Dupilumab enhances lung function parameters in children with type 2 asthma

According to a recent study, dupilumab resulted in significant and sustained improvements in lung function across various measures in children (aged 6-11 years) suffering from uncontrolled, moderate-to-severe type 2 asthma. This study’s findings were published in the Journal of Allergy and Clinical Immunology.

In the LIBERTY ASTHMA VOYAGE phase 3 trial, children with asthma were subjected to randomization in a 2:1 ratio to receive either add-on dupilumab 100/200 mg based on bodyweight or a placebo every 2 weeks for a total of 52 weeks. This study analyzed the spirometry parameters among children with type 2 asthma (baseline blood eosinophils ≥150 cells/μL or fractional exhaled nitric oxide [FeNO] ≥20 parts per billion [ppb]), as well as subgroups identified by baseline blood eosinophils or FeNO values.

At baseline, a total of 116 children (49%) who received dupilumab and 59 children (52%) who received placebo had impaired lung function (prebronchodilator percent-predicted forced expiratory volume in 1 second [ppFEV1] less than 80%). The administration of dupilumab resulted in significant improvements in pre- and postbronchodilator ppFEV1 as early as week 2, and these improvements were sustained for up to 52 weeks (the least squares mean difference versus placebo at week 52 was 7.79 percentage points ; 95% confidence interval [CI]: 4.36-11.22; P < .001) and 4.37 points (95% CI: 0.95-7.78; P = .01) for pre- and postbronchodilator measurements, respectively). Additionally, consistent improvements were observed in other lung function parameters, including pre- and postbronchodilator forced vital capacity (FVC), FEV₁/FVC ratio, and prebronchodilator forced expiratory flow, across all populations.

Thus, it can be concluded that dupilumab led to significant and sustained improvements in lung function across various measures in children (aged 6-11 years) with uncontrolled, moderate-to-severe type 2 asthma.

Effect of serum S100B level in the management of pediatric minor head trauma

A recent study demonstrated the efficacy of serum S100B level in managing pediatric minor head trauma through a decrease in the need for cranial computed tomographic (CCT) scans and hospital observation when monitored according to a specific clinical decision algorithm. This study’s findings were published in the journal, JAMA network open.

In this multicenter, prospective, interventional randomized clinical trial, children and adolescents aged 16 years or younger were enrolled. The control group [n= 926] underwent CCT scans or were hospitalized as per the prevailing recommendations. In the S100B biomonitoring group [n=1152], blood sampling was conducted within 3 hours after minor head trauma, and the subsequent management was contingent upon the levels of serum S100B protein. If the S100B level was within the reference range suitable for the child's age, they were discharged from the emergency department. Otherwise, they received the same treatment as the control group. The main outcome of the study was the proportion of patients who underwent CCT scans within 48 hours after experiencing a minor head trauma.

At the end of the study, 299 children (32.3%) in the control group and 112 (9.7%) in the S100B biomonitoring group underwent cranial CT scans. A substantial 50% decline in hospitalizations was observed in the S100B biomonitoring group (479 [41.6%] vs 849 [91.7%]).

Based on the above results, it can be concluded that implementation of S100B biomonitoring resulted in a decline in the number of CCT scans required and the duration of in-hospital monitoring when assessed based on the criteria outlined in a clinical decision algorithm.

Uncovering the future of pediatric research in India by addressing challenges and revealing opportunities

This study examined the present state of pediatric research in India, highlighting challenges like insufficient funding, lack of research facilities, complex regulatory systems, and the increasing prevalence of childhood obesity. Despite these challenges, there are many opportunities for improving child health outcomes through technological advancements. This study was published in the IP International Journal of Medical Paediatrics and Oncology.

This paper provides several applications for improving pediatric health outcomes. Artificial Intelligence (AI) holds very good scope in pediatric research to analyze data, predict disease conditions, and develop individualized treatment plans. It can be beneficial to analyze larger datasets to find out patterns associated with pediatric diseases for early detection and the development of personalized treatment strategies. Integrating AI into general pediatric research and its application can immensely improve healthcare accessibility in India, irrespective of dynamic social and economic scenarios.

Proteomics research allows us to better understand the structure and function of proteins in various diseases; hence, proteomics research is important for investigating disease mechanisms. Similarly, it can be used for monitoring disease susceptibility and progression, monitoring treatment effectiveness, and assessing the likelihood of exacerbations.

Microbiome research can help us to understand the impact of the microbiome on child health and shed light on the relationship between gut bacteria, the immune system, the central nervous system, and metabolic processes.

Nanotechnology opens new possibilities for targeted drug delivery and precision medicine among children. Engineered nanoparticles with increased efficacy and minimal systemic toxicity can be potentially used in the treatment of pediatric cancer and viral infectious diseases.

The use of advanced fetal imaging technology and early treatment can prevent congenital abnormalities. Adolescent health research can help to deal with mental health problems, nutrition deficiency problems, and lifestyle diseases that Indian teenagers are facing today.

Pediatric interventional radiology includes advanced imaging technologies to diagnose and treat various conditions by utilizing minimally invasive procedures with less recovery time and complications. Improving access to interventional radiology in India has the potential to widen treatment options for pediatric cardiac defects, birth defects, and cancer-related issues.

To conclude, pediatric research in India can be transformed by navigating current challenges and seizing emerging opportunities. The integration of AI, microbiome research, nanotechnology, interventional radiology, and the progress in fetal as well as adolescent health will cater for precise diagnosis and personalized treatment plans, leading to improved health outcomes in children and adolescents.

The efficacy of lubiprostone in the treatment of functional constipation in adolescents and children

A recent study has shown that lubiprostone is effective and has good tolerability as a pharmacotherapy for children and adolescents, offering a potential shift in the treatment approach for pediatric functional constipation (FC). This study’s findings were published in the Journal of Pediatric Gastroenterology and Nutrition.

This single-blinded, randomized controlled trial included 280 patients (aged 8-18 years) with FC. These patients were randomly assigned to receive either a weight-based lubiprostone dose (n = 140) or conventional laxatives (n = 140), which included bisacodyl, lactulose, or sodium picosulfate, for a duration of 12 weeks. Subsequently, a 4-week posttreatment follow-up was carried out.

The lubiprostone group demonstrated an improvement in constipation in 91.4% (128 patients) when compared to 34.3% (48 patients) in the conventional therapy group and persisted even after treatment discontinuation. Additionally, within 48 hours of starting the medication, one quarter of the lubiprostone group experienced their first spontaneous bowel movement. Throughout the last 4 weeks of therapy and the subsequent 4 weeks of follow-up, 75.7% of the lubiprostone group maintained a Bristol stool form of 3 or 4 compared to 35.7% (50 patients) in the conventional therapy group. No life-threatening adverse drug reactions were reported, and no patients discontinued treatment due to adverse effects.

Thus, it can be concluded that lubiprostone may be a well-tolerated and effective pharmacotherapy for children and adolescents, presenting a promising alternative in the management of pediatric functional constipation (FC).