Browsing by Author "Custovic, Adnan"

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    Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multinational cohort
    (2021) Papadopoulos, Nikolaos G.; Mathioudakis, Alexander G.; Custovic, Adnan; Deschildre, Antoine; Phipatanakul, Wanda; Wong, Gary; Xepapadaki, Paraskevi; Abou-Taam, Rola; Agache, Ioana; Castro-Rodriguez, Jose A.; Chen, Zhimin; Cros, Pierrick; Dubus, Jean-Christophe; El-Sayed, Zeinab Awad; El-Owaidy, Rasha; Feleszko, Wojciech; Fierro, Vincenzo; Fiocchi, Alessandro; Garcia-Marcos, Luis; Goh, Anne; Hossny, Elham M.; Huerta Villalobos, Yunuen R.; Jartti, Tuomas; Le Roux, Pascal; Levina, Julia; Lopez Garcia, Aida Ines; Ramos, Angel Mazon; Morais-Almeida, Mario; Murray, Clare; Nagaraju, Karthik; Nagaraju, Major K.; Navarrete Rodriguez, Elsy Maureen; Namazova-Baranova, Leyla; Nieto Garcia, Antonio; Pozo Beltran, Cesar Fireth; Ratchataswan, Thanaporn; Rivero Yeverino, Daniela; Rodriguez Zagal, Erendira; Schweitzer, Cyril E.; Tulkki, Marleena; Wasilczuk, Katarzyna; Xu, Dan
    Background The interplay between COVID-19 pandemic and asthma in children is still unclear. We evaluated the impact of COVID-19 pandemic on childhood asthma outcomes.
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    Impact of COVID-19 on Pediatric Asthma: Practice Adjustments and Disease Burden
    (2020) Papadopoulos, Nikolaos G.; Custovic, Adnan; Deschildre, Antoine; Mathioudakis, AleXander G.; Phipatanakul, Wanda; Wong, Gary; Xepapadaki, Paraskevi; Agache, Ioana; Bacharier, Leonard; Bonini, Matteo; Castro-Rodriguez, Jose A.; Chen, Zhimin; Craig, Timothy; Ducharme, Francine M.; El-Sayed, Zeinab AWad; Feleszko, Wojciech; Fiocchi, Alessandro; Garcia-Marcos, Luis; Gern, James E.; Goh, Anne; Gomez, Rene MaXimiliano; Hamelmann, Eckard H.; Hedlin, Gunilla; Hossny, Elham M.; Jartti, Tuomas; Kalayci, Omer; Kaplan, Alan; Konradsen, Jon; Kuna, Piotr; Lau, Susanne; Souef, Peter Le; Lemanske, Robert F.; Makela, Mika J.; Morais-Almeida, Manio; Murray, Clare; Nagaraju, Karthik; Namazova-Baranova, Leyla; Garcia, Antonio Nieto; Yusuf, Osman M.; Pitrez, Paulo M. C.; Pohunek, Petr; Beltran, Cesar Fireth Pozo; Roberts, Graham C.; Valiulis, Arunas; Zar, Heather J.
    BACKGROUND: It is unclear whether asthma may affect susceptibility or severity of coronavirus disease 2019 (COVID-19) in children and how pediatric asthma services worldwide have responded to the pandemic.
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    Management of asthma in childhood: study protocol of a systematic evidence update by the Paediatric Asthma in Real Life (PeARL) Think Tank
    (2021) Mathioudakis, Alexander G.; Miligkos, Michael; Boccabella, Cristina; Alimani, Gioulinta S.; Custovic, Adnan; Deschildre, A.; Ducharme, Francine Monique; Kalayci, Omer; Murray, Clare; Garcia, Antonio Nieto; Phipatanakul, Wanda; Price, David; Sheikh, Aziz; Agache, Ioana Octavia; Bacharier, Leonard; Beloukas, Apostolos; Bentley, Andrew; Bonini, Matteo; Castro-Rodriguez, Jose A.; De Carlo, Giuseppe; Craig, Timothy; Diamant, Zuzana; Feleszko, Wojciech; Felton, Tim; Gern, James E.; Grigg, Jonathan; Hedlin, Gunilla; Hossny, Elham M.; Ierodiakonou, Despo; Jartti, Tuomas; Kaplan, Alan; Lemanske, Robert F.; Le Souef, Peter N.; Makela, Mika J.; Mathioudakis, Georgios A.; Matricardi, Paolo; Mitrogiorgou, Marina; Morais-Almeida, Mario; Nagaraju, Karthik; Papageorgiou, Effie; Pite, Helena; Pitrez, Paulo M. C.; Pohunek, Petr; Roberts, Graham; Tsiligianni, Ioanna; Turner, Stephen; Vijverberg, Susanne; Winders, Tonya A.; Wong, Gary W. K.; Xepapadaki, Paraskevi; Zar, Heather J.; Papadopoulos, Nikolaos G.
