P207 Symptoms, asthma control, lung function, and corticosteroid sparing following omalizumab initiation in allergic asthma patients

Abstract Background Investigating the endotypes of the different asthma phenotypes would help disease monitoring, prognosis determination, and improving asthma management standardization. This study aimed to classify asthma into four endotypes according to the allergic and eosinophilic characteristics and explore the phenotypes (clinical characteristics, pulmonary functions, and fractional expired nitric oxide (FeNO)) of each endotype. Methods This retrospective study included non-acute asthma patients treated at the First Hospital of Shanxi Medical University (05/2016–01/2018). The patients were classified into the eosinophilic allergic, eosinophilic non-allergic, non-eosinophilic allergic, and non-eosinophilic non-allergic asthma endotypes. Serum sIgE, lung function, FeNO, and induced sputum cytology were tested and compared among groups. Results Of the 171 included patients, 22 had eosinophilic allergic asthma, 17 had eosinophilic non-allergic asthma, 66 had non-eosinophilic allergic asthma, and 66 had non-eosinophilic non-allergic asthma. Lung function measurements (FEV1%, FEF25%, FEF50%, FEF75%, and FEF25–75%) showed that airway dysfunction was worse in eosinophilic non-allergic asthma than in the other three endotypes (all P < 0.001). In allergic asthma patients, eosinophilic asthma had worse airway dysfunction than non-eosinophilic asthma (all P < 0.05). Similar results were found in non-allergic asthma (all P < 0.01). The FeNO levels in eosinophilic allergic asthma were higher than in eosinophilic non-allergic and non-eosinophilic non-allergic asthma (both P = 0.001). Conclusions FeNO can objectively reflect eosinophilic airway inflammation in asthma. Endotypic classification of asthma patients regarding the allergic and eosinophilic characteristics is conducive to the effective management of patients with asthma.

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Assessment of disease control in patients with asthma

Medicina ◽

10.3390/medicina45120121 ◽

2009 ◽

Vol 45 (12) ◽

pp. 943 ◽

Cited By ~ 1

Author(s):

Guoda Pilkauskaitė ◽

Kęstutis Malakauskas ◽

Raimundas Sakalauskas

Keyword(s):

Lung Function ◽

Asthma Control ◽

Control Level ◽

Asthma Management ◽

Control Test ◽

Uncontrolled Asthma ◽

Asthma Control Test ◽

Inhaled Steroids ◽

Asthma Patients ◽

Β2 Agonists

International guidelines indicate that the main criterion of asthma management is asthma control level. The aim of this study was to assess asthma control and its relation with age, gender, and lung function. Material and methods. A total of 106 family physicians and 13 pulmonologists and allergists took part in this study. Each doctor had selected 10–15 asthma patients and had sent invitations to them by post. On the visit day, the patients themselves filled in the Asthma Control Test. The doctors interviewed the patients and filled in a special questionnaire. Pulmonologists and allergists also assessed lung function by performing spirometry. According to the results of the Asthma Control Test, the disease control level was indicated as “totally controlled” (25 points), “well controlled” (24–20 points), and “uncontrolled” (19 points or less). Results. A total of 876 asthma patients were examined. Uncontrolled asthma was diagnosed to 56.2% of the patients, 36.5% of patients had well controlled and 7.3% totally controlled asthma. There was no significant difference in asthma control level comparing men and women. A correlation between asthma control level and age was found revealing poorer asthma control in older patients. Ninety-five percent of patients were treated with inhaled steroids; most of them had used inhaled steroids in combination with long-acting β2 agonists. It was found that lung function correlated with clinical symptoms of asthma, the demand of shortacting β2 agonists, and asthma control level. Conclusion. The study showed that uncontrolled asthma was diagnosed to more than half of the patients, despite most of them used inhaled steroids. Asthma control was worsening with the age of patients with asthma and it correlated with lung function. We suggest that periodical assessment of asthma control should help to optimize asthma management.

