Asthma control endpoints

Katedra i Klinika Chorób Wewnętrznych i Alergologii AM we Wrocławiu.
Kierownik: dr hab. n. med. B. Panaszek, profesor nadzwyczajny
Correspondence to: Andrzej M. Fal, Katedra i Klinika Chorób Wewnętrznych i Alergologii AM we Wrocławiu, ul. Traugutta 57/59, 50-417 Wrocław, tel. 071 370 01 28
Source of financing: Department own sources

Pediatr Med rodz Vol 5 Numer 3, p. 154-159
ABSTRACT

It’s being discussed which parameters should be considered most relevant in asthma and asthma treatment monitoring, so called end-points. So far spirometric values, syptom presence (eg., night awakenings, night or day-time dyspnea) and rescue- medication-need were the most commonly used end-points in asthma. They do not, however monitor all aspects of the disease. Therefore monitoring of inflammatory and QoL parameters should be added. Authors present a wide panel of possible end-points, divided into several groups of parameters: inflammatory (blood/sputum ECP, sputum eosinophilia, eNO), bronchial reactivity (PC20, PD20), spirometric parameters (FEV1, PEF), QoL (hospitalization rate, rate and magnitude of exacerbations). In the paper it is also demonstrated, that QoL monitoring seems to gain an increasing interest of clinicians as far as asthma controlling is concerned. It is well documented that life quality correlates with several other parameters as well as it is crucial for patients compliance and good patient-doctor relations. Many clinical trials showing the accuracy and correlations of different asthma-control-parameters are further analyzed. Also data are presented to show the necessity of combining various end-points to obtain a more accurate clinical evaluation that is especially stressed by GINA 2006 and is also crucial for accurate treatment adjustment. In conclusion authors suggest that optimal asthma monitoring requires monitoring of at least one parameter of each presented group and further that research is needed to obtain accurate asthma-monitoring-strategy.

Keywords: bronchial asthma, evaluation criteria, end- points, spirometria parameters, QoL