    Introduction Clinical recommendations for childhood asthma are often based on data extrapolated from studies conducted in adults, despite significant differences in mechanisms and response to treatments. The Paediatric Asthma in Real Life (PeARL) Think Tank aspires to develop recommendations based on the best available evidence from studies in children. An overview of systematic reviews (SRs) on paediatric asthma maintenance management and an SR of treatments for acute asthma attacks in children, requiring an emergency presentation with/without hospital admission will be conducted. Methods and analysis Standard methodology recommended by Cochrane will be followed. Maintenance pharmacotherapy of childhood asthma will be evaluated in an overview of SRs published after 2005 and including clinical trials or real-life studies. For evaluating pharmacotherapy of acute asthma attacks leading to an emergency presentation with/without hospital admission, we opted to conduct de novo synthesis in the absence of adequate up-to-date published SRs. For the SR of acute asthma pharmacotherapy, we will consider eligible SRs, clinical trials or real-life studies without time restrictions. Our evidence updates will be based on broad searches of Pubmed/Medline and the Cochrane Library. We will use A MeaSurement Tool to Assess systematic Reviews, V.2, Cochrane risk of bias 2 and REal Life EVidence AssessmeNt Tool to evaluate the methodological quality of SRs, controlled clinical trials and real-life studies, respectively. Next, we will further assess interventions for acute severe asthma attacks with positive clinical results in meta-analyses. We will include both controlled clinical trials and observational studies and will assess their quality using the previously mentioned tools. We will employ random effect models for conducting meta-analyses, and Grading of Recommendations Assessment, Development and Evaluation methodology to assess certainty in the body of evidence. Ethics and dissemination Ethics approval is not required for SRs. Our findings will be published in peer reviewed journals and will inform clinical recommendations being developed by the PeARL Think Tank. PROSPERO registration numbers CRD42020132990, CRD42020171624.
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    New paradigms in acute viral bronchiolitis: Is it time to change our approach?
    (2024) Castro Rodríguez, José Antonio; Astudillo Paredes, Patricio Andrés; Puranik , Sandeep; Brown, Mark A.; Custovic, Adnan; Forno, Erick
    Viral bronchiolitis is the most common pediatric acute respiratory infection leading to hospitalization, and it causes a significant healthcare burden worldwide. Current guidelines recommend supportive management after many clinical trials on specific therapies failed to demonstrate benefits. However, several studies in the past decade have revealed that bronchiolitis may not be a homogeneous disease, but instead may constitute an umbrella comprised of different “endotypes” and “phenotypes” based on patient characteristics, etiology, pathophysiological mechanisms, and clinical presentation. In this extensive review, we summarize the current evidence that several different types of bronchiolitis (“bronchiolitides”) coexist, with different short- and long-term consequences on respiratory health and the risk of asthma development. Disease pathobiology, immune response, and clinical characteristics may differ between the two most prevalent viral agents, respiratory syncytial virus and rhinovirus. Recent randomized trials have shown that some subgroups of children may benefit from the use of systemic corticosteroids and/or bronchodilators. These findings also suggest that some children may benefit from individualized therapeutical approaches for viral bronchiolitis rather than following broad recommendations for treating all patients uniformly using only supportive management.
