Consequences of severe asthma exacerbations

Busse, William W.

doi:10.1097/aci.0000000000000870

Cited by 4 publications

(3 citation statements)

References 55 publications

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“…[28][29][30] Increasing lung function loss is caused by asthma exacerbations and is further affected by the escalation of airway inflammation that occurs during an asthma exacerbation. 31,32 In this study, a BDR ≥20% and severe asthma exacerbations were identified as predictors of aOR=adjusted odds ratio; BDR=bronchodilator responsiveness; CI=confidence interval; cOR=crude odds ratio; FEF 25- recurrent asthma exacerbations. However, only BDR ≥20% was identified as an independent predictor of asthma exacerbation.…”

Section: Discussionmentioning

confidence: 79%

Predictor of recurrent exacerbations in pediatric asthma

Tran,

Phan,

Vo-Pham-Minh

et al. 2024

Med J Indones

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BACKGROUND Asthma imposes a heavy morbidity burden during childhood. Severe persistent asthma significantly increases patients’ risk of exacerbations, hospital admissions, and mortality and often substantially impairs their quality of life. This study aimed to identify high-risk patients for exacerbation recurrence using spirometric parameters. METHODS A prospective cohort study involving patients with asthma aged 6–15 years was conducted at the principal children’s hospital in Mekong Delta, Vietnam, from June 2020 to June 2022. Demographic, clinical, and lung function characteristics of the patients were collected. Spirometry measurement parameters were utilized as predictive factors for the short-term asthma exacerbation recurrence. RESULTS Among all patients (mean age of 9.5 years old), 10.4% experienced recurrent exacerbations. FEV1, FVC, FEV1/FVC, FEF25–75, FEF25–75/FVC, and PEF, gradually decreased with increasing exacerbation severity (p<0.01). All patients showed a positive bronchodilator responsiveness (BDR), with a mean value of 16.85 (3.00)%, which was significantly different between the severe and non-severe asthma groups (20.53 [2.83] versus 16.00 [2.35], p<0.001). After adjusting in multivariable logistic regression, a BDR ≥20% was identified as the sole independent factor associated with an increased risk of asthma exacerbation recurrence (aOR 6.95, 95% CI 1.08–44.75, p = 0.041). CONCLUSIONS A high BDR can serve as a predictor of acute asthma exacerbation recurrence.

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Section: Discussionmentioning

confidence: 79%

Predictor of recurrent exacerbations in pediatric asthma

Tran,

Phan,

Vo-Pham-Minh

et al. 2024

Med J Indones

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“…SEA patients experience frequent exacerbations and often rely on high-dose OCS, which are strongly associated with major adverse events, in order to manage or prevent their occurrence [ 7 ]. Exacerbations are also associated with reduced pulmonary function and a significant increase in hospitalizations [ 5 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Achieving clinical outcomes with benralizumab in severe eosinophilic asthma patients in a real-world setting: ORBE II study

Padilla-Galo,

Moya Carmona,

Ausín

et al. 2023

Respir Res

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Background The ORBE II study aimed to describe the characteristics and clinical outcomes of adult patients with severe eosinophilic asthma (SEA) treated with benralizumab in a real-world setting in Spain. Methods ORBE II (NCT04648839) was an observational, retrospective cohort study in adult SEA patients who had been prescribed benralizumab. Demographic and clinical data of 204 SEA patients were collected 12 months prior to benralizumab initiation (baseline) and at follow-up. Exacerbation rate, asthma symptoms, maintenance oral corticosteroid (OCS) use and lung function were evaluated, among other variables. Results A total of 204 SEA patients were evaluated. Mean (standard deviation, SD) age of the study population was 56.4 (12.4) years, 62.3% were women and mean (SD) duration of asthma was 15.1 (12.7) years. Median (Q1–Q3) follow-up duration was 19.5 (14.2–24.2) months. At baseline, 72.6% of the overall population (OP) presented blood eosinophil counts ≥ 300 cells/µL; 36.8% had comorbid chronic rhinosinusitis with nasal polyps (CRSwNP); 84.8% reported at least one severe exacerbation, and 29.1% were OCS-dependent. At 1 year of follow-up, patients receiving benralizumab treatment had a 85.6% mean reduction in exacerbations from baseline, and 81.4% of patients achieved zero exacerbations. We also found a clinically relevant mean (SD) increase in pre-bronchodilator (BD) FEV1 of 331 (413) mL, with 66.7% of patients achieving a pre-BD FEV1 increase ≥ 100 mL, and 46.3% of patients achieving a pre-BD FEV1 ≥ 80% of predicted. Regarding symptom control, 73.8% of the OP obtained an ACT score ≥ 20 points. After 1 year of follow-up, mean reduction in the daily OCS dose was 70.5%, and complete OCS withdrawal was achieved by 52.8% of the OCS-dependent patients. Almost half (43.7%) of the OP on benralizumab met all four criteria for clinical remission. Patients with concomitant CRSwNP obtained similar or enhanced outcomes. Conclusions These data support the real-world benefits of benralizumab in SEA patients, and particularly in those with concomitant CRSwNP. Trial registration NCT04648839.

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“…Although these differences in improvements with tezepelumab versus placebo are of lower magnitude than those observed in patients with T2-high asthma, and the 95% confidence intervals include zero, it is important to note that the observed trends of improvement for these outcomes do not rule out meaningful improvement for individual patients. Additionally, asthma exacerbations are discrete events that are specific to asthma pathophysiology and are considered a major factor in asthma morbidity ( 5 ). However, assessments of patient-reported symptoms and HRQoL are inherently more variable and less precise, and clinical trial assessments are complicated by large improvements from baseline among placebo recipients.…”

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confidence: 99%