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Long-term efficacy and safety of omalizumab in patients with allergic asthma: A real-life study

Allergy and Asthma Proceedings ◽

10.2500/aap.2021.42.210014 ◽

2021 ◽

Vol 42 (3) ◽

pp. 235-242 ◽

Cited By ~ 1

Author(s):

Andriana I. Papaioannou ◽

Myrto Mplizou ◽

Konstantinos Porpodis ◽

Evangelia Fouka ◽

Eleftherios Zervas ◽

...

Keyword(s):

Lung Function ◽

Adverse Events ◽

Allergic Asthma ◽

Asthma Control ◽

Real Life ◽

Efficacy And Safety ◽

Life Study ◽

Long Term Treatment ◽

Real Life Study

Background: The efficacy and safety of omalizumab in patients with severe allergic asthma have been established in both randomized controlled trials and real-life studies. Objective: To evaluate the sustained effectiveness and safety of long-term treatment with omalizumab in a real-world setting. Methods: In this retrospective study, we included patients treated with omalizumab for at least 8 years in four asthma clinics in Greece. Pulmonary function, asthma control, oral corticosteroids (OCS) dose, and exacerbations were recorded before treatment, 6 months later, and annually thereafter. Adverse events were also recorded. Results: Forty-five patients (66.7% women), mean ± standard deviation (SD) age 55.3 ± 12.2 years, were included. The duration of treatment with omalizumab was 10.6 ± 1.2 years. The annual exacerbation rate decreased from 4.1 before omalizumab initiation to 1.1 after 1 year of treatment and remained low up to the 8th year of treatment (p < 0.001). From the 19 patients who were receiving OCS at baseline, 21.1% patients discontinued after 6 months, 47.4% were still on OCS after 4 years of therapy, and 31.6% were on OCS after 8 years. With regard to the OCS dose, 36.8% of the patients reduced the dose ≥ 50% after 6 months and 68.4% achieved 50% reduction after 2 years. The mean daily OCS dose before omalizumab initiation was 7.8 mg of prednisolone or the equivalent, reduced to 4.7 mg/day after 6 months, which reached 1.6 mg/day after 8 years (p < 0.001). Treatment with omalizumab resulted in significant improvements of asthma control and lung function. No severe adverse events were reported. Conclusion: In this real-life study, omalizumab resulted in significant and sustained improvements in asthma exacerbations, asthma control, and lung function, and had a steroid sparing effect and a good safety profile.

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Does unified allergic airway disease impact on lung function and type 2 biomarkers?

Allergy Asthma & Clinical Immunology ◽

10.1186/s13223-019-0388-4 ◽

2019 ◽

Vol 15 (1) ◽

Author(s):

Chris RuiWen Kuo ◽

Rory Chan ◽

Brian Lipworth

Keyword(s):

Allergic Rhinitis ◽

Lung Function ◽

Allergic Asthma ◽

Asthma Control ◽

Persistent Asthma ◽

Airway Disease ◽

Allergic Airway Disease ◽

Positive Skin Prick Test ◽

Positive Skin

AbstractThe concept of the unified allergic airway disease (UAD) recognises the association between allergic inflammation in the upper and lower airways. Patients with asthma and concomitant allergic rhinitis experience more asthma-related primary and secondary care visits. We therefore aimed to determine differences in asthma control (asthma control questionnaire ACQ-6), lung function (spirometry) and T2 biomarkers (FeNO and Eos) in relation to the presence of allergic rhinitis in patients with allergic asthma. Retrospectively, we evaluated a cohort of 60 consecutive patients with persistent asthma attending our research unit for screening into clinical trials. All included subjects were receiving inhaled corticosteroids (ICS) and had a positive skin prick test (SPT) to at least one common aeroallergen to fulfil the criterion of allergic asthma. Patients with UAD had a diagnosis of allergic asthma in addition to established concomitant allergic rhinitis. T2 biomarkers were significantly higher in patients with allergic rhinitis in contrast to those without. FEV1 % predicted and FEF25-75 % predicted were also significantly lower in patients with concomitant allergic rhinitis. However, there was no difference in ACQ-6 observed between groups. In summary, patients with allergic asthma, the presence of concomitant allergic rhinitis is associated with worse lung function and higher type 2 biomarkers.

