GEMA 5.3. Spanish Guideline on the Management of Asthma

Plaza Moral, Vicente; Alobid, Isam; Álvarez Rodríguez, Cesáreo; Blanco Aparicio, Marina; Ferreira, Jorge; García, Gabriel; Gómez-Outes, Antonio; Garín Escrivá, Noé; Gómez Ruiz, Fernando; Hidalgo Requena, Antonio; Korta Murua, Javier; Molina París, Jesús; Pellegrini Belinchón, Francisco Javier; Plaza Zamora, Javier; Praena Crespo, Manuel; Quirce Gancedo, Santiago; Sanz Ortega, José; Soto Campos, José Gregorio

doi:10.1016/j.opresp.2023.100277

Cited by 16 publications

(10 citation statements)

References 1,084 publications

(1,266 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Standards indications for each biologic according to the 2023 Spanish Guideline on the Management of Asthma [ 20 ] are as follows: (1) Omalizumab: severe persistent allergic asthma who have a positive skin test or in vitro reactivity to perennial aeroallergens and with reduced lung function (FEV 1 < 80%) as well as frequent symptoms during the day or awakenings at night and who have had multiple documented severe asthma exacerbations, despite using daily high-dose inhaled corticosteroids, plus a long-acting inhaled beta2-agonist and a total IgE between 70 and 1500 KU/L; and (2) Benralizumab and mepolizumab: uncontrolled severe asthma with an eosinophilic phenotype. The predictive biomarker which has showed a higher efficacy has been an eosinophilia >150 eosinophils/µL in peripheral blood and a determination of >300 eosinophils/µL in any moment of the last 12 months.…”

Section: Methodsmentioning

confidence: 99%

Clinical characteristics of complete responders versus non-complete responders to omalizumab, benralizumab and mepolizumab in patients with severe asthma: a long-term retrospective analysis

Basagaña,

Martínez-Rivera,

Padró

et al. 2024

Annals of Medicine

View full text Add to dashboard Cite

Background Some patients with severe asthma may benefit from treatment with biologics, but evidence has been mostly collected from randomized controlled trials (RCTs), in which patients’ characteristics are different from those encountered in asthma patients in the real-world setting. The aim of this study was to describe the clinical features of complete responders versus non-complete responders to long-term treatment with biologics in patients with severe asthma attended in routine daily practice. Methods Data of a cohort of 90 patients with severe asthma who were treated with biologics (omalizumab, benralizumab, and mepolizumab) for at least 12 months and were followed up to March 2022. Data recorded included clinical characteristics and effectiveness of treatment (exacerbation, Asthma Control Test [ACT] score, lung function, use of maintenance oral corticosteroids [mOCS]), FeNO, and blood eosinophils at baseline, at 12 months, and at the end of follow-up. Complete response is considered if, in addition to not presenting exacerbations or the use of mOCS, the ACT score was >20 and, the FEV 1 >80% predicted. Results An improvement in all asthma control parameters was observed after 12 months of treatment and a mean follow-up of 55 months. After 12 months of treatment 27.2% of patients met the criteria of complete response and this percentage even increased to 35.3% at the end of follow-up. Long-term complete response was associated to better lung function with mepolizumab and omalizumab treatment and to less previous exacerbations in the benralizumab group. The main cause of not achieving a complete response was the persistence of an airflow obstructive pattern. Conclusions This study shows that omalizumab, benralizumab, and mepolizumab improved the clinical outcomes of patients with severe asthma in a clinic environment with similar effect sizes to RCTs in the long term follow-up. Airflow obstruction, however, was a predictor of a non-complete response to biologics.

show abstract

Section: Methodsmentioning

confidence: 99%

Clinical characteristics of complete responders versus non-complete responders to omalizumab, benralizumab and mepolizumab in patients with severe asthma: a long-term retrospective analysis

Basagaña,

Martínez-Rivera,

Padró

et al. 2024

Annals of Medicine

View full text Add to dashboard Cite

show abstract

“…The remaining 20% of the cohort includes patients with severe asthma (GINA 27,28 step 5) recruited from the outpatient of Severe Asthma Unit of the Pulmonology Department of Hospital Clinic de Barcelona (HCB) following similar steps.…”

Section: Methods and Analysismentioning

confidence: 99%

Protocol for the Enhanced Management of Multimorbid Patients with Chronic Pulmonary Diseases: Role of Indoor Air Quality

