Journal of Asthma最新文献

{"title":"Long-term efficacy and safety of dupilumab in patients enrolled from Latin American centers from the open-label extension LIBERTY ASTHMA TRAVERSE study.","authors":"Abraham Alí Munive, Marco Antonio Fernández Corzo, Adrián Rendón, Daniela Cavalet Blanco, Martti A Antila, Patricia Fernández, Ana Stok, Jérôme Msihid, Christine Cazeau, Rebecca Gall, Harry J Sacks, Juby A Jacob-Nara, Jorge F Máspero","doi":"10.1080/02770903.2026.2696570","DOIUrl":"10.1080/02770903.2026.2696570","url":null,"abstract":"<p><strong>Objective: </strong>Uncontrolled asthma is common among Latin American patients. Dupilumab, a human monoclonal antibody, blocks the shared receptor component for interleukin (IL)-4 and IL-13, drivers of type 2 inflammation.</p><p><strong>Methods: </strong>This <i>post hoc</i> analysis of 48-96 week open-label extension TRAVERSE (NCT0213402) study assessed dupilumab 300 mg every 2 wk up to 148 wk (parent study plus extension) in patients with moderate-to-severe asthma enrolled from Latin American centers who previously completed a dupilumab asthma study (phase 2b or phase 3 QUEST). Endpoints included treatment-emergent adverse events, severe asthma exacerbations, pre-bronchodilator forced expiratory volume in 1 s (FEV₁), 5-Item Asthma Control Questionnaire (ACQ-5), Asthma Quality of Life Questionnaire (AQLQ), and type 2 biomarkers.</p><p><strong>Results: </strong>A total of 596 (28.9%) patients were enrolled from Latin American centers. Safety was consistent with the known dupilumab safety profile. Annualized rate of severe exacerbations remained low across patients (0.115-0.459). Improvements in pre-bronchodilator FEV₁ were sustained to Week 96 (mean change from parent study baseline of 0.28-0.35 L) and in ACQ-5 and AQLQ scores to Week 48 (last assessed time-point). Patients receiving placebo during parent studies demonstrated improvements once switched to dupilumab in TRAVERSE. Patients receiving dupilumab during parent studies demonstrated further improvements in exacerbations, ACQ-5, and AQLQ. Type 2 biomarkers decreased over time.</p><p><strong>Conclusions: </strong>Consistent with results in the overall population, long-term efficacy and safety of dupilumab was observed in patients with moderate-to-severe asthma with a treatment duration of up to 148 wk, supporting the long-term benefits of dupilumab use in Latin American patients.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1507-1518"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proton pump inhibitor target genes and asthma susceptibility: a Mendelian randomization study with identification of IL-2 as a potential mediator.","authors":"Lingwen Gu, Jinglin Li, Ziqian Yin, Dan Zhang, Jiang Wu","doi":"10.1080/02770903.2026.2700538","DOIUrl":"10.1080/02770903.2026.2700538","url":null,"abstract":"<p><strong>Objective: </strong>Previous observational studies on the relationship between proton pump inhibitors (PPIs) and asthma have yielded controversial results, with the underlying mechanisms remaining unclear. This study aimed to elucidate the causal relationship between PPIs and asthma using Mendelian randomization (MR) approaches.</p><p><strong>Methods: </strong>Instrumental variables proxying the expression of PPI target genes were derived from the eQTLGen Consortium and GTEx project. Asthma summary statistics were obtained from the Trans-National Asthma Genetic Consortium (TAGC) and FinnGen consortium. Drug-target MR and summary-data-based MR (SMR) analyses were employed to assess the causal associations between PPI target genes and asthma. Two-sample MR was further conducted to evaluate the causal effects of inflammatory proteins on asthma, followed by mediation analysis to explore potential mediators. A series of sensitivity analyses and colocalization analyses were performed to test the robustness of our findings.</p><p><strong>Results: </strong>Genetically proxied elevation of MAPT and DDAH1 levels was associated with an increased risk of asthma, while elevated AHR levels were linked to a decreased risk. The SMR analysis further supported the association between MAPT and asthma. We also identified causal associations between four inflammatory proteins and asthma. Mediation analysis suggested that interleukin-2 (IL-2) may serve as a potential mediator in the pathways from AHR and MAPT to asthma, with estimated mediation proportions of 26.5% and 28.7%, respectively.