Uniform definition of asthma severity, control, and exacerbations: Document presented for the World Health Organization Consultation on Severe Asthma

Bousquet, Jean; Mantzouranis, Eva; Cruz, Álvaro Augusto; Aït-Khaled, N; Baena-Cagnani, Carlos E.; Bleecker, Eugene R.; Brightling, Christopher E.; Burney, Peter; Bush, Andrew; Busse, William W.; Casale, Thomas B.; Chan‐Yeung, Moira; Chen, Rongchang; Chowdhury, Badrul A.; Chung, Kian Fan; Dahl, Ronald; Drazen, Jeffrey M.; Fabbri, Leonardo M.; Holgate, Stephen T.; Kauffmann, F.; Haahtela, Tari; Khaltaev, Nikolaï; Kiley, James P.; Masjedi, Mohammad Reza; Mohammad, Yousser; O'Byrne, Paul M.; Partridge, Martyn R; Rabe, Klaus F.; Togias, Alkis; Weel, Chris van; Wenzel, Sally E.; Zhong, Nanshan; Zuberbier, Torsten

doi:10.1016/j.jaci.2010.07.019

Cited by 629 publications

(556 citation statements)

References 89 publications

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“…The hypothesis for this absence of trend for asthma control is that the association observed for uncontrolled asthma was mainly due to exacerbations which are not part of the definition of partly controlled asthma. Asthma control consists of two main domains: 1) lack of impairment (absence of symptoms, minimal treatment use, normal activity level and lung function level); and 2) lack of future risk to the patient (absence of asthma exacerbations, prevention of accelerated decline in lung function over time and no side-effects from medications) [4,11]. It has been suggested that exacerbations should be considered separately from current clinical control because they may occur even if the patient has adequate current control of symptoms and few activity limitations [4].…”

Section: Figurementioning

confidence: 99%

“…Despite the importance of the separate concepts of asthma severity, which reflects the intrinsic severity of the disease, and asthma control, which reflects the activity of the disease over a short period, the terminology applied is often used interchangeably and is not standardised [4]. Asthma severity is difficult to define in epidemiology [4,5] and the definitions used are not always adequate [3]. Recent guidelines have moved away from the concept of severity to focus more on asthma control [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…Asthma severity is difficult to define in epidemiology [4,5] and the definitions used are not always adequate [3]. Recent guidelines have moved away from the concept of severity to focus more on asthma control [3,4].…”

Section: Introductionmentioning

confidence: 99%

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Occupational exposures and uncontrolled adult-onset asthma in the European Community Respiratory Health Survey II

Moual¹,

Carsin²,

Siroux³

et al. 2013

European Respiratory Journal

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Occupational exposure is a well-recognised modifiable risk factor for asthma, but the relationship between occupational exposure and asthma control has not been studied. We aimed to study this association among working-age adults from the European Community Respiratory Health Survey (ECRHS).Data were available for 7077 participants (mean age 43 years, 45% never-smokers, 5867 without asthma and 1210 with current asthma). Associations between occupational exposure to specific asthmagens and asthma control status (33% with uncontrolled asthma, based on the Global Initiative for Asthma guidelines) were evaluated using logistic and multinomial regressions, adjusted for age, sex and smoking status, with study areas included as a random effect.Statistically significant positive associations were observed between uncontrolled adult-onset asthma and both past 12-month and 10-year exposure to any occupational asthmagens (OR (95% CI) 1.6 (1.0-2.40) and 1.7 (1.2-2.5), respectively); high (1.7 (1.0-2.8) and 1.9 (1.3-2.9), respectively) and low (1.6 (1.0-2.7) and 1.8 (1.2-2.7), respectively) molecular weight agents; and cleaning agents (2.0 (1.1-3.6) and 2.3 (1.4-3.6), respectively), with stronger associations for long-term exposures. These associations were mainly explained by the exacerbation domain of asthma control and no associations were observed between asthmagens and partly controlled asthma.These findings suggest that occupational exposure to asthmagens is associated with uncontrolled adult-onset asthma. Occupational risk factors should be quickly identified to prevent uncontrolled asthma. @ERSpublications Occupational exposure to asthmagens is associated with uncontrolled adult-onset asthma in ECRHS II

