Risk Factors for Frequent Severe Exacerbations in Late-Onset Eosinophilic Asthma

Identification of phenotypic clusters of nonsteroidal anti-inflammatory drugs exacerbated respiratory disease

“…It has been reported that NERD present with moderate‐to‐severe asthma . Patients with a higher endoscopy score of the paranasal sinuses, a lower lung function, a higher blood eosinophil count, and a more frequent OCS/ICS use suffer from more frequent asthma exacerbations . In the present study, although %fall of FEV1 after Lys‐ASA BPT and PC 20 methacholine values were not significantly different among the four subtypes, the baseline FEV1% value was lower in subtypes 1, 2, and 3 compared to subtype 4.…”

Exacerbation-prone asthma in the context of race and ancestry in Asthma Clinical Research Network trials

“…1,[4][5][6][7][8]42 Both sinus disease and GERD were unique risk factors in black subjects but have consistently been associated with exacerbation risk in multiple asthma cohorts. 6,12,42,43 The role of these comorbid conditions in determining asthma exacerbations in black subjects is unclear, but genetic African ancestry has been associated with IgE levels in different Hispanic asthma cohorts of African descent, suggesting mechanisms related to allergic inflammation in subjects of African descent. 17,18,24 High-throughput genotyping has provided an unprecedented opportunity for ancestry-based genetic studies in diverse cohorts to precisely and objectively define genetic ancestry to improve our understanding of how genetic variation from a common ancestry associates with disease outcomes.…”

“…1,[4][5][6][7][8][9] Recently, we identified a black, exacerbation-prone asthma subgroup from a randomized trial cohort that was best characterized by subjects with an asthma exacerbation in the prior year and lower lung function, factors also associated with exacerbations in other cohorts. [10][11][12][13] Post hoc analyses of National Heart, Lung, and Blood Institute (NHLBI)-sponsored Asthma Clinical Research Network (ACRN) and AsthmaNet clinical trial cohorts have shown that African American subjects have lower lung function, a greater proportion of uncontrolled asthma, and a greater likelihood of treatment failure compared with their white counterparts. 14,15 Race and ethnic designations do not sufficiently capture the ancestral genetic, cultural, geographic, or socioeconomic contexts that underlie differences in asthma severity between racial groups.…”

ERS/EAACI statement on severe exacerbations in asthma in adults: facts, priorities and key research questions

“…For this purpose, multiple initiatives have investigated and weighed the importance of individual traits in predicting recurrent exacerbations. Many other characteristics and conditions have also been reported, such as amount of asthma medication, comorbidities including obesity, occupational stress [31], sensitisation, indoor and outdoor pollution, small airway dysfunction [32], loss of lung elastic recoil [33], and psychological factors [29,[34][35][36][37][38][39][40][41][42][43][44]. Retrospective studies have shown that repeated assessment of composite scores of control, such as the Asthma Control Test or Asthma Control Questionnaire, and other tools, such as eHealth and mHealth [45], may predict severe exacerbations [46].…”