The burden of adult asthma in the United States: Evidence from the Medical Expenditure Panel Survey

Sullivan, Patrick W.; Ghushchyan, Vahram; Slejko, Julia F.; Belozeroff, Vasily; Globe, Denise; Lin, Shao-Lee

doi:10.1016/j.jaci.2010.10.042

Cited by 153 publications

(113 citation statements)

References 14 publications

(16 reference statements)

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“…Similarly, asthma affects 39.5 million Americans, including 29.0 million adults (3), and 300 million people worldwide (4). The annual U.S. medical expenditure attributable to asthma among adults is about $18 billion (5). The burden of depression and asthma in the United States is high (6,7).…”

Section: At a Glance Commentarymentioning

confidence: 99%

Depression and Risk of Incident Asthma in Adults. The CARDIA Study

Brunner

Schreiner

Sood

et al. 2014

Am J Respir Crit Care Med

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Rationale: Asthma is associated with depression, but the temporality of the association has not been established.Objectives: To examine the association between prevalent elevated depressive symptoms and incident asthma, and between prevalent asthma and incident elevated depressive symptoms in a cohort of young and middle-aged adults.Methods: We examined the longitudinal association between asthma and depressive symptoms bidirectionally in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort. First, 3,614 participants, free of asthma, were classified by elevated depressive symptoms at the CARDIA Year-5 exam (n = 856 elevated vs. 2,758 not elevated; ages 23-35 yr) and followed for 20 years to incident asthma. Then, 3,016 participants, free of elevated depressive symptoms, were classified by self-reported current asthma status (n = 188 prevalent vs. 2,828 not prevalent) at the CARDIA Year-5 exam and followed for 20 years until onset of elevated depressive symptoms. Measurements and Main Results:The relative hazard of incident asthma among those with elevated depressive symptoms was 1.26 (95% confidence interval [CI] = 1.02-1.56) after adjustment for covariates. When depressive status was modeled as the total number of reports of elevated depressive symptoms before the onset of asthma, the adjusted hazard ratio was 1.15 (95% CI = 1.02-1.29). The hazard of incident elevated depressive symptoms for those with asthma was no different than the hazard in those without asthma (adjusted hazard ratio = 0.92; 95% CI = 0.70-1.20).Conclusions: This longitudinal observational study points to depression as a marker of risk for incident adult-onset asthma. On the other hand, prevalent asthma is not associated with incident adultonset depression.

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Section: At a Glance Commentarymentioning

confidence: 99%

Depression and Risk of Incident Asthma in Adults. The CARDIA Study

Brunner

Schreiner

Sood

et al. 2014

Am J Respir Crit Care Med

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“…20 The total annual per patient costs of IBS-C found in this study are comparable with annual costs estimated for migraine patients 21 and comparable or higher than those for patients with asthma, although cost drivers may vary across therapeutic areas. 22,23 Mitra et al (2011) 11 also used migraine as a benchmark and found the adjusted 12-month all-cause health care charges for migraine patients to be much lower than those for IBS-C patients. These comparisons indicate IBS-C presents a similar, if not more costly, burden to the health care system compared with other chronic conditions for which there tends to be higher awareness among payers, further emphasizing the need to reduce health care costs associated with IBS-C.…”

Section: ■■ Discussionmentioning

confidence: 99%

Economic Burden of Irritable Bowel Syndrome with Constipation: A Retrospective Analysis of Health Care Costs in a Commercially Insured Population

Doshi¹,

Cai²,

Buono³

et al. 2014

JMCP

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“…Additionally, the production of IL-10 and TGF-b from Treg cells stimulates B cells to undergo class switching and produce the protective antibodies IgG 4 and IgA 2 . 31,32 Dendritic cells and oral mucosal Langerhans cells also play a role in the induction of tolerance, whereby they stimulate production of Treg subsets and are also able to directly secrete the key effector cytokines, IL-10 and TGF-b , when subjected to an allergen challenge.…”