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Section: Figurementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Occupational exposures and uncontrolled adult-onset asthma in the European Community Respiratory Health Survey II

Moual¹,

Carsin²,

Siroux³

et al. 2013

European Respiratory Journal

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“…These symptoms wax and wane over time. Its prevalence ranges from 1% to 18% of the population in different countries, and are severe in 10% of the population (1). According to the World Health Organization, 15 million disability years are lost due to asthma.…”

Section: Introductionmentioning

confidence: 99%

Bronchial thermoplasty: a non‐pharmacological approach

Singh

Tiwari

2015

Clinical Respiratory J

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Introduction: Asthma is a chronic inflammatory disorder of the airway characterized by the episodic symptoms of breathlessness, wheezes and cough. Even with the use of maximum anti-asthmatic pharmacological treatment sometimes it remains uncontrolled. For such patients, bronchial thermoplasty is the new mode of treatment.Objective: To review published article on bronchial thermoplasty. Methods: We identified 102 English articles on PubMed, and 56 were excluded by the abstract. The remaining articles were retrieved for full-text detailed evaluation by authors, and 28 relevant articles were selected for final review. Results: Bronchial thermoplasty is the radiofrequency ablation of the airway smooth muscle with the help of flexible fiberoptic bronchoscope. It reduces the smooth muscle mass of the bronchial wall and decreases its contractility. Conclusion: Bronchial thermoplasty causes improvement in the quality of life, and causes reduction in the emergency room visit and exacerbation due to asthma. Long-term safety has been established by various prospective studies.

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“…Asthma affects about 300 million people of all ages and ethnic groups worldwide [1], with an estimated increase in prevalence to 400 million by 2025 [2]. The economic burden in terms of direct (hospitalization, use of emergency room visits, therapy) and indirect (missed days of work/school) costs adds to the emotional, physical and social impact of asthma, with consequent quality of life deterioration for both patients and their families [3].…”

Section: Introductionmentioning

confidence: 99%

Fluticasone propionate/formoterol: A fixed-combination therapy with flexible dosage

Papi

Blasi

Canonica

et al. 2014

European Journal of Internal Medicine

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International guidelines describe asthma control as the main outcome of asthma management. Prevention of symptoms, improved quality of life, and reduction of exacerbations are the main components, consequently decreasing health care costs. However, many of these objectives remain unmet in real life: several surveys show that a large proportion of asthmatic patients are not well controlled despite the efficacy of current available treatment. Several randomized controlled clinical trials indicate that combining inhaled corticosteroids and long-acting β 2 -agonists, by means of a single inhaler, greatly improves the management of the disease. The results of 9 multicenter phase III clinical studies demonstrate that the fixed combination of fluticasone propionate/formoterol in a single inhaler is effective in terms of lung function and symptom control. These studies highlight the dose flexibility, safety and tolerability of this new inhaled combination. These characteristics meet the recommendations of international guidelines, and the preferences of respiratory physicians who identified these aspects as critical components of a successful asthma therapy. Combination of fluticasone propionate/formoterol in a single inhaler provides potent anti-inflammatory activity of fluticasone propionate and rapid onset of action of the β 2 -agonist formoterol making this association a viable treatment option both in terms of effectiveness and compliance.

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Uniform definition of asthma severity, control, and exacerbations: Document presented for the World Health Organization Consultation on Severe Asthma

Cited by 629 publications

References 89 publications

Occupational exposures and uncontrolled adult-onset asthma in the European Community Respiratory Health Survey II

Occupational exposures and uncontrolled adult-onset asthma in the European Community Respiratory Health Survey II

Bronchial thermoplasty: a non‐pharmacological approach

Fluticasone propionate/formoterol: A fixed-combination therapy with flexible dosage

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