Development and initial validation of the Asthma Severity Scoring System (ASSESS)

Fitzpatrick, Anne M.; Szefler, Stanley J.; Mauger, David T.; Phillips, Brenda R.; Denlinger, Loren C.; Moore, Wendy C.; Sorkness, Ronald L.; Wenzel, Sally E.; Gergen, Peter J.; Bleecker, Eugene R.; Castro, Mario; Erzurum, Serpil C.; Fahy, John V.; Gaston, Benjamin; Israel, Elliot; Levy, Bruce D.; Meyers, Deborah A.; Teague, W. Gerald; Bacharier, Leonard B.; Ly, Ngoc P.; Phipatanakul, Wanda; Ross, Kristie; Zein, Joe; Jarjour, Nizar N.

doi:10.1016/j.jaci.2019.09.018

Cited by 21 publications

(32 citation statements)

References 44 publications

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“…The GDG recommends re‐evaluation of response after 4‐6 months (conditional recommendation, expert opinion‐based). Of note, in some patients, exacerbations might not decrease significantly in this short period of time and a composite end point should be used to define response 158,159 . The definition of a suboptimal response relies on individualized predefined cut‐offs of the selected outcomes (conditional recommendation, expert opinion‐based).…”

Section: Clinical Decision Algorithm For the Initiation And Follow‐upmentioning

confidence: 99%

“…Of note, in some patients, exacerbations might not decrease significantly in this short period of time and a composite end point should be used to define response. 158,159 The definition of a suboptimal response relies on individualized predefined cut-offs of the selected outcomes (conditional recommendation, expert opinion-based). As there is no consensus or validated criteria to define response, the GDG recommends individualized predefined targets established by informed shared decision focused on the patient's goals to control their asthma, in alignment with the principles of personalized treatment.…”

Section: Clinic Al Decis Ion Algorithm For the Initiation And Follow-up Of B I Olog I C Al S For The Tre Atment Of Patients With Un Contrmentioning

confidence: 99%

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EAACI Biologicals Guidelines—Recommendations for severe asthma

Agache

Akdiş

et al. 2020

Allergy

204

179

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Severe asthma imposes a significant burden on patients, families and healthcare systems. Management is difficult, due to disease heterogeneity, co-morbidities, complexity in care pathways and differences between national or regional healthcare systems. Better understanding of the mechanisms has enabled a stratified approach to the management of severe asthma, supporting the use of targeted treatments with biologicals. However, there are still many issues that require further clarification. These include selection of a certain biological (as they all target overlapping disease phenotypes), the definition of response, strategies to enhance the responder rate, the duration of treatment and its regimen (in the clinic or home-based) and its costeffectiveness. The EAACI Guidelines on the use of biologicals in severe asthma follow the GRADE approach in formulating recommendations for each biological and each outcome. In addition, a management algorithm for the use of biologicals in the clinic is proposed, together with future approaches and research priorities.

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Section: Clinical Decision Algorithm For the Initiation And Follow‐upmentioning

confidence: 99%

Section: Clinic Al Decis Ion Algorithm For the Initiation And Follow-up Of B I Olog I C Al S For The Tre Atment Of Patients With Un Contrmentioning

confidence: 99%

EAACI Biologicals Guidelines—Recommendations for severe asthma

Agache

Akdiş

et al. 2020

Allergy

204

179

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“…How do we move from a global philosophy where management of acute attacks is the priority to one where longitudinal care or preferably prevention of symptom development is the rule? We now have measures of asthma burden such as the Composite Asthma Severity Index and Asthma Severity Scoring System 104‐106 and tools to predict who is at risk for seasonal exacerbations 36, 37 . These tools need studying and probably modifying in LMICs.…”

Section: Setting Standards and Improving Guidelines For Primary Carementioning

confidence: 99%

A worldwide charter for all children with asthma

Szefler

Fitzgerald

Adachi

et al. 2020

Pediatric Pulmonology

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Childhood asthma is a huge global health burden. The spectrum of disease, diagnosis, and management vary depending on where children live in the world and how their community can care for them. Global improvement in diagnosis and management has been unsatisfactory, despite ever more evidence‐based guidelines. Guidelines alone are insufficient and need supplementing by government support, changes in policy, access to diagnosis and effective therapy for all children, with research to improve implementation. We propose a worldwide charter for all children with asthma, a roadmap to better education and training which can be adapted for local use. It includes access to effective basic asthma medications. It is not about new expensive medications and biologics as much can be achieved without these. If implemented carefully, the overall cost of care is likely to fall and the global future health and life chance of children with asthma will greatly improve. The key to success will be community involvement together with the local and national development of asthma champions. We call on governments, institutions, and healthcare services to support its implementation.

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“… 28 Triamcinolone, a synthetic glucocorticoid, is used to treat autoimmune diseases, asthma, rheumatoid and arthritic conditions. 29 , 30 , 31 The beta-lactam antibiotic, Amoxicillin, inhibits transpeptidation required for bacterial cell membrane synthesis. 32 The loop diuretic, Hydrochlorothiazide, inhibits distal convoluted tubule renal sodium chloride transporter resulting in the loss of sodium and potassium, and reduction in blood pressure.…”

Section: Discussionmentioning

confidence: 99%

Drug repositioning candidates identified using in-silico quasi-quantum molecular simulation demonstrate reduced COVID-19 mortality in 1.5M patient records

Alamgir¹,

Yajima

Ergas³

et al. 2021

Preprint

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Background: Drug repositioning is a key component of COVID-19 pandemic response, through identification of existing drugs that can effectively disrupt COVID-19 disease processes, contributing valuable insights into disease pathways. Traditional non in silico drug repositioning approaches take substantial time and cost to discover effect and, crucially, to validate repositioned effects. Methods: Using a novel in-silico quasi-quantum molecular simulation platform that analyzes energies and electron densities of both target proteins and candidate interruption compounds on High Performance Computing (HPC), we identified a list of FDA-approved compounds with potential to interrupt specific SARS-CoV-2 proteins. Subsequently we used 1.5M patient records from the National COVID Cohort Collaborative to create matched cohorts to refine our in-silico hits to those candidates that show statistically significant clinical effect. Results: We identified four drugs, Metformin, Triamcinolone, Amoxicillin and Hydrochlorothiazide, that were associated with reduced mortality by 27%, 26%, 26%, and 23%, respectively, in COVID-19 patients. Conclusions: Together, these findings provide support to our hypothesis that in-silico simulation of active compounds against SARS-CoV-2 proteins followed by statistical analysis of electronic health data results in effective therapeutics identification.

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Development and initial validation of the Asthma Severity Scoring System (ASSESS)

Abstract: Symptom control (ACT score) (up to 6 points) Lung function (up to 3 points) Medications (up to 7 points) Exacerbations (up to 4 points)

Cited by 21 publications

References 44 publications

EAACI Biologicals Guidelines—Recommendations for severe asthma

EAACI Biologicals Guidelines—Recommendations for severe asthma

A worldwide charter for all children with asthma

Drug repositioning candidates identified using in-silico quasi-quantum molecular simulation demonstrate reduced COVID-19 mortality in 1.5M patient records

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