</p><p><strong>Conclusion: </strong>This study provides genetic evidence supporting causal links between PPI-related genes (AHR, DDAH1, MAPT) and asthma. IL-2 may play a mediating role in the pathways connecting AHR and MAPT to asthma, offering novel insights into the potential mechanisms underlying the PPI-asthma relationship.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1638-1649"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nasal eosinophilia as a noninvasive biomarker of type 2 inflammation and treatment response in children with asthma.","authors":"Martina Neuschlova, Peter Kunc, Marian Grendar, Renata Pecova","doi":"10.1080/02770903.2026.2696573","DOIUrl":"10.1080/02770903.2026.2696573","url":null,"abstract":"<p><strong>Methods: </strong>A total of 202 children aged 7-18 years were included in the study and stratified according to the treatment type and fractional exhaled nitric oxide (FeNO) values. Absolute peripheral blood eosinophil counts, nasal eosinophil percentages, FeNO levels and age were assessed.</p><p><strong>Results: </strong>Antihistamines and leukotriene receptor antagonists were associated with a significant reduction in nasal eosinophilia (<i>p</i> = 0.004 and <i>p</i> = 0.001, respectively), whereas inhaled corticosteroids showed no significant effect (<i>p</i> = 0.928). A significant positive association was demonstrated between FeNO levels and nasal eosinophilia (<i>p</i> < 0.001), while age showed a significant negative effect (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Nasal cytology may represent an easily applicable, and ethically acceptable tool for noninvasive monitoring local eosinophilic inflammation in pediatric asthma. Nasal eosinophilia appears to reflect dynamic airway inflammatory changes more directly than peripheral blood eosinophils and may be useful adjunctive marker for monitoring treatment-related changes and guiding personalized therapy.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1519-1530"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction.","authors":"","doi":"10.1080/02770903.2026.2742616","DOIUrl":"10.1080/02770903.2026.2742616","url":null,"abstract":"","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"i"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Mediterranean diet associated with severe asthma control? A multi-center cross-sectional study in Greece.","authors":"Maria Sfika, Maria-Iosifina Kasdagli, Konstantinos Bartziokas, Nikoleta Kosmidou, Evangelia Fouka, Konstantinos Porpodis, Nikoleta Bizymi, Katerina Antoniou, Nikolaos Tzanakis, Chrysoula Kontogianni, Konstantinos Samitas, Eleftherios Zervas, Christina Aggelopoulou, Konstantinos Exarchos, Athena Gogali, Konstantinos Kostikas, Lamprini Kontopoulou, Ourania S Kotsiou, Niki Papapostolou, Michael Makris, Miltiadis Markatos, Stylianos Vittorakis, Maria Kipourou, Konstantinos Katsoulis, Emmanouil Antonakis, Ilias Papanikolaou, Savvas Katsaridis, Paschalis Steiropoulos, Eleni Tzortzaki, Georgia Papaiakovou, Nikoletta Rovina, Pagona Lagiou, Androniki Naska, Stelios Loukides, Petros Bakakos","doi":"10.1080/02770903.2026.2696563","DOIUrl":"10.1080/02770903.2026.2696563","url":null,"abstract":"<p><strong>Background: </strong>Lifestyle choices may affect the pathogenesis and/or clinical expression of asthma. Certain dietary habits such as the Mediterranean diet (MD), possibly through pro-inflammatory effects may be implicated.</p><p><strong>Objective: </strong>To assess the association between adherence to MD and asthma control in severe asthmatics.</p><p><strong>Methods: </strong>During the period between March 2022 and 2023, patients with severe asthma from 16 pulmonary centers all over Greece were recruited. Adherence to MD was assessed through a short interviewer-administered questionnaire, the MD Adherence Screener, previously validated in Mediterranean populations. The level of asthma control was assessed by the Asthma Control Test. A multiple logistic regression model was applied, adjusting for gender, age, body mass index, corticosteroid intake, comorbidities, and treatment.</p><p><strong>Results: </strong>The study sample included 315 severe asthmatics (30% males) with mean age 56.6 years (standard deviation, S.D. = 14.3 years). There is an indication, albeit not statistically significant, that higher adherence to MD was associated with better asthma control in patients with severe asthma (OR: 1.19, 95% CIs: 0.61, 2.34). Furthermore, controlling for the patients' personal characteristics and dietary habits, other diet related conditions and metabolic diseases, such as obesity or diabetes, were significantly associated with poorer asthma control.