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    Recommendations for asthma monitoring in children: A PeARL document endorsed by APAPARI, EAACI, INTERASMA, REG, and WAO
    (2024) Papadopoulos, Nikolaos G.; Custovic, Adnan; Deschildre, Antoine; Gern, James E.; Nieto Garcia, Antonio; Miligkos, Michael; Phipatanakul, Wanda; Wong, Gary; Xepapadaki, Paraskevi; Agache, Ioana; Arasi, Stefania; El-Sayed, Zeinab Awad; Bacharier, Leonard B.; Bonini, Matteo; Braido, Fulvio; Caimmi, Davide; Castro-Rodriguez, Jose A.; Chen, Zhimin; Clausen, Michael; Craig, Timothy; Diamant, Zuzana; Ducharme, Francine M.; Ebisawa, Motohiro; Eigenmann, Philippe; Feleszko, Wojciech; Fierro, Vincezo; Fiocchi, Alessandro; Garcia-Marcos, Luis; Goh, Anne; Gomez, Rene Maximiliano; Gotua, Maia; Hamelmann, Eckard; Hedlin, Gunilla; Hossny, Elham M.; Ispayeva, Zhanat; Jackson, Daniel J.; Jartti, Tuomas; Jesenak, Milos; Kalayci, Omer; Kaplan, Alan; Konradsen, Jon R.; Kuna, Piotr; Lau, Susanne; Le Souef, Peter; Lemanske, Robert F.; Levin, Michael; Makela, Mika J.; Mathioudakis, Alexander G.; Mazulov, Oleksandr; Morais-Almeida, Mario; Murray, Clare; Nagaraju, Karthik; Novak, Zoltan; Pawankar, Ruby; Pijnenburg, Marielle W.; Pite, Helena; Pitrez, Paulo M.; Pohunek, Petr; Price, David; Priftanji, Alfred; Ramiconi, Valeria; Rivero Yeverino, Daniela; Roberts, Graham; Sheikh, Aziz; Shen, Kun-Ling; Szepfalusi, Zsolt; Tsiligianni, Ioanna; Turkalj, Mirjana; Turner, Steve; Umanets, Tetiana; Valiulis, Arunas; Vijveberg, Susanne; Wang, Jiu-Yao; Winders, Tonya; Yon, Dong Keon; Yusuf, Osman M.; Zar, Heather J.
    Monitoring is a major component of asthma management in children. Regular monitoring allows for diagnosis confirmation, treatment optimization, and natural history review. Numerous factors that may affect disease activity and patient well-being need to be monitored: response and adherence to treatment, disease control, disease progression, comorbidities, quality of life, medication side-effects, allergen and irritant exposures, diet and more. However, the prioritization of such factors and the selection of relevant assessment tools is an unmet need. Furthermore, rapidly developing technologies promise new opportunities for closer, or even "real-time," monitoring between visits. Following an approach that included needs assessment, evidence appraisal, and Delphi consensus, the PeARL Think Tank, in collaboration with major international professional and patient organizations, has developed a set of 24 recommendations on pediatric asthma monitoring, to support healthcare professionals in decision-making and care pathway design. image
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    Treatment of asthma in young children: evidence-based recommendations
    (2016) Castro Rodríguez, José Antonio; Custovic, Adnan; Ducharme, Francine M.
    Abstract In the present review, we focus on evidence-based data for the use of inhaled corticosteroids (ICS), leukotriene receptor antagonist (LTRA), long-acting beta2-agonits (LABA) and oral corticosteroids (OCS), with a special emphasis on well-performed randomized clinical trials (RCTs) and meta-analyses of such trials for the chronic management of asthma/wheeze in infants and preschoolers. Results: Seven meta-analyses and 14 RCTs were reviewed. Daily ICS should be the preferred drug for infants/preschoolers with recurrent wheezing, especially in asthmatics. For those with moderate or severe episodes of EVW, the use of high intermittent ICS doses significantly reduce the use of OCS. There is no evidence of effect of intermittent ICS at low-moderate dose in preschoolers with mild EVW episodes. In preschoolers with asthma, there were no significant differences between daily vs. intermittent ICS in terms of asthma exacerbations with insufficient power to conclude to equivalence; however, for other asthma control outcomes, daily ICS works significantly better than intermittent ICS for older children. Daily ICS is superior to daily or intermittent LRTA for reducing symptoms, preventing exacerbations, and improving lung function. No RCTs testing combination therapy with ICS and LABA (or LTRA) were published in infant/preschoolers. Parent-initiation of OCS at the first sign of symptoms is not effective in children with recurrent wheezing episode. In terms of ICS safety, growth suppression is dose and molecule-dependent but it’s effect is not cumulative beyond the first year of therapy and may be associated with some catch-up growth while on or off therapy. Linear growth must be monitored as individual susceptibility to ICS drugs may vary considerably.