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Correlation of illness perception, asthma control, and lung function value to the quality of life of asthma outpatients

Farmasains Jurnal Farmasi dan Ilmu Kesehatan ◽

10.22219/farmasains.v4i1.10176 ◽

2019 ◽

Vol 4 (1) ◽

pp. 43

Author(s):

Nadia Aisah Mayzika ◽

Asri Wido Mukti

Keyword(s):

Quality Of Life ◽

Lung Function ◽

Asthma Control ◽

Illness Perception ◽

Life Quality ◽

Equation Modeling ◽

Asthmatic Patients ◽

Asthma Patients ◽

The Relationship

Asthma is a heterogeneous disease and chronic inflammation of the respiratory tract that has an impact on the decreased quality of life. The design of this research is non-experimental cross-sectional. The variables of this study are illness perception, control of asthma, lung function values, and life quality of asthma patients. The relationship of asthma control, illness perception, lung function value, and life quality of asthma patients can be seen with structural equation modeling using Smart-PLS software. The results are only control of asthma affects life quality, where the coefficient value is 0.511, which is positive and significant (p = 0,000). Lung function value and asthma quality indicate that lung function has a positive relationship direction seen from the coefficient value of 0.306 but not significant (p = 0.061). The correlation between illness perception and life quality of asthma was negative, where the coefficient value was - 0.142 and not significantly different (p = 0.332). This means that the direction of the relationship is reversed; it means the quality of life of asthmatic patients, which affects illness perception by 14.2%. The conclusion is that the life quality of asthmatic patients is influenced by the control of asthma and lung function. But it’s different from illness perception, where there is a negative relationship between illness perception and life quality of asthma patients. Which means illness perception affects the life quality of asthma patients.

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Clinical Experience with Anti-IgE Monoclonal Antibody (Omalizumab) In Paediatric Severe Allergic Asthma – A Romanian Perspective

10.20944/preprints202110.0160.v1 ◽

2021 ◽

Author(s):

Berghea Elena Camelia ◽

Mihaela Balgradean ◽

Carmen Pavelescu ◽

Catalin Cirstoveanu ◽

Claudia Toma ◽

...

Keyword(s):

Monoclonal Antibody ◽

Lung Function ◽

Allergic Asthma ◽

Asthma Control ◽

Immunoglobulin E ◽

Real Life ◽

First Year ◽

Severe Exacerbation ◽

Exacerbation Rate ◽

Severe Allergic Asthma

Background: Asthma is the most common chronic disease affecting children and altering their quality of life. The severity of asthma is often modulated by immunoglobulin E (IgE)-mediated allergen sensitization and is associated with comorbid allergic dis-eases. Omalizumab is a humanized monoclonal antibody anti-IgE, the first biological therapy approved to treat patients aged ≥6 years with severe allergic asthma. The primary objective of our study was to investigate the efficacy and safety of Omali-zumab in Romanian paediatric patients with severe allergic asthma. Methods: In this observational real-life study, 12 children aged 6 to 18 years, (mean age 12.4 years ) with severe allergic asthma received Omalizumab as an add-on treatment. The levels of asthma control, exacerbations, lung function and adverse events were evaluated at baseline and after the first year of treatment. Results: We noticed general improvements in total asthma symptom scores and the rate of exacerbation of severe asthma. Omalizumab increased the initial variables of lung function, and no serious adverse reactions were reported. FEV1 improved statistically significant after one year of treatment with Omalizumab, [ΔFEV1 (% pred.) =18.3, and similarly, ΔMEF50 (%) = 25.8]. The mean severe exacerbation rates due to asthma decreased from 4.1 (2.8 SD) to 1.15 (0.78 SD) during the treatment year (p<0.0001) with Omalizumab. Conclusions: Treatment with Omalizumab can be an effective and safe therapeutic option for Romanian children with severe allergic asthma, providing clinically relevant in-formation on asthma control and exacerbation rate in children and adolescents. The results highlighted the effect of Omalizumab in young patients, starting from the first year of treatment.