Gómez-López,

Arismendi,

Cano

et al. 2024

Preprint

View full text Add to dashboard Cite

Introduction: Reducing unplanned hospital admissions in chronic patients at risk is a key area for action due to the high healthcare and societal burden of the phenomenon. The inconclusive results of preventive strategies in patients with chronic respiratory disorders and comorbidities are explainable by multifactorial but actionable factors. The current protocol (January 2024 to December 2025) relies on the hypothesis that intertwined actions in four dimensions: i) management change, ii) personalisation of the interventions based on early detection/treatment of acute episodes and enhanced management of comorbidities, iii) mature digital support, and iv) comprehensive assessment, can effectively overcome most of the limitations shown by previous preventive strategies. Accordingly, the main objective is to implement a novel integrated care preventive service for enhanced management of these patients, as well as to evaluate its potential for value generation. Methods and analysis: At the end of 2024, the specifics of the novel service will be defined through the articulation of its four main components: i) Enhanced lung function testing through oscillometry, ii) Continuous monitoring of indoor air quality as a potential triggering factor, iii) Digital support with an adaptive case management approach, and iv) Predictive modelling for early identification and management of exacerbations. During 2025, the novel service will be assessed using a Quintuple Aim approach. Moreover, the Consolidated Framework for Implementation Research will be applied to assess the implementation. The service components will be articulated through four sequential six-months Plan-Do-Study-Act cycles. Each cycle involves a targeted co-creation process following a mixed-methods approach with the active participation of patients, health professionals, managers, and digital experts. Ethics and dissemination: The Ethics Committee for Human Research at Hospital Clinic de Barcelona approved the protocol on June 29, 2023 (HCB/2023/0126). Before any procedure, all patients in the study must sign an informed consent form. Registration:NCT06421402. Keywords: COPD, Severe Asthma, Digital Support, Integrated Care, Quintuple Aim, Service Assessment

show abstract

“…Common aspects across definitions include absence of exacerbations, assessing symptom control with questionnaires like ACT or ACQ, discontinuing systemic glucocorticoid therapy, and evaluating treatment effects on lung function. Authors vary in their opinions on the impact of drugs on lung function, with some emphasizing maintaining FEV1 more than 80% and others highlighting the need for stabilization [18][19][20].…”

Section: Clinical Remissionmentioning

confidence: 99%

“…In Germany, new asthma guidelines published in March 2023 define clinical remission as meeting four criteria over at least 12 months: no exacerbations, no systemic steroid use, absence of asthmarelated symptoms, and stable lung function [18]. Spanish guidelines for asthma management (GEMA 5.3), released in May 2023, introduce two types of remission [19].…”

Section: National Asthma Registries and Clinical Remissionmentioning

confidence: 99%

Clinical remission in severe asthma: lights and shadows on an ambitious goal

Pelaia,

Zannoni,

Paoletti

et al. 2024

Current Opinion in Allergy &Amp; Clinical Immunology

View full text Add to dashboard Cite

Purpose of review The aim of this study was Describe the latest evidence related to the concept of clinical remission in patients with severe asthma, focusing on the lights and shadows of this concept. Recent findings The idea of clinical remission in severe asthma patients brings about a significant shift in the way asthma is treated and managed. Although there has yet to be unanimous agreement among various scientific societies on the precise definition, this concept can be extremely useful in advancing the treatment of the disease. Summary Asthma is a common respiratory condition that affects more than 300 million people globally. It has variable symptoms and severity levels, with about 10% of patients experiencing severe asthma. While there have been advancements in treatment, severe asthma poses significant challenges. Recent approaches have focused on achieving clinical remission, which goes beyond symptom control to address underlying inflammation and biological processes. Clinical remission criteria include the absence of symptoms, reduced medication usage, and normalized inflammatory markers. Various biologic therapies show promise, with some patients achieving remission. However, remission's definition varies globally, hindering standardization and a valid comparison. Standardizing remission criteria and refining predictive factors are crucial for effective asthma management. Overall, achieving clinical remission offers hope for improved long-term outcomes in severe asthma patients.

show abstract

GEMA 5.3. Spanish Guideline on the Management of Asthma

Cited by 16 publications

References 1,084 publications

Clinical characteristics of complete responders versus non-complete responders to omalizumab, benralizumab and mepolizumab in patients with severe asthma: a long-term retrospective analysis

Clinical characteristics of complete responders versus non-complete responders to omalizumab, benralizumab and mepolizumab in patients with severe asthma: a long-term retrospective analysis

Protocol for the Enhanced Management of Multimorbid Patients with Chronic Pulmonary Diseases: Role of Indoor Air Quality

Clinical remission in severe asthma: lights and shadows on an ambitious goal

Contact Info

Product

Resources

About