Incidence and risk factors of frequent asthma exacerbations in a multinational, multidatabase cohort study

Background: There is sparse real world evidence on the incidence and risk factors of frequent exacerbations in asthmatic patients.Aim: To assess incidence and risk factors of frequent exacerbations in asthmatic patients.Methods: Asthma patients aged ≥18 yrs with ≥1 year of follow-up were identified through the EU-ADR alliance in primary care databases from the Netherlands (IPCI), Italy (HSD), UK (CPRD) and Spain (SIDIAP) and secondary care Aarhus database in Denmark in the period 2008-2013. Patients were categorised into frequent exacerbators (FE) (≥2 severe exacerbations in the year following studystart) or non-FE (
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: General practice and primary care Source Type: research

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Poor control in patients with difficult-to-treat asthma might be due to several factors, including poor adherence and undertreated asthma co-morbidities. After an assessment addressing these issues, only few patients still need targeted therapy.We aimed to evaluate the effect of a multidimensional intervention in improvement asthma control in patients with difficult asthma.Fifty patients with difficult asthma were prospectively included in this study conducted in AbderrahmenMami hospital between March 2018 and September 2018. Clinical, biological and functional characteristics were collected. Then, coexisting conditions (p...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Airway pharmacology and treatment Source Type: research
Asthma control changes over time and many factors contribute to this variability. Environmental exposures such as seasonal allergen fluctuations, second-hand tobacco exposure, and viral upper respiratory tract infections (RTI) are just a few of the known triggers of lability 1. In addition, host factors such as inhaler technique and co-morbid conditions including atopic diseases, obesity, and acid reflux can also contribute to this changeability. During times of lability, overzealous intervention can lead to overuse of oral corticosteroids (OCS) and healthcare visits, while delayed treatment can lead to severe exacerbation...
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: Review Source Type: research
Gastro-oesophageal reflux disease (GORD) has long been associated with poor asthma control without an established cause-effect relationship.610 asthmatics (421 severe/88 mild-moderate) and 101 healthy controls were assessed clinically and a subset of 154 severe asthmatics underwent proteomic analysis of induced sputum using untargeted mass spectrometry, LC-IMS-MSE. Univariate and multiple logistic regression analyses (MLR) were conducted to identify proteins associated with GORD in this cohort.When compared to mild/moderate asthmatics and healthy individuals, respectively, GORD was three- and ten-fold more prevalent in sev...
Source: Respiratory Medicine - Category: Respiratory Medicine Authors: Source Type: research
Conclusion: Obese asthmatics appear to perceive their symptoms as more severe, have a greater prevalence of functional co-morbidities and lose a greater number of days to illness, but have lower airway inflammation as assessed by FeNO. Different mechanisms may be driving symptoms in Obese-Difficult Asthma, requiring specific assessment and management strategies.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical Problems Source Type: research
Abstract BACKGROUND: Despite adding Omalizumab to conventional therapy, several severe asthmatics still show poor disease control. We investigated the factors that may affect a reduced Omalizumab response in a large population of severe asthmatics. METHODS: 340 patients were retrospectively evaluated. FEV1%, FVC%, Asthma Control Test (ACT), fractional exhaled nitric oxide (FENO), possible step-downs/step-ups of concomitant therapies, exacerbations, disease control levels, ICS doses and SABA use, observed at the end of treatment, were considered as a response to Omalizumab. RESULTS: Age was an independent...
Source: European Journal of Internal Medicine - Category: Internal Medicine Authors: Tags: Eur J Intern Med Source Type: research
Conclusion: Highly prevalent uncontrolled asthma and its wide variability is a health issue in mainland China. It is necessary to improve asthma care through the implementation of optional management and addressing comorbidities.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Monitoring Airway Disease Source Type: research
ConclusionsAn international effort in the implementation of SUA patients registries could help to better understand the clinical features and to manage severe asthma, representing a non negligible socio‐economic burden for health services.This article is protected by copyright. All rights reserved.
Source: Allergy - Category: Allergy & Immunology Authors: Tags: Original Article: Airway Diseases Source Type: research
Conclusions Almost all patients with difficult-to-control asthma have comorbidities, in particular asthmatic women of older age, former smokers, and asthmatics who are prednisone dependent. Recognition of these typical characteristics can help physicians in the diagnostic workup, so that adequate preventive measures can be taken.
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Conclusions Routinely collected data could be used proactively via automated searches to identify individuals at risk of recurrent asthma attacks. Further research is needed to assess the impact of such knowledge on clinical prognosis.
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Conclusion: For the 1st time we have demonstrated that dysphonia occurring in asthmatic women who used inhaled corticosteroids was mostly due to a functional mechanism and not as a consequence of organic lesions (like inflammation or mycosis).
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 5.1 Airway Pharmacology and Treatment Source Type: research
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