Recommendations for asthma monitoring in children: A PeARL document endorsed by APAPARI, EAACI, INTERASMA, REG, and WAO

Papadopoulos N.G. Custovic A. Deschildre A. Gern J.E. Nieto Garcia A. Miligkos M. Phipatanakul W. Wong G. Xepapadaki P. Agache I. Arasi S. Awad El-Sayed Z. Bacharier L.B. Bonini M. Braido F. Caimmi D. Castro-Rodriguez J.A. Chen Z. Clausen M. Craig T. Diamant Z. Ducharme F.M. Ebisawa M. Eigenmann P. Feleszko W. Fierro V. Fiocchi A. Garcia-Marcos L. Goh A. Gómez R.M. Gotua M. Hamelmann E. Hedlin G. Hossny E.M. Ispayeva Z. Jackson D.J. Jartti T. Jeseňák M. Kalayci O. Kaplan A. Konradsen J.R. Kuna P. Lau S. Le Souef P. Lemanske R.F. Levin M. Makela M.J. Mathioudakis A.G. Mazulov O. Morais-Almeida M. Murray C. Nagaraju K. Novak Z. Pawankar R. Pijnenburg M.W. Pite H. Pitrez P.M. Pohunek P. Price D. Priftanji A. Ramiconi V. Rivero Yeverino D. Roberts G. Sheikh A. Shen K.-L. Szepfalusi Z. Tsiligianni I. Turkalj M. Turner S. Umanets T. Valiulis A. Vijveberg S. Wang J.-Y. Winders T. Yon D.K. Yusuf O.M. Zar H.J.
April 2024 John Wiley and Sons Inc

Pediatric Allergy and Immunology
2024 #35 Issue 4

Monitoring is a major component of asthma management in children. Regular monitoring allows for diagnosis confirmation, treatment optimization, and natural history review. Numerous factors that may affect disease activity and patient well-being need to be monitored: response and adherence to treatment, disease control, disease progression, comorbidities, quality of life, medication side-effects, allergen and irritant exposures, diet and more. However, the prioritization of such factors and the selection of relevant assessment tools is an unmet need. Furthermore, rapidly developing technologies promise new opportunities for closer, or even “real-time,” monitoring between visits. Following an approach that included needs assessment, evidence appraisal, and Delphi consensus, the PeARL Think Tank, in collaboration with major international professional and patient organizations, has developed a set of 24 recommendations on pediatric asthma monitoring, to support healthcare professionals in decision-making and care pathway design. (Figure presented.).

asthma management , biomarkers , childhood , consensus , diagnosis , guidelines , therapy

