{"doi":"10.1111/pai.14252","title":"Inhaled corticosteroid response in youth with asthma and history of child maltreatment","abstract":"Child maltreatment is associated with worse asthma outcomes.1, 2 We previously showed that increased distress from exposure to violence in the previous 6 months was associated with reduced growth in lung function in youth treated with low-dose inhaled corticosteroids (ICS) for 48 weeks. Based on prior findings, we assessed whether child maltreatment is linked to reduced ICS responsiveness in the Stress and Treatment Response in Puerto Rican and African American Children with Asthma study (STAR). In STAR, African American and Puerto Rican youth with asthma aged 8–20 years were recruited from Pittsburgh (Pennsylvania) and San Juan (Puerto Rico) from 2018 to 2022. All participants had physician-diagnosed mild to moderate persistent asthma and had not received any corticosteroids for ≥4 weeks. STAR was approved by the institutional review boards of the University of Puerto Rico and the University of Pittsburgh. Written parental consent and assent were obtained from participants <18 years, and written consent was obtained from participants ≥18 years. After a baseline visit, participants were treated with medium-dose inhaled mometasone (100 mcg, 2 puffs/day for children <12 years; and 200 mcg, 2 puffs/day for children ≥12 years) for 6 weeks. Participants received in-person education on proper inhaler use at three visits during the study, conducted 1 week before ICS was dispensed, when ICS was dispensed, and 2 weeks after ICS was dispensed. Treatment adherence was monitored weekly during the study by reviewing the metered dose inhaler (MDI) dose-counter during in-person visits and phone calls from study personnel. At baseline, participants completed the modified Traumatic Experiences Questionnaire (mTEQ), the Pediatric Asthma-specific Quality of Life Questionnaire (PAQLQ), and spirometry (conducted following ATS/ERS recommendations), and both the PAQLQ and spirometry were repeated at the 6-week visit. The mTEQ is a validated tool to assess physical and sexual abuse, and neglect.2 An individual could endorse ≥1 type of maltreatment. If abuse was suspected, a report was made to the Department of Family (in San Juan) or the Pennsylvania Department of Human Services (in Pittsburgh). The PAQLQ is a validated questionnaire (score: 1–7 points) to assess asthma-related quality of life. A change ≥0.5 points in the overall score is considered clinically relevant,3 and separate scores are provided for three subdomains (Activity, Emotional, and Symptoms). ICS responsiveness was defined as an increase ≥5% in FEV1 or ≥0.5 points in the PAQLQ after treatment. Of note, a recent multi-stakeholder working group identified the PAQLQ as a core outcome measure that should be used in clinical trials to evaluate treatment efficacy,4 and the PAQLQ was used as an outcome in the VOYAGE study evaluating dupilumab for treatment of asthma in children 6–11 years old.5 Logistic regression was used for the multivariable analysis. The mean age (SD) of the 138 participants was 14.2 ± 3.0 years. Of these participants, 47% were male, 66% were overweight or obese, and 40% had a parent who attended college. Further, 55/138 (39.9%) reported ≥1 type of child maltreatment, including 43 who reported physical abuse (31.2%), 5 who reported sexual abuse (3.6%), and 20 who reported neglect (14.5%). Median ICS adherence was 93% (interquartile range [IQR] = 80%–100%). There were no significant differences in baseline characteristics or in ICS adherence by history of child maltreatment (Table 1). Measures of ICS responsiveness in children with and without history of maltreatment are shown in Table 2. Compared with children without maltreatment history, those with maltreatment history had significantly lower median baseline PAQLQ score (5.82 vs. 6.26 points, p = .04) and higher improvement in PAQLQ score after ICS treatment (0.74 vs. 0.15 points, p < .0001) and were significantly more likely to have a relevant improvement in their overall PAQLQ score. Children with history of maltre","journal":"Pediatric Allergy and Immunology","year":2024,"id":504130,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9604,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1108100,"name":"Yueh Ying Han","orcid":null,"position":1,"is_corresponding":false},{"id":355639,"name":"F.J. Rosser","orcid":"0000-0003-1202-044X","position":2,"is_corresponding":false},{"id":277431,"name":"Erick Forno","orcid":"0000-0001-6497-9885","position":3,"is_corresponding":false},{"id":281738,"name":"Glorisa Canino","orcid":"0000-0003-1775-4020","position":4,"is_corresponding":false},{"id":363262,"name":"Anna L. Marsland","orcid":"0000-0001-8951-7513","position":5,"is_corresponding":false},{"id":88795,"name":"Juan C. Celedón","orcid":"0000-0002-6139-5320","position":6,"is_corresponding":false},{"id":558540,"name":"K.M. Gaietto","orcid":"0000-0002-4618-2984","position":0,"is_corresponding":true}],"reference_count":7,"raw_metadata":null,"created_at":"2026-07-19T02:10:35.597333Z","pmid":"39350699","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}