# Characteristics of children with severe preschool asthma prior to starting the TIPP study

## TL;DR

This study examines the baseline characteristics and asthma control in 100 preschool children with severe asthma before starting treatment in the TIPP study.

## Contribution

The study provides detailed insights into the severity and control of asthma in preschool children, a less-researched age group.

## Key findings

- Most children had frequent severe asthma exacerbations in the past 24 months.
- Only 7% of children were well-controlled according to GINA guidelines at randomization.
- Daily symptom tracking revealed high rates of uncontrolled or partially controlled asthma despite ICS use.

## Abstract

Children with preschool asthma suffer disproportionally more often from severe asthma exacerbations with emergency visits and hospital admissions than school children. However, there are only a few reports on characteristics, hospitalization, phenotypes and symptoms in this age cohort.

This analysis of an ongoing prospective trial of Tiotropium bromide in preventing severe asthma exacerbations (the TIPP study) assessed baseline characteristics, hospitalizations and symptoms in 100 children with severe preschool asthma. Children aged 1–5 years were analyzed at study enrollment and daily symptoms were recorded by an electronic diary [Pediatric Asthma Caregiver Diary (PACD)] for the following four weeks until randomization.

At enrollment, the total number of severe asthma exacerbations, defined as three days systemic steroid use or hospitalization in the last 24 months, was mean (±SD) 5.8 ± 5.7 and the test for respiratory and asthma control in kids (TRACK) was mean 46.9 ± 19.0. Daily recording of symptoms by the PACD revealed that only 7 patients were controlled at randomization, whereas 35 were partially and 58 were uncontrolled according to GINA.

Despite protective therapy with inhaled corticosteroids (ICS), most children of this severe asthma cohort were only partially or uncontrolled according to GINA guidelines.