</p><p><strong>Conclusions: </strong>In a cross-sectional study undertaken in a Mediterranean population, we observed a positive, but not statistically significant, association between higher adherence to MD and better asthma control in severe asthmatic patients. However, our findings are limited by the study design which does not allow us to infer causality and by the use of a screener to assess adherence to MD.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1488-1495"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors, preventive strategies, and long-term effects of lower respiratory tract infections in early childhood: a comprehensive review.","authors":"Arul Kiruba N M, Mary Minolin T, Mary Nithya P","doi":"10.1080/02770903.2026.2666102","DOIUrl":"10.1080/02770903.2026.2666102","url":null,"abstract":"<p><strong>Objective: </strong>To synthesize existing evidence on the risk factors, preventive measures, and long-term outcomes of lower respiratory tract infections (LRTIs) in early childhood, and to identify key gaps in research and policy.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Scopus, and Web of Science for studies published between January 2000 and August 2025, supplemented by reports from WHO, UNICEF, and the Global Burden of Disease (GBD) database. Eligible studies included randomized controlled trials, cohort, case-control, and cross-sectional studies, as well as systematic reviews involving children aged 0-5 years. Studies focused solely on acute treatment or adult populations were excluded.</p><p><strong>Results: </strong>Early-life LRTIs arise from interacting determinants, including prematurity, malnutrition, indoor air pollution, inadequate immunization, and socioeconomic inequities. Preventive strategies such as vaccination, maternal immunization, exclusive breastfeeding, micronutrient supplementation, and the use of clean fuels-significantly reduce childhood morbidity and mortality. Evidence also indicates long-term health consequences, including asthma, impaired lung function, neurodevelopmental delay, and increased cardiometabolic risk.</p><p><strong>Conclusions: </strong>Early-life LRTIs represent both an acute health burden and a determinant of lifelong respiratory and systemic outcomes. Expanding equitable vaccination coverage, improving maternal and child nutrition, reducing environmental exposures, and strengthening health-system capacity are essential to mitigate both short- and long-term global impacts.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1387-1398"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parent perspectives on the potential use of smart inhalers for asthma management in children: a qualitative interview study.","authors":"Lindsey Cooke, Natasha Noble, Jamie Bryant, Janine Curtis, Ellen Newman, Donna Vaughan, Nicholas Zwar, Bernadette Goddard, Simon Deeming, Christopher Oldmeadow, Joerg Mattes, Megan Freund","doi":"10.1080/02770903.2026.2751829","DOIUrl":"https://doi.org/10.1080/02770903.2026.2751829","url":null,"abstract":"<p><p>Achieving adequate adherence to preventer medication remains a challenge in the management of paediatric asthma. A minimum of 75% adherence is recommended to achieve adequate clinical control, however actual adherence rates are often lower and are influenced by the unpredictability of family life and competing demands. Smart inhalers aim to support adherence to preventer medications by monitoring use and providing medication reminders, as well as tracking reliever use. This study explored the perceptions of parents of children aged 5-9 years with recent uncontrolled asthma regarding the potential usefulness of smart inhalers to manage their children's asthma, and perceived barriers and facilitators to their use. Semi-structured interviews were conducted via Zoom with parents residing in New South Wales, Australia. Interviews explored parents' perspectives about barriers to asthma management, awareness and perceived need for smart inhalers, desired features and functionalities, attitudes towards data sharing, perceived support requirements and cost considerations. Data were analysed