5. Strengths and limitations
The French CobraPed cohort has
enrolled a subsequent and well-characterized population.
In particular, preschoolers
represent a significant number, of whom 61 could be included in the
cluster analysis on the basis of positivity to at least one c-sIgE,
providing more information than previously (10). However, this study had
several limitations. We excluded patients receiving the anti-IgE
omalizumab. Although the biological rationale behind this choice is
clear, we excluded severe asthmatic patients, often highly atopic with
multiple sensitizations (30,31). However, because omalizumab was mostly
offered to school-age children, per guidelines, the results for the
preschoolers was not influenced by this bias. In addition, we applied a
strict definition for SRW and SA based on the current guidelines at the
time of enrollment (12). Consequently, the patients with SRW/SA had a
high burden, with frequent symptoms, exacerbations, and alteration of
lung function and were representative of these children.