
• 31. Important information about COVID-19 for those with asthma. From the American College of Allergy, Asthma and Immunology.ARLINGTON HEIGHTS, Ill (March 12, 2020) Available from: https://acaai.org/news/important-information-about-covid-19-those-asthma. Aaccessed 23 June 2020.
• 32. Important information about COVID-19 for those with asthma. From the American College of Allergy, Asthma and Immunology.ARLINGTON HEIGHTS, Ill (March 12, 2020). Available from: https://acaai.org/news/important-information-about-covid-19-those-asthma. Aaccessed 23 June 2020.
• 33. COVID-19: information for the respiratory community. Available from: https://www.brit-thoracic.org.uk/about-us/covid-19-information-for-the-respiratory-community/. Aaccessed 23 June 2020