Section: Mechanisms Of Allergic Reactions and Allergen-specific Immunmentioning

confidence: 99%

“…2,3 A recent estimate of the total national medical expenditure attributable to adult asthma was reported as $18 billion, with the largest contributors being prescription drugs and inpatient hospitalizations. 4,5 Although allergen avoidance is an integral component and step of therapy, it is often impractical and insuffi cient. As a consequence, the mainstay of allergic disease management has been pharmacotherapy, especially antihistamines, bronchodilators, and inhaled/intranasal corticosteroids, which are targeted to regulate infl ammation of the upper and lower airways.…”

mentioning

confidence: 99%

Allergen Immunotherapy in Allergic Respiratory Diseases

Viswanathan

Busse

2012

Chest

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Over the past 2 decades, the prevalence of allergic respiratory diseases has increased, in part refl ecting changes in lifestyle and environment that promote a T-helper (Th) 2 cell phenotype. 1 It has been estimated that up to 20% of the US and Western Europe populations may be affl icted by allergic respiratory diseases. 2,3 A recent estimate of the total national medical expenditure attributable to adult asthma was reported as $18 billion, with the largest contributors being prescription drugs and inpatient hospitalizations. 4,5 Although allergen avoidance is an integral component and step of therapy, it is often impractical and insuffi cient. As a consequence, the mainstay of allergic disease management has been pharmacotherapy, especially antihistamines, bronchodilators, and inhaled/intranasal corticosteroids, which are targeted to regulate infl ammation of the upper and lower airways. Although these treatments are effective and, in most cases, safe, they offer no lasting benefi t once treatment is stopped and have limited intrinsic disease-modifying effects. Moreover, it has become apparent that allergic diseases are the result of immune dysregulation and refl ect an impairment in the natural tolerance that develops to allergens. 6,7 Immunotherapy has the potential to modify fundamental, underlying disease mechanisms and to have, Allergen-specifi c immunotherapy (SIT) involves the repeated administration of allergenic extracts to atopic individuals over a period of 3 to 5 years either subcutaneously (SCIT) or sublingually (SLIT) for the treatment of allergic respiratory diseases, including asthma and allergic rhinitis (AR). In studies, SCIT and SLIT have been shown to improve existing symptoms of asthma and AR and to also have the capability to cause disease-modifying changes of the underlying atopic condition so as to prevent new allergic sensitization as well as arrest progression of AR to asthma. Recent evidence suggests that immunotherapy brings about these effects through actions that use T-regulatory cells and blocking antibodies such as IgG 4 and IgA 2, which can then result in an "immune deviation" from a T-helper (Th) 2 cell pattern to a Th1 cell pattern. Numerous meta-analyses and studies have been performed to evaluate the existing data among these studies, with the consensus recommendation favoring the use of immunotherapy because of its potential to modify existing diseases. Signifi cant adverse reactions can occur with immunotherapy, including anaphylaxis and, very rarely, death. A primary factor in considering SIT is its potential to provide longlasting effects that are able to be sustained well after its discontinuation. Given the signifi cant burden these allergic diseases impose on the health-care system, SIT appears to be a cost-effective adjunctive treatment in modifying the existing disease state. CHEST 2012; 141(5):1303-1314Abbreviations: AR 5 allergic rhinitis; BHR 5 bronchial hyperresponsiveness; PEF 5 peak expiratory fl ow; SCIT 5 subcutaneous immunotherapy; SIT 5 allergen-specifi c...

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The burden of adult asthma in the United States: Evidence from the Medical Expenditure Panel Survey

Cited by 153 publications

References 14 publications

Depression and Risk of Incident Asthma in Adults. The CARDIA Study

Depression and Risk of Incident Asthma in Adults. The CARDIA Study

Economic Burden of Irritable Bowel Syndrome with Constipation: A Retrospective Analysis of Health Care Costs in a Commercially Insured Population

Allergen Immunotherapy in Allergic Respiratory Diseases

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