Looking beyond the magic bullet: Novel asthma drugs or education, which works better?

  • R Masekela
  • M Levin
  • PM Jeena
  • M Annamalai
  • V Naidoo
  • A van Niekerk
  • D Hawarden
  • S Emanuel
  • H Katz
  • H Zar
  • RJ Green
  • FE Kritzinger
  • AI Manjra

Abstract

Although ˂5% of children with asthma suffer from severe asthma, they account for the highest use of health resources. The field of asthma therapy is changing rapidly, with a number of new drugs and biologics being added to the treatment armamentarium, particularly for adults. This, though, is not the case for paediatric patients, in whom a number of these novel molecules and drugs have not been investigated. Even though adults have shown responses to medication in some studies, this does not necessarily imply that there will be similar results in children. In the management of severe asthma, use of specific interventions to ensure treatment adherence and goal-setting for selfmanagement is critical to ensure the best treatment outcomes. The objective of this article is to review and grade the current evidence base for use of novel asthma drugs and to make evidence-based recommendations for their administration in children with severe asthma in the South Africa context. We also review the evidence for medication-adherence strategies and self-management plans.

S Afr Med J 2018;108(8):619-623

Author Biographies

R Masekela
Inkosi Albert Luthuli Central Hospital and Department of Paediatrics and Child Health, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
M Levin
Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, and Medical Research Council Unit on Child and Adolescent Health, Faculty of Health Sciences, University of Cape Town, South Africa
PM Jeena
Inkosi Albert Luthuli Central Hospital and Department of Paediatrics and Child Health, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
M Annamalai
Private practice, Lenmed Ethekwini Hospital and Heart Centre, Durban, South Africa
V Naidoo
Inkosi Albert Luthuli Central Hospital and Department of Paediatrics and Child Health, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
A van Niekerk
Steve Biko Academic Hospital and Department of Paediatrics and Child Health, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa
D Hawarden
Division of Allergology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, South Africa
S Emanuel
Private practice, The Asthma Clinic, Cape Town, South Africa
H Katz
Allergy Live, Allergy Foundation South Africa
H Zar
Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, and Medical Research Council Unit on Child and Adolescent Health, Faculty of Health Sciences, University of Cape Town, South Africa
RJ Green
Steve Biko Academic Hospital and Department of Paediatrics and Child Health, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa
FE Kritzinger
Netcare Christiaan Barnard Memorial Hospital, Cape Town; and Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
AI Manjra
Private practice, Life Westville Hospital, Durban, South Africa
Published
2018-10-11
Section
Articles

Journal Identifiers


eISSN: 0256-95749
print ISSN: 2078-5135