Phenotyping to Target Obstructive Sleep Apnoea Syndrom (OSAS) in adults patients with severe asthma

Portel, L.; Parrat, Éric; Nocent-Ejnaini, C.; Mangiapan, G.; Prudhomme, A.; Oster, Jean-Philippe; Vecchi, Corinne Aperre de; Maurer, C.; Debieuvre, D.

doi:10.1016/j.resmer.2022.100888

Cited by 6 publications

(2 citation statements)

References 17 publications

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“…It is generally accepted that GERD is more common in patients with ‘difficult-to-control’ asthma than in patients with well-controlled asthma. 30,31 Conversely, patients with GERD are reported to have significantly worse asthma control (based on the Asthma control test) than patients without GERD. It has previously been suggested that obesity, OSA and GERD are collinear comorbidities in severe asthma.…”

Section: Discussionmentioning

confidence: 99%

Improvement in severe asthma patients receiving biologics and factors associated with persistent insufficient control: a real-life national study

Guilleminault,

Camus,

Raherison-Semjen

et al. 2023

Ther Adv Respir Dis

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Background: Biological therapies have revolutionized the treatment of severe asthma with type 2 inflammation. Although such treatments are very effective in reducing exacerbation and the dose of oral steroids, little is known about the persistence of symptoms in severe asthma patients treated with biologics. Purpose: We aim to describe asthma control and healthcare consumption of severe asthma patients treated with biologics. Design: The Second Souffle study is a real-life prospective observational study endorsed by the Clinical Research Initiative in Severe Asthma: a Lever for Innovation & Science Network. Methods: Adults with a confirmed diagnosis of severe asthma for at least 12 months’ duration were enrolled in the study. A self-administered questionnaire including the Asthma Control Questionnaire (ACQ), Asthma Quality of Life Questionnaire (AQLQ) and a compliance evaluation test was given to the patients. Healthcare consumption within 12 months prior to enrolment was documented. In patients receiving biologics, doctors indicated whether the patients were biologic responders or non-responders. Results: The characteristics of 431 patients with severe asthma were analysed. Among them, 409 patients (94.9%) presented asthma with type 2 inflammation (T2 high) profile, and 297 (72.6%) patients with a T2 high phenotype were treated with a biologic. Physicians estimated that 88.2% of patients receiving biologics were responders. However, asthma control was only achieved in 25.3% of those patients (ACQ > 0.75). A high proportion of patients (77.8%) identified as responders to biologics were not controlled according to the ACQ score. About 50% of patients continue to use oral corticosteroids either daily (25.2%) or more than three times a year for at least three consecutive days (25.6%). Gastro-oesophageal Reflux Disease (GERD) and Obstructive Sleep Apnoea syndrome (OSA) were identified as independent factors associated with uncontrolled asthma. Conclusion: Although a high proportion of severe asthma patients respond to biologics, only 25.3% have controlled asthma. GERD and OSA are independent factors of uncontrolled asthma.

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Section: Discussionmentioning

confidence: 99%

Improvement in severe asthma patients receiving biologics and factors associated with persistent insufficient control: a real-life national study

Guilleminault,

Camus,

Raherison-Semjen

et al. 2023

Ther Adv Respir Dis

Self Cite

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“…The reference tools for OSAS diagnosis are clinical polysomnography or nocturnal portable multi-channel monitoring. Frequently, continuous positive airway pressure (CPAP) therapy is the first treatment for a patient ( 5 , 6 ). Long-term CPAP treatment may present limited compliance, and there is no unanimous opinion on other alternative treatments for OSAS in literature on the subject.…”

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confidence: 99%