Commentary on Japanese Pediatric Guideline for The Treatment and Management of Asthma 2020 Chapter 7 Long-term Management of Childhood Asthma

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  • Yagi Hisako
    Department of Pediatrics, Gunma University Graduate School of Medicine
  • Ito Yasunori
    Department of Pediatrics, Faculty of Medicine, University of Toyama
  • Takizawa Takumi
    Department of Pediatrics, Gunma University Graduate School of Medicine

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  • 第7章　長期管理に関する薬物療法

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Abstract

<p>In the Japanese Pediatric Guideline for the Treatment and Management of Asthma (JPGL) 2020, several newly applied drugs for pediatric use such as formoterol fumarate hydrate/fluticasone propionate, mepolizumab, and dupilumab have been incorporated into the long-term management plan. The title of the table, "Drug treatment plan in long-term management of asthma" was changed to "Long-term management of asthma" in the JPGL2020 because it contains items on risk factor management, patient education, and patient-doctor partnership. Biologics are placed on the top of the drugs list in the "additional therapy" of Step 4 treatment for patients aged 6 years and older. In addition, evaluation items and checklists are presented in the tables to ensure the proper use of biologics. We also added evidence-based suggestions for assessing asthma control status and mite allergen-specific immunotherapy for asthma. Difficult asthma is defined as asthma that remains uncontrolled even with the "basic therapy" of Step 4 treatment after differential diagnosis of asthma, and severe asthma is defined as difficult asthma that remains uncontrolled even after the risk factors have been addressed.</p>

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