Imperial College London
Portrait Picture

DrLouiseFleming

Faculty of Medicine, National Heart & Lung Institute

Honorary Senior Research Fellow
 
 
 
//

Contact

 

+44 (0)20 7352 8121 ext 2938l.fleming

 
 
//

Location

 

Department of Respiratory PaediaRoyal BromptonRoyal Brompton Campus

//

Summary

 

Publications

Citation

BibTex format

@unpublished{Saglani:2021:au.163419834.45334889/v1,
author = {Saglani, S and Bingham, Y and Balfour-Lynn, I and Goldring, S and Gupta, A and Banya, W and Moreiras, J and Fleming, L and Bush, A and Rosenthal, M},
doi = {au.163419834.45334889/v1},
title = {Blood eosinophils in managing preschool wheeze: lessons learnt from a proof-of-concept trial},
url = {http://dx.doi.org/10.22541/au.163419834.45334889/v1},
year = {2021}
}
Download

RIS format (EndNote, RefMan)

TY  - UNPB
AB  - <jats:p id="p1">Background: Management of preschool wheeze is based predominantly onsymptom pattern. Objective: To determine whether personalising therapyusing blood eosinophils or airway bacterial infection results in fewerattacks compared to standard care. Methods: A proof-of-concept,randomised trial to investigate whether prescription of inhaledcorticosteroids (ICS) guided by blood eosinophils, or targetedantibiotics for airway bacterial infection, results in fewer unscheduledhealthcare visits (UHCV) compared to standard care. Children aged 1-5years with >2 wheeze attacks in the previous year werecategorised as episodic viral wheeze (EVW), or multiple trigger wheeze(MTW). The intervention group were prescribed ICS if blood eosinophils>3%, or targeted antibiotics if positive culture oninduced sputum/cough swab. The control group received standard care.Primary outcome: UHCV at 4 months. Results: 60 children, median age 36.5(range 14-61) months were randomised. Median blood eosinophils were 5.2(range 0-21)%, 27/60 (45%) children were atopic and 8/60 (13%) hadairway bacterial infection. There was no relationship between EVW, MTWand either blood eosinophils, atopic status, or infection. 67% in eachgroup were prescribed ICS. 15/30 control subjects and 16/30 interventiongroup had UHCV over 4 months, p=0.8. Time to first UHCV was similar.50% returned adherence monitors, in those, median ICS adherence was67%. There were no differences in any parameter between those that didand did not have an UHCV. Conclusion: Clinical phenotype was unrelatedto allergen sensitisation or blood eosinophils. ICS treatment determinedby blood eosinophils did not impact UHCV, but ICS adherence was poor.</jats:p>
AU  - Saglani,S
AU  - Bingham,Y
AU  - Balfour-Lynn,I
AU  - Goldring,S
AU  - Gupta,A
AU  - Banya,W
AU  - Moreiras,J
AU  - Fleming,L
AU  - Bush,A
AU  - Rosenthal,M
DO  - au.163419834.45334889/v1
PY  - 2021///
TI  - Blood eosinophils in managing preschool wheeze: lessons learnt from a proof-of-concept trial
UR  - http://dx.doi.org/10.22541/au.163419834.45334889/v1
ER  -
Download