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Am. J. Respir. Crit. Care Med., Volume 162, Number 1, July 2000, 50-56

Relationship between Increased Airway Responsiveness and Asthma Severity in the Childhood Asthma Management Program

SCOTT T. WEISS, MARK L. VAN NATTA, and ROBERT S. ZEIGER, for the Childhood Asthma Management Program Research Group*

Brigham and Women's Hospital, Channing Laboratory, Boston, Massachusetts; Johns Hopkins Center for Clinical Trials, Baltimore, Maryland; and Department of Allergy, Kaiser Permanente Medical Center and Department of Pediatrics, University of California, San Diego, California

The relationship between increased airway responsiveness and asthma severity in children is unclear. The Childhood Asthma Management Program (CAMP) with 1,041 children with mild to moderate asthma offers an opportunity to relate the concentration of methacholine that causes a 20% fall in FEV1 (PC20) to level of lung function, occurrence of respiratory symptoms, duration of disease, and assessment of severity by clinical staff. Decreasing PC20 was found to be associated with lower levels of lung function (prebronchodilator percent predicted FEV1: r = 0.29, beta  = 3.5, p < 0.001), the occurrence of chronic asthma symptoms, persistent wheezing (odds ratio [OR] = 1.66, p < 0.001), subjective clinical staff assessment of asthma severity (p < 0.001), and longer duration of asthma (r = -0.11, beta  = -0.20, p < 0.002). These data provide evidence that the degree of airway responsiveness is linked to disease severity in children with mild to moderate asthma.




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