Use of Asthma Medications in African American Children With Sickle Cell Disease: A Single Center Experience.

Objective: To investigate use of asthma controller medications and their effect on lung function in pediatric patients with sickle cell disease (SCD).

Methods: Retrospective study in pediatric patients who self-identified as African American with SCD treated at Phoenix Children's between 2014 and 2021. Associations of asthma controller medications with changes in lung symptoms (cough, wheeze, chest pain, shortness of breath with exercise, sleep disturbance), Acute Chest Syndrome (ACS), and percent predicted probabilities (FEV₁, FVC, FEV₁/FVC, FEF_25%-75%)) were examined (Fisher exact, Wilcoxon rank sum) in SCD patients overall, and by physician-diagnosed asthma.

Results: Of the total 98 SCD patients, 28 (29%) had an asthma diagnosis and 76 (78%) were treatment naïve. During study follow-up, asthma controller medications were used by 57 (58%) patients (35 new prescriptions, 13 continued prescriptions and 9 with prescription escalation), with 41 patients remaining treatment naïve. Medication use vs non-use during follow-up improved cough (33% vs 7%, p = 0.002), chest pain (12% vs 5%, p = 0.03) and shortness of breath with exercise (32% vs 10%, p = 0.01) among all SCD patients. Medications also improved the mean relative percent change FEV₁ (12.3 vs -3.6; p < 0.0001), FVC (10.5 vs -1.3; p < 0.0001), and FEF_25%-75%, (20.6 vs -8.8; p < 0.0001), overall and in both asthmatics and non-asthmatics.

Conclusion: These findings demonstrate improved lung function and respiratory symptoms with asthma controller medications in pediatric patients with SCD, irrespective of an asthma diagnosis, and hold great promise for this undertreated population.