Severe Asthma

Thomson, Carey C.; Welsh, Carolyn H.; Carno, Margaret; Wenzel, Sally E.; Chung, Fan; Brožek, Jan; Wilson, Kevin C.

doi:10.1513/annalsats.201405-199cme

Cited by 10 publications

(5 citation statements)

References 2 publications

(1 reference statement)

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“…A 6-year-old boy with severe asthma 7 presented with a history of anaphylaxis to milk, egg, fish, nuts, shrimp, soy, and peanut. He had been diagnosed with asthma at age 4, treated with montelukast, salmeterol, and fluticasone (up to 500 mg/day) for 18 months, and despite good pharmacological compliance 8 uncontrolled.…”

Section: Case Reportmentioning

confidence: 99%

IgE Immunoadsorption Knocks Down the Risk of Food-Related Anaphylaxis

Dahdah

Ceccarelli²,

Amendola

et al. 2015

Pediatrics

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The effects of an immunoadsorption procedure, specifically designed to remove immunoglobulin E (IgE), on food-induced anaphylaxis have never been evaluated. We evaluate the effects of IgE removal on the allergic thresholds to foods. A 6-year-old boy with anaphylaxis to multiple foods and steroid-resistant unstable allergic asthma displayed serum IgE levels of 2800 to 3500 kU/L. To lower IgE serum concentrations, which could be overridden by a high dose of omalizumab, 1.5 plasma volumes were exchanged in 8 apheresis sessions. During the procedure, serum IgE levels fell to 309 kU/L. After the procedure, the threshold of reactivity to baked milk increased from 0.125 to 5 g of milk protein (full tolerance) after the first session, and the threshold of reactivity to hazelnut increased from 0.037 to 0.142 g of protein after the first session, 0.377 g after the eighth, and 1.067 g (full tolerance) after the first administration of omalizumab. Immediately after the sixth IgE immunoadsorption, we started omalizumab therapy. In the next 40 days, the threshold of reactivity to hazelnut increased to 7.730 (full tolerance). Asthma control was obtained, treatment with montelukast was stopped, and fluticasone was tapered from 500 to 175 μg/day. The boy became partially or fully tolerant to all the tested foods, and quality of life was improved. IgE immunoadsorption, used to establish the starting basis for omalizumab administration, is able to increase the tolerance threshold to foods.

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Section: Case Reportmentioning

confidence: 99%

IgE Immunoadsorption Knocks Down the Risk of Food-Related Anaphylaxis

Dahdah

Ceccarelli²,

Amendola

et al. 2015

Pediatrics

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“…Only patients who, after an extensive assessment addressing these issues, still need high-intensity inhaled treatment or systemic corticosteroids to prevent their asthma from becoming uncontrolled or who remain uncontrolled despite this therapy should be labelled as "severe refractory" asthma patients, and are candidate for novel therapeutic approaches [3,4]. Therefore, in patients presenting with chronic severe asthma symptoms, a systematic approach, preferably multidisciplinary [5], is recommended by all international severe asthma guidelines [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

A 1-day visit in a severe asthma centre: effect on asthma control, quality of life and healthcare use

et al. 2016

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Patients with uncontrolled asthma report ongoing symptoms, poor quality-of-life and extensive healthcare use (HCU) and might benefit from management by a specialised severe asthma team. It is unknown whether a one-time evaluation by asthma experts, without long-term supervision by a specialised team, provides favourable outcomes. We evaluated asthma control (Asthma Control Questionnaire; ACQ), quality-of-life (Asthma-related Quality of Life Questionnaire; AQLQ) and HCU before and 1 year after a 1-day visit programme in a severe asthma centre, including a multidisciplinary assessment resulting in a personalised management plan to be implemented by patients own pulmonologists.40 uncontrolled asthma patients completed questionnaires (ACQ, AQLQ, HCU) at baseline, and 6 and 12 months follow-up.ACQ improved from 2.6 (interquartile range 1.7-3.2) to 1.8 (1.2-3.2) (p=0.003) and AQLQ from 4.8 (4.0-5.2) to 5.3 (4.4-6.0) (p<0.001). We found a reduction in patients with ≥2 exacerbations (95% versus 17%; p<0.001), ≥1 emergency room visit (78% versus 37%; p<0.001) and ≥1 hospitalisation (47% versus 10%; p=0.001).Evaluation of uncontrolled asthma patients in a 1-day visit programme in a severe asthma centre resulted in significant improvements in asthma control, quality-of-life and healthcare use after 1 year. This 1-day visit approach seems beneficial for uncontrolled asthma patients and might reduce their dependence on expensive treatment modalities and long-term management in specialised centres.

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“…Asthma, a chronic inflammatory disease that affects the airways, is characterized by variable degrees of airflow obstruction, recurrent wheezing, shortness of breath, tightness in the chest, chronic cough, and sputum production. Severe asthma is defined as a condition (a) requires treatment with high-dose inhaled corticosteroids plus a second controller during the full previous year and/or systemic corticosteroids during 50% or more of the previous year to prevent symptoms from becoming “uncontrolled”, or (b) remains “uncontrolled” despite this therapy ( 1 ). Severe asthma is associated with airway inflammation and remodeling ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Editorial: Airway remodeling in asthma—what is new?

Yamasaki¹

2023

Front. Allergy

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Severe Asthma

Cited by 10 publications

References 2 publications

IgE Immunoadsorption Knocks Down the Risk of Food-Related Anaphylaxis

IgE Immunoadsorption Knocks Down the Risk of Food-Related Anaphylaxis

A 1-day visit in a severe asthma centre: effect on asthma control, quality of life and healthcare use

Editorial: Airway remodeling in asthma—what is new?

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