using a hybrid inductive analysis approach. Ten parents participated (children aged 5-8); none had previously used a smart inhaler to manage their child's asthma. Overall attitudes toward smart inhalers were positive. Four primary themes were identified: perceived benefits of smart inhalers, including access to reliable medication data to share with healthcare providers; barriers to adoption, including concerns about technology difficulties; cost considerations with affordability influencing the likelihood of uptake; and implementation needs including the need for support for initial set up. Parents generally viewed smart inhalers as a promising tool for managing childhood asthma. Study findings suggest that successful implementation will require consideration of cost, ease of use, and adequate support for use.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-15"},"PeriodicalIF":1.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Albuterol-Budesonide Versus Albuterol Alone in Asthma: A GRADE-assessed Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Zain Ul Abideen, Muhammad Farhan Ashraf, Sara Javed, Laiba Khalid, Muhammad Owais Malik, Neha Bhagwan das, Abida Ambreen, Taqwa Faheem, Amna Amir Jalal, Arsalan Ahmad","doi":"10.1080/02770903.2026.2751840","DOIUrl":"https://doi.org/10.1080/02770903.2026.2751840","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis evaluated the efficacy and safety of the recently FDA-approved fixed-dose combination of albuterol (a short-acting β₂-agonist) and budesonide (an inhaled corticosteroid) as a reliever therapy in patients with asthma.</p><p><strong>Data sources: </strong>A comprehensive literature search was conducted in PubMed, Cochrane Central Register of Controlled Trials, and Google Scholar from inception to the latest available date.</p><p><strong>Study selections: </strong>Randomized controlled trials (RCTs) enrolling patients aged ≥12 years with asthma and comparing albuterol-budesonide with albuterol alone or standard reliever therapy were included. Outcomes assessed were risk, number, and annual rate of severe exacerbations; lung function changes (forced expiratory volume in 1 second [FEV₁] at week 12); systemic corticosteroid exposure; and adverse events. Hazard ratios (HRs) were used for time-to-event data, relative risks (RRs) for dichotomous outcomes and mean differences (MDs) for continuous outcomes. Certainty of evidence was evaluated using the GRADE approach.</p><p><strong>Results: </strong>Three RCTs comprising 6,134 participants met the inclusion criteria. Albuterol-budesonide significantly reduced the risk (HR = 0.72; 95% CI: 0.58-0.89; p = 0.002), number (RR = 0.64; 95% CI: 0.49-0.82; p = 0.0006), and annual rate (RR = 0.68; 95% CI: 0.51-0.89; p = 0.006) of severe exacerbations. Significant improvements in FEV₁ were observed (MD = 80.19 mL; 95% CI: 46.46-113.92; p < 0.0001), alongside reduced annual systemic corticosteroid exposure (MD = -39.33 mg; 95% CI: -62.77 to -15.89; p = 0.001). Adverse events were comparable between groups (RR = 0.99; 95% CI: 0.94-1.04; p = 0.61). The certainty of evidence was moderate for the risk and annual rate of severe exacerbations and for corticosteroid exposure, low for the number of severe exacerbations and for FEV₁, and high for adverse events.</p><p><strong>Conclusion: </strong>Albuterol-budesonide significantly reduces severe asthma exacerbations and systemic corticosteroid use while improving lung function, supporting its use as an effective and safe reliever therapy in asthma management, although the small number of trials and the heterogeneity seen for some outcomes should be kept in mind.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-14"},"PeriodicalIF":1.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic patterns of asthma morbidity: a systematic review of Sand and dust storm (SDS) impacts in Asia.","authors":"Mohammad Reza Gonehgar, Maryam Sharif Shoushtari, Samira Ghobadzadeh, Kosar Ghorbanzade, Mohammad-Ali Assarehzadegan","doi":"10.1080/02770903.2026.2751845","DOIUrl":"10.1080/02770903.2026.2751845","url":null,"abstract":"<p><strong>Objective: </strong>Sand and Dust Storms (SDS) are prevalent in Asia, releasing fine particulate matter (PM₁₀ and PM_2.5) that pose significant risks to respiratory health, particularly for asthmatic populations. This systematic review evaluates the impact of SDS on asthma incidence, hospital admissions, and exacerbations across Asia, providing a basis for public health interventions.