Asthma similarities across ProAR (Brazil) and U-BIOPRED (Europe) adult cohorts of contrasting locations, ethnicity and socioeconomic status

Abstract

Background: Asthma prevalence is 339 million globally. 'Severe asthma' (SA) comprises subjects with uncontrolled asthma despite proper management. Objectives: To compare asthma from diverse ethnicities and environments. Methods: A cross-sectional analysis of two adult cohorts, a Brazilian (ProAR) and a European (U-BIOPRED). U-BIOPRED comprised of 311 non-smoking with Severe Asthma (SAn), 110 smokers or ex-smokers with SA (SAs) and 88 mild to moderate asthmatics (MMA) while ProAR included 544 SA and 452 MMA. Although these projects were independent, there were similarities in objectives and methodology, with ProAR adopting operating procedures of U-BIOPRED. Results: Among SA subjects, age, weight, proportion of former smokers and FEV 1 pre-bronchodilator were similar. The proportion of SA with a positive skin prick tests (SPT) to aeroallergens, the scores of sino-nasal symptoms and quality of life were comparable. In addition, blood eosinophil counts (EOS) and the % of subjects with EOS > 300 cells/μl were not different. The Europeans with SA however, were more severe with a greater proportion of continuous oral corticosteroids (OCS), worse symptoms and more frequent exacerbations. FEV 1 /FVC pre-and post-bronchodilator were lower among the Europeans. The MMA cohorts were less comparable in control and treatment, but similar in the proportion of allergic rhinitis, gastroesophageal reflux disease and EOS >3%. Conclusions: ProAR and U-BIOPRED cohorts, with varying severity, ethnicity and environment have similarities, which provide the basis for global external validation of asthma phenotypes. This should stimulate collaboration between asthma consortia with the aim of understanding SA, which will lead to better management.

Oral health-related quality of life in individuals with severe asthma

“…Trata-se de um estudo transversal realizado entre fevereiro de 2017 e novembro de 2019. A amostra consistiu em 125 pacientes, em três grupos: o grupo de estudo, formado por 40 pacientes do Programa para o Controle da Asma na Bahia (ProAR) com asma não tratada previamente e considerada grave de acordo com definições anteriores de gravidade, (13) e dois grupos de comparação, um deles formado por 35 pacientes com asma leve a moderada (conforme a classificação da Global Initiative for Asthma) (14) (15) e pela European Association of Dental Public Health. (16) Embora não haja um ponto de corte de referência para a frequência de escovação, todos os pacientes são orientados a escovar os dentes após as refeições.…”

Genome-wide association study of asthma, total IgE, and lung function in a cohort of Peruvian children

“…The ProAR severe asthma case-control study 31 was carried out in the city of Salvador, Bahia, Brazil, in 2013. Adult individuals (aged >18 years) with no other lung diseases were recruited, and a total of 1065 individuals with FEV 1 percent predicted data available were included in the analysis.…”

Depression, suicidal motivation and suicidal ideation among individuals with asthma: a cross-sectional study

“…As part of the program, they receive free medication for asthma control, and they are assisted by a multiprofessional team. The phenotypes of these patients are untreated SA (before being enrolled in the program), difficult-to-treat SA and treatment resistant SA, but they do not make continuous use of oral corticosteroids (19). Neither does Montelukast make up our medication protocol for the treatment of asthma.…”

“…ProAR operates within the scope of the Unified Health System of Brazil (SUS). In the beginning of its activities, in 2003, patients enrolled were evaluated by specialists and were included if they presented SA according to contemporary classifications, as described in detail previously (19,20). Clinical symptoms such as cough, wheezing, dyspnea, and reversibility of symptoms using bronchodilators were considered, according to the Global Initiative for Asthma (GINA, 2012) (21).…”

“…Pregnant women, individuals with terminal diseases such as advanced neoplasms, with stroke, with congestive heart failure (CHF) syndrome, myopathies, lung diseases (beyond asthma) and other diseases that cause dyspnea, persons with allergy to medications available for asthma, as well as individuals with neurological and psychiatric problems were excluded (19).…”