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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

  • Alexander G Mathioudakis
  • , Michael Miligkos
  • , Cristina Boccabella
  • , Gioulinta S Alimani
  • , Adnan Custovic
  • , A Deschildre
  • , Francine Monique Ducharme
  • , Omer Kalayci
  • , Clare Murray
  • , Antonio Nieto Garcia
  • , Wanda Phipatanakul
  • , David Price
  • , Aziz Sheikh
  • , Ioana Octavia Agache
  • , Leonard Bacharier
  • , Apostolos Beloukas
  • , Andrew Bentley
  • , Matteo Bonini
  • , Jose A Castro-Rodriguez
  • , Giuseppe De Carlo
  • Timothy Craig, Zuzana Diamant, Wojciech Feleszko, Tim Felton, James E Gern, Jonathan Grigg, Gunilla Hedlin, Elham M Hossny, Despo Ierodiakonou, Tuomas Jartti, Alan Kaplan, Robert F Lemanske, Peter N Le Souëf, Mika J Mäkelä, Georgios A Mathioudakis, Paolo Matricardi, Marina Mitrogiorgou, Mario Morais-Almeida, Karthik Nagaraju, Effie Papageorgiou, Helena Pité, Paulo M C Pitrez, Petr Pohunek, Graham Roberts, Ioanna Tsiligianni, Stephen Turner, Susanne Vijverberg, Tonya A Winders, Gary WK Wong, Paraskevi Xepapadaki, Heather J Zar, Nikolaos G Papadopoulos* (Corresponding Author)
*Corresponding author for this work
  • University of Manchester
  • University of Athens
  • Catholic University of the Sacred Heart
  • University of West Attica
  • Imperial College London
  • Hôpital Jeanne de Flandre
  • University of Montreal
  • Hacettepe Universitesi, Ankara
  • La Fe University and Polytechnic Hospital, Valencia
  • Boston Children's Hospital
  • University of Edinburgh
  • Transylvania University
  • University of Washington
  • Manchester University NHS Foundation Trust
  • Pontifical Universidad Catolica de Chile
  • European Federation of Pharmaceutical Industries and Associations
  • Pennsylvania State University
  • University of Groningen
  • Medical University of Warsaw
  • University of Wisconsin-Madison
  • Queen Mary University of London
  • Karolinska Institutet
  • Ain Shams University
  • University of Crete
  • University of Turku
  • University of Toronto
  • University of Western Australia
  • University of Helsinki
  • Athens Breath Centre
  • Charité – Universitätsmedizin Berlin
  • National and Kapodistrian University of Athens
  • Hospital CUF Descobertas, Lisboa
  • Allergy & Asthma, VN, Chennai
  • Pontifícia Universidade Católica do Rio Grande do Sul
  • Charles University Prague
  • University of Southampton
  • University of Amsterdam
  • Allergy & Asthma, Global Patient Platform, Virginia
  • The Chinese University of Hong Kong, Shenzhen
  • University of Cape Town

Research output: Contribution to journalArticlepeer-review

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Abstract

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.
Original languageEnglish
Article numbere048338
Number of pages9
JournalBMJ Open
Volume11
Issue number7
DOIs
Publication statusPublished - 1 Jul 2021

Bibliographical note

Funding This work was supported by the Respiratory Effectiveness Group (REG). REG has received support from AstraZeneca, Novartis and Sanofi for continued work on PeARL. (Award/Grant name: PeARL, Award/Grant Number: N/A). This is an investigator initiated study and the funders were not involved in the selection of the topic, or design of these systematic reviews. AGM was supported by the National Institute for Health Research Manchester Biomedical Research Centre (NIHR Manchester BRC).
Acknowledgements AGM was supported by the National Institute of Health Research Manchester Biomedical Research Centre (NIHR Manchester BRC). We thank Mrs Maria Kritikou for excellent administrative support of the study

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