</p><p><strong>Data sources: </strong>We performed a systematic search in PubMed, EMBASE, Scopus, and Web of Science for studies published up to May 2023 using terms related to sand and dust storms, SDS, asthma, and respiratory health.</p><p><strong>Study selection: </strong>Thirty-three studies met the inclusion criteria, predominantly from Japan, Korea, and the Middle East. Cohort (<i>n</i> = 13; 39.4%) and panel designs (<i>n</i> = 12; 36.4%) were the frequent methodologies.</p><p><strong>Results: </strong>Findings consistently revealed a significant association between SDS and increased asthma exacerbations, hospital admissions, and emergency visits, peaking within 1-5 days post-exposure. Overall, the vast majority of the evaluated studies documented a positive association between SDS and asthma-related healthcare utilization, although the magnitude and statistical significance varied according to study designs and outcome definitions. The impact was disproportionately high among children and the elderly. Notably, studies from East Asia demonstrated more pronounced health impacts, including higher odds ratios and longer hospital stays, compared to the Middle East.</p><p><strong>Conclusion: </strong>SDS are a significant burden on respiratory health in Asia. Our findings underscore the need for targeted, region-specific public health strategies and improved air quality monitoring. However, results are subject to limitations, including significant study heterogeneity and potential language bias due to the exclusion of non-English publications.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-13"},"PeriodicalIF":1.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing Patterns of Diagnostic Testing in Children With Asthma: Evidence of Redistribution, Overuse, and Recovery After the COVID-19 Pandemic.","authors":"Jefferson Antonio Buendía","doi":"10.1080/02770903.2026.2751830","DOIUrl":"https://doi.org/10.1080/02770903.2026.2751830","url":null,"abstract":"<p><strong>Background: </strong>Real-world implementation of diagnostic strategies in pediatric asthma remains heterogeneous, and the long-term impact of the COVID-19 pandemic on diagnostic practice patterns is incompletely understood, particularly in middle-income countries. Guideline-recommended objective testing (e.g., spirometry) is inconsistently applied in pediatric asthma worldwide, and whether the COVID-19 pandemic produced a transient disruption or a lasting restructuring of diagnostic practice across testing domains remains unclear. We aimed to characterize longitudinal trends in diagnostic testing among children with asthma, examining pre-pandemic trajectories, COVID-associated changes, and post-pandemic recovery.</p><p><strong>Methods: </strong>We conducted a nationwide population-based interrupted time-series study using Colombia's mandatory healthcare registry (2015-2024). Asthma encounters were identified using ICD-10 codes (J45-J46). Diagnostic procedures were classified into nine clinically defined domains. Diagnostic intensity was calculated as tests per 100 asthma encounters. Segmented regression estimated pre-pandemic trends, immediate 2020 level changes, and post-pandemic slope modifications.</p><p><strong>Results: </strong>A total of 1,954,680 asthma encounters generated 117,324 diagnostic tests. Pre-pandemic trajectories diverged across domains. Pulmonary function testing (PFT) declined before 2020 (IRR 0.80; 95% CI 0.74-0.86) but showed a significant immediate increase in 2020 (IRR 1.42; 95% CI 1.28-1.57) and sustained post-pandemic acceleration (IRR 1.17; 95% CI 1.09-1.26). Imaging and sleep studies exhibited sharp pandemic-associated declines with partial or full recovery. Cardiopulmonary testing demonstrated marked pre-pandemic expansion (IRR 1.96).</p><p><strong>Conclusions: </strong>Pediatric asthma diagnostic practice underwent domain-specific restructuring rather than uniform disruption, consistent with a process of diagnostic redistribution across testing domains. Post-pandemic intensification of PFT may reflect improved adherence to objective diagnostic confirmation, whereas persistent contraction in selected domains warrants continued monitoring.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-15"},"PeriodicalIF":1.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}