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Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, United Kingdom
Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
Department of Pediatrics, Imperial College London, London, United Kingdom
Univ. Lille, Pediatric Pulmonology and Allergy Department, Hôpital Jeanne de Flandre, CHU Lille, Lille cedex, France
Department of Pediatrics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
Pediatric Pulmonology & Allergy Unit Childrens Hospital la Fe, Health Research Institute La Fe, Valencia, Spain
Childrens Hospital Boston, Pediatric Allergy and Immunology, Boston, MA, United States
Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
Allergy & Clinical Immunology, Transylvania University, Brasov, Romania
Allergy Department, Bambino Gesù Childrens Hospital, IRCCS, Rome, Italy
Pediatric Allergy, Immunology and Rheumatology Unit, Childrens Hospital, Ain Shams University, Cairo, Egypt
Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Monroe Carell Jr Childrens Hospital at Vanderbilt University Medical Center, Nashville, TN, United States
Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
National Heart and Lung Institute (NHLI), Imperial College London, London, United Kingdom
University of Genoa, Genoa, Italy
Respiratory Diseases and Allergy Department, Research Institute and Teaching Hospital San Martino, Genoa, Italy
Interasma – Global Asthma Association (GAA), Japan
Allergy Unit, CHU de Montpellier, Montpellier, France
IDESP, UA11 INSERM-Universitè de Montpellier, Montpellier, France
Department of Pediatrics Pulmonology, School of Medicine, Pontifical Universidad Catolica de Chile, Santiago, Chile
Pulmonology Department, Childrens Hospital Zhejiang University School of Medicine, Hangzhou, China
Childrens Hospital, Landspitali University Hospital, Reykjavik, Iceland
Department of Allergy and Immunology, Penn State University, Hershey, PA, United States
Vinmec International Hospital, Hanoi, Viet Nam
Department of Clinical Pharmacy & Pharmacology, University of Groningen, University Medical Center of Groningen and QPS-NL, Groningen, Netherlands
Department of Pediatrics and of Social and Preventive Medicine, University of Montreal, Montreal, QC, Canada
National Hospital Organization Sagamihara National Hospital, Kanagawa, Sagamihara, Japan
Department of Women-Children-Teenagers, University Hospital of Geneva, Geneva, Switzerland
Department of Pediatric Respiratory Diseases and Allergy, The Medical University of Warsaw, Warsaw, Poland
Pediatric Respiratory and Allergy Units, “Virgen de la Arrixaca” Childrens University Clinical Hospital, University of Murcia, Murcia, Spain
Department of Pediatrics, Respiratory Medicine Service, KK Womens and Childrens Hospital, Singapore City, Singapore
Faculty of Health Sciences, Catholic University of Salta, Salta, Argentina
Center of Allergy and Immunology, Tbilisi, Georgia
Childrens Center Bethel, Evangelical Hospital Bethel, University of Bielefeld, Bielefeld, Germany
Paediatric Allergy, Centre for Allergy Research, Karolinska Institutet, Solna, Sweden
Department of Allergology and Clinical Immunology, Kazakh National Medical University, Almaty, Kazakhstan
Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
Department of Pediatrics, Turku University Hospital and University of Turku, Turku, Finland
Department of Pediatrics, Jessenius Faculty of Medicine in Martin, Center for Vaccination in Special Situations, University Hospital in Martin, Comenius University in Bratislava, Bratislava, Slovakia
Department of Clinical Immunology and Allergology, Jessenius Faculty of Medicine in Martin, Center for Vaccination in Special Situations, University Hospital in Martin, Comenius University in Bratislava, Bratislava, Slovakia
Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey
Chair Family Physician Airways Group of Canada, ON, Canada
Astrid Lindgren Childrens Hospital, Karolinska University Hospital, Stockholm, Sweden
Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Lodz, Poland
Charité Universitätsmedizin Berlin, Pediatric Respiratpry Medicine, Immunology and Intensive Care Medicine, Berlin, Germany
School of Medicine, University of Western Australia, Perth, WA, Australia
Division of Paediatric Allergy, Department of Paediatrics, University of Cape Town, Cape Town, South Africa
inVIVO Planetary Health Group of the Worldwide Universities Network, South Africa
Department of Allergy, Helsinki University Central Hospital, Helsinki, Finland
North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
First Pediatric Department of Pediatrics, National Pirogov Memorial Medical University, Vinnytsia Childrens Regional Hospital, Vinnytsia Oblast, Ukraine
Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal
VN Allergy & Asthma Research Centre, Tamilnadu, Chennai, India
Pediatric Department, University of Szeged, Szeged, Hungary
Department of Pediatrics, Nippon Medical School, Tokyo, Japan
Division of Respiratory Medicine and Allergology, Department of Pediatrics, Erasmus University Medical Centre – Sophia Childrens Hospital, Rotterdam, Netherlands
Allergy Center, CUF Descobertas Hospital and CUF Tejo HospitalInfante Santo Hospital, Lisbon, Portugal
NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
Pulmonary Division, Hospital Santa Casa de Porto Alegre, Porto Alegre, Brazil
Pediatric Pulmonology, Pediatric Department, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
University Hospital Motol, Prague, Czech Republic
Division of Applied Health Sciences, Centre of Academic Primary Care, University of Aberdeen, Aberdeen, United Kingdom
Observational and Pragmatic Research Institute, Singapore City, Singapore
Department of Allergy, Mother Theresa School of Medicine, University of Tirana, Tirana, Albania
The European Federation of Allergy and Airways Diseases Patients Associations (EFA), Brussels, Belgium
Benemérita Universidad Autónoma de Puebla, Hospital Universitario de Puebla, Puebla, Mexico
Paediatric Allergy and Respiratory Medicine within Medicine at the University of Southampton, Southampton, United Kingdom
Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, United Kingdom
Department of Respiratory Medicine, Beijing Childrens Hospital, Capital Medical University, National Center for Childrens Health, China
Division of Pediatric Pulmonology, Allergy and Endocrinologyneumology, Department of Pediatrics and Juvenile Medicine, Comprehensive Center Pediatrics, Medical University of Vienna, Vienna, Austria
Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
Srebrnjak Childrens Hospital, Zagreb, Croatia
Medical School of Catholic University of Croatia, Zagreb, Croatia
Child Health, Royal Aberdeen Childrens Hospital and University of Aberdeen, Aberdeen, United Kingdom
Department of Respiratory Diseases and Respiratory Allergy in Children, SI “Institute of Pediatrics, Obstetrics and Gynecology named after Academician O. Lukjanova of NAMS of Ukraine, Kyiv, Ukraine
Clinic of Childrens Diseases, Institute of Clinical Medicine, Medical Faculty of Vilnius University, Vilnius, Lithuania
Department of Paediatric Pulmonology, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
China Medical University Childrens Hospital Taichung, Taichung, Taiwan
Allergy and Asthma Network, Vienna, VA, United States
Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
The Allergy & Asthma Institute, Islamabad, Pakistan
Department of Pediatrics & Child Health, Director MRC Unit on Child & Adolescent Health, Red Cross War Memorial Childrens Hospital, University of Cape Town, Cape Town, South Africa

