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

doi:10.1136/bmjopen-2020-048338

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 CarloTimothy 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

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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 language	English
Article number	e048338
Number of pages	9
Journal	BMJ Open
Volume	11
Issue number	7
DOIs	https://doi.org/10.1136/bmjopen-2020-048338
Publication status	Published - 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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Mathioudakis, A. G., Miligkos, M., Boccabella, C., Alimani, G. S., Custovic, A., Deschildre, A., Ducharme, F. M., Kalayci, O., Murray, C., Garcia, A. N., Phipatanakul, W., Price, D., Sheikh, A., Agache, I. O., Bacharier, L., Beloukas, A., Bentley, A., Bonini, M., Castro-Rodriguez, J. A., ... Papadopoulos, N. G. (2021). Management of asthma in childhood: study protocol of a systematic evidence update by the Paediatric Asthma in Real Life (PeARL) Think Tank. BMJ Open, 11(7), Article e048338. https://doi.org/10.1136/bmjopen-2020-048338

Mathioudakis, AG, Miligkos, M, Boccabella, C, Alimani, GS, Custovic, A, Deschildre, A, Ducharme, FM, Kalayci, O, Murray, C, Garcia, AN, Phipatanakul, W, Price, D, Sheikh, A, Agache, IO, Bacharier, L, Beloukas, A, Bentley, A, Bonini, M, Castro-Rodriguez, JA, De Carlo, G, Craig, T, Diamant, Z, Feleszko, W, Felton, T, Gern, JE, Grigg, J, Hedlin, G, Hossny, EM, Ierodiakonou, D, Jartti, T, Kaplan, A, Lemanske, RF, Le Souëf, PN, Mäkelä, MJ, Mathioudakis, GA, Matricardi, P, Mitrogiorgou, M, Morais-Almeida, M, Nagaraju, K, Papageorgiou, E, Pité, H, Pitrez, PMC, Pohunek, P, Roberts, G, Tsiligianni, I, Turner, S, Vijverberg, S, Winders, TA, Wong, GWK, Xepapadaki, P, Zar, HJ & Papadopoulos, NG 2021, 'Management of asthma in childhood: study protocol of a systematic evidence update by the Paediatric Asthma in Real Life (PeARL) Think Tank', BMJ Open, vol. 11, no. 7, e048338. https://doi.org/10.1136/bmjopen-2020-048338

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title = "Management of asthma in childhood: study protocol of a systematic evidence update by the Paediatric Asthma in Real Life (PeARL) Think Tank",

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.",

author = "Mathioudakis, {Alexander G} and Michael Miligkos and Cristina Boccabella and Alimani, {Gioulinta S} and Adnan Custovic and A Deschildre and Ducharme, {Francine Monique} and Omer Kalayci and Clare Murray and Garcia, {Antonio Nieto} and Wanda Phipatanakul and David Price and Aziz Sheikh and Agache, {Ioana Octavia} and Leonard Bacharier and Apostolos Beloukas and Andrew Bentley and Matteo Bonini and Castro-Rodriguez, {Jose A} and {De Carlo}, Giuseppe and Timothy Craig and Zuzana Diamant and Wojciech Feleszko and Tim Felton and Gern, {James E} and Jonathan Grigg and Gunilla Hedlin and Hossny, {Elham M} and Despo Ierodiakonou and Tuomas Jartti and Alan Kaplan and Lemanske, {Robert F} and {Le Sou{\"e}f}, {Peter N} and M{\"a}kel{\"a}, {Mika J} and Mathioudakis, {Georgios A} and Paolo Matricardi and Marina Mitrogiorgou and Mario Morais-Almeida and Karthik Nagaraju and Effie Papageorgiou and Helena Pit{\'e} and Pitrez, {Paulo M C} and Petr Pohunek and Graham Roberts and Ioanna Tsiligianni and Stephen Turner and Susanne Vijverberg and Winders, {Tonya A} and Wong, {Gary WK} and Paraskevi Xepapadaki and Zar, {Heather J} and Papadopoulos, {Nikolaos G}",

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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doi = "10.1136/bmjopen-2020-048338",

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T2 - study protocol of a systematic evidence update by the Paediatric Asthma in Real Life (PeARL) Think Tank

AU - Mathioudakis, Alexander G

AU - Miligkos, Michael

AU - Boccabella, Cristina

AU - Alimani, Gioulinta S

AU - Custovic, Adnan

AU - Deschildre, A

AU - Ducharme, Francine Monique

AU - Kalayci, Omer

AU - Murray, Clare

AU - Garcia, Antonio Nieto

AU - Phipatanakul, Wanda

AU - Price, David

AU - Sheikh, Aziz

AU - Agache, Ioana Octavia

AU - Bacharier, Leonard

AU - Beloukas, Apostolos

AU - Bentley, Andrew

AU - Bonini, Matteo

AU - Castro-Rodriguez, Jose A

AU - De Carlo, Giuseppe

AU - Craig, Timothy

AU - Diamant, Zuzana

AU - Feleszko, Wojciech

AU - Felton, Tim

AU - Gern, James E

AU - Grigg, Jonathan

AU - Hedlin, Gunilla

AU - Hossny, Elham M

AU - Ierodiakonou, Despo

AU - Jartti, Tuomas

AU - Kaplan, Alan

AU - Lemanske, Robert F

AU - Le Souëf, Peter N

AU - Mäkelä, Mika J

AU - Mathioudakis, Georgios A

AU - Matricardi, Paolo

AU - Mitrogiorgou, Marina

AU - Morais-Almeida, Mario

AU - Nagaraju, Karthik

AU - Papageorgiou, Effie

AU - Pité, Helena

AU - Pitrez, Paulo M C

AU - Pohunek, Petr

AU - Roberts, Graham

AU - Tsiligianni, Ioanna

AU - Turner, Stephen

AU - Vijverberg, Susanne

AU - Winders, Tonya A

AU - Wong, Gary WK

AU - Xepapadaki, Paraskevi

AU - Zar, Heather J

AU - Papadopoulos, Nikolaos G

N1 - 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

PY - 2021/7/1

Y1 - 2021/7/1

N2 - 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.

AB - 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.

U2 - 10.1136/bmjopen-2020-048338

DO - 10.1136/bmjopen-2020-048338

M3 - Article

SN - 2044-6055

VL - 11

JO - BMJ Open

JF - BMJ Open

IS - 7

M1 - e048338

ER -

Management of asthma in childhood: study protocol of a systematic evidence update by the Paediatric Asthma in Real Life (PeARL) Think Tank

Abstract

Bibliographical note

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