Severe asthma in adults: What are the important questions?

Chanez, Pascal; Wenzel, Sally E.; Anderson, Gary P.; Antó, Josep M; Bel, Elisabeth H.; Boulet, Louis‐Philippe; Brightling, Christopher E.; Busse, William W.; Castro, Mario; Dahlén, B.; Dahlén, Sven Erik; Fabbri, Leonardo M.; Holgate, Stephen T.; Humbert, Marc; Gaga, Mina; Joos, Guy; Levy, Bruce D.; Rabe, Klaus F.; Sterk, Peter J.; Wilson, Susan J.; Vachier, Isabelle

doi:10.1016/j.jaci.2006.11.702

Cited by 258 publications

(223 citation statements)

References 117 publications

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“…5(3), (2011) Asthma is a common airway inflammatory disorder characterized by variable airway obstruction and hyperresponsiveness [301]. Asthma is of variable severity and is increasingly recognized as a condition presenting as various phenotypes [1,2]. Asthma control is the main goal of therapy and is achieved when the disease results in minimal or no symptoms, normal sleep and activities, and optimal pulmonary function [3,4].…”

Section: Reviewmentioning

confidence: 99%

“…Depression may affect control of asthma in reducing adherence to the treatment and follow-up. However, more severe forms of psychopathology, such as bipolar disorder, personality disorders and schizophrenia do not seem more frequent in asthma [2,123]. Psychological conditions may affect asthma in modulating symptoms' report or perception, or in influencing medication compliance and follow-up, disease assessment and self-monitoring and they are associated with more frequent urgent care and hospitalizations [124][125][126][127].…”

Section: Psychopathologiesmentioning

confidence: 99%

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Asthma-related comorbidities

Boulet¹,

Boulay²

2011

Expert Review of Respiratory Medicine

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214

147

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Section: Reviewmentioning

confidence: 99%

Section: Psychopathologiesmentioning

confidence: 99%

Asthma-related comorbidities

Boulet¹,

Boulay²

2011

Expert Review of Respiratory Medicine

Self Cite

214

147

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“…In Finland and several European counties, improvements in asthma care during the last two decades have resulted in cost savings at both societal and patient levels, despite the increasing number of asthma patients [2–5]. However, many severe asthma patients are still uncontrolled [6,7], and asthma imposes a high burden on health care systems and on society [1,8]. …”

Section: Introductionmentioning

confidence: 99%

Health care resource utilization and characteristics of patients with eosinophilic asthma in secondary health care in Finland

Mäkelä

Christensen

Karlsson

et al. 2018

European Clinical Respiratory Journal

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Background: Eosinophilic airway inflammation is common in asthma patients and appears to be associated with severe exacerbations and loss of asthma control. Objective: To describe the resource utilization and clinical characteristics of patients with eosinophilic asthma. Design: Asthma patients ≥18 years with ≥1 blood eosinophil count in secondary care (South West Finland) during 2003‒2013 were included. Clinical characteristics (age, lung function, body mass index, and comorbidities) and asthma-related resource utilization (hospital admissions, outpatient visits, and emergency room [ER] visits) were retrieved. Resource utilization rates were compared for patients with blood eosinophil ≤ or >300 cells/μL, using adjusted negative binomial regression models. Results: Overall, 4,357 eligible patients were identified (mean age 60 years, females 68%), of which 1,927 (44%) had >300 eosinophil cells/μL blood. Patients with ≤300 and >300 eosinophil counts, exhibited similar clinical characteristics, including advanced age, poor lung function, and overweight. Comorbidities such as pneumonia, sinusitis, and nasal polyps, were more frequent among those with >300 eosinophil cells/μL blood compared with patients with lower counts. Eosinophil counts >300 cells/μL were associated with greater hospital admissions (rate ratio [RR] [95% confidence interval CI]: 1.13 [1.02;1.24]) and outpatient visits (RR [95% CI]: 1.11 [1.03;1.20]) compared with patients with lower eosinophil counts. Rates of ER visits were similar between the patient groups (RR [95% CI]: 0.99 [0.87;1.12]). Conclusions: Hospital admissions and outpatient visits occurred more often for patients with eosinophil counts >300 cells/µL, than for patients with lower eosinophil counts. Routine blood eosinophil screening might be useful to identify patients with an eosinophilic phenotype eligible for more targeted treatments.

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“…Il semble acquis que l'asthme sévère (voir Encadré) représente la forme clinique pour laquelle inflammation et remodelage des bronches s'intriquent. C'est sur ces mécanismes qu'il faut envisager d'agir pour mieux contrôler la maladie de ces patients et en modifier le pronostic [3]. Pour étudier les phénomènes du remodelage bronchique en clinique, il existe plusieurs approches [3].…”

Section: L'asthme Et Sa Mesure Clinique : La Fonction Respiratoire Lunclassified

“…C'est sur ces mécanismes qu'il faut envisager d'agir pour mieux contrôler la maladie de ces patients et en modifier le pronostic [3]. Pour étudier les phénomènes du remodelage bronchique en clinique, il existe plusieurs approches [3]. Mais c'est indiscutablement l'apport de la biopsie endobronchique obtenue relativement aisément au cours d'une fibroscopie souple qui a réellement fait progresser ce domaine.…”

Section: L'asthme Et Sa Mesure Clinique : La Fonction Respiratoire Lunclassified