Division of Infection
Allergy Department
Department of Pediatrics
Univ. Lille
Department of Pediatrics and Medicine
Pediatric Pulmonology & Allergy Unit Childrens Hospital la Fe
Childrens Hospital Boston
Department of Pediatrics
Allergy & Clinical Immunology
Allergy Department
Pediatric Allergy
Division of Allergy
Department of Cardiovascular and Pulmonary Sciences
National Heart and Lung Institute (NHLI)
University of Genoa
Respiratory Diseases and Allergy Department
Interasma – Global Asthma Association (GAA)
Allergy Unit
IDESP
Department of Pediatrics Pulmonology
Pulmonology Department
Childrens Hospital
Department of Allergy and Immunology
Vinmec International Hospital
Department of Clinical Pharmacy & Pharmacology
Department of Pediatrics and of Social and Preventive Medicine
National Hospital Organization Sagamihara National Hospital
Department of Women-Children-Teenagers
Department of Pediatric Respiratory Diseases and Allergy
Pediatric Respiratory and Allergy Units
Department of Pediatrics
Faculty of Health Sciences
Center of Allergy and Immunology
Childrens Center Bethel
Paediatric Allergy
Department of Allergology and Clinical Immunology
Department of Pediatrics
Department of Pediatrics
Department of Pediatrics
Department of Clinical Immunology and Allergology
Pediatric Allergy and Asthma Unit
Chair Family Physician Airways Group of Canada
Astrid Lindgren Childrens Hospital
Department of Internal Medicine
Charité Universitätsmedizin Berlin
School of Medicine
Division of Paediatric Allergy
inVIVO Planetary Health Group of the Worldwide Universities Network
Department of Allergy
North West Lung Centre
First Pediatric Department of Pediatrics
Allergy Center
VN Allergy & Asthma Research Centre
Pediatric Department
Department of Pediatrics
Division of Respiratory Medicine and Allergology
Allergy Center
NOVA Medical School
Pulmonary Division
Pediatric Pulmonology
University Hospital Motol
Division of Applied Health Sciences
Observational and Pragmatic Research Institute
Department of Allergy
The European Federation of Allergy and Airways Diseases Patients Associations (EFA)
Benemérita Universidad Autónoma de Puebla
Paediatric Allergy and Respiratory Medicine within Medicine at the University of Southampton
Asthma UK Centre for Applied Research
Department of Respiratory Medicine
Division of Pediatric Pulmonology
Health Planning Unit
Srebrnjak Childrens Hospital
Medical School of Catholic University of Croatia
Child Health
Department of Respiratory Diseases and Respiratory Allergy in Children
Clinic of Childrens Diseases
Department of Paediatric Pulmonology
China Medical University Childrens Hospital Taichung
Allergy and Asthma Network
Department of Pediatrics
The Allergy & Asthma Institute
Department of Pediatrics & Child Health

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