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Asthma control, lung function, nutritional status, and health-related quality of life: differences between adult males and females with asthma

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37562017000000216 ◽

2018 ◽

Vol 44 (4) ◽

pp. 273-278 ◽

Cited By ~ 1

Author(s):

Gabriele Carra Forte ◽

Maria Luiza Hennemann ◽

Paulo de Tarso Roth Dalcin

Keyword(s):

Quality Of Life ◽

Lung Function ◽

Nutritional Status ◽

Asthma Control ◽

Health Related Quality ◽

Asthma Patients ◽

Related Quality ◽

Health Related ◽

Males And Females

ABSTRACT Objective: To evaluate health-related quality of life in asthma patients treated at a referral center in southern Brazil, identifying differences between male and female patients, as well as to evaluate differences between the males and females in terms of asthma control, lung function, and nutritional status. Methods: This was a cross-sectional study involving patients ≥ 18 years of age treated at an asthma outpatient clinic. We evaluated clinical parameters, lung function, nutritional status, and quality of life. Results: A total of 198 patients completed the study. The mean age was 56.2 ± 14.8 years, and 81.8% were female. The proportion of patients with uncontrolled asthma was higher among females than among males (63.0% vs. 44.4%; p = 0.041). The body mass index (BMI) and percentage of body fat were higher in females than in males (30.2 ± 5.8 kg/m2 vs. 26.9 ± 4.5 kg/m2 and 37.4 ± 6.4% vs. 26.5 ± 7.4%; p = 0.002 and p < 0.001, respectively). Quality of life was lower in females than in males in the following domains: symptoms (3.8 ± 1.5 vs. 4.6 ± 1.7; p = 0.006); activity limitation (3.6 ± 1.3 vs. 4.4 ± 1.5; p = 0.001); emotional function (3.6 ± 1.9 vs. 4.5 ± 1.7; p = 0.014); and environmental stimuli (3.2 ± 1.6 vs. 4.3 ± 1.9; p = 0.001). Conclusions: Male asthma patients appear to fare better than do female asthma patients in terms of health-related quality of life, asthma control, BMI, percentage of body fat, and comorbidities.

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Asthma control, lung function, symptoms, and corticosteroid sparing after omalizumab initiation in patients with allergic asthma

Allergy and Asthma Proceedings ◽

10.2500/aap.2018.39.4111 ◽

2018 ◽

Vol 39 (2) ◽

pp. 127-135 ◽

Cited By ~ 6

Author(s):

Dominic Pilon ◽

Abhishek Kavati ◽

Benjamin Ortiz ◽

Brandee Paknis ◽

Ashok Vegesna ◽

...

Keyword(s):

Lung Function ◽

Allergic Asthma ◽

Asthma Control

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Follow-up of patients with uncontrolled asthma: clinical features of asthma patients according to the level of control achieved (the COAS study)

European Respiratory Journal ◽

10.1183/13993003.01885-2015 ◽

2017 ◽

Vol 49 (3) ◽

pp. 1501885 ◽

Cited By ~ 5

Author(s):

Rosa Munoz-Cano ◽

Alfons Torrego ◽

Joan Bartra ◽

Jaime Sanchez-Lopez ◽

Rosa Palomino ◽

...

Keyword(s):

Lung Function ◽

Asthma Control ◽

Forced Expiratory Volume ◽

Uncontrolled Asthma ◽

Asthma Control Test ◽

Disease Evolution ◽

Factors Associated ◽

Asthma Patients ◽

The Mean ◽

Global Initiative

Our aim was to study the asthma control achieved in patients with uncontrolled asthma who had received appropriate treatment according to the Global Initiative for Asthma (GINA) 2010 (valid at the time the study was designed), and to analyse the factors associated with a lack of asthma control.This was a multicentre study in routine clinical practice performed in patients with uncontrolled asthma according to GINA 2010. At visit 1, we recorded demographics, asthma characteristics and spirometry. We assessed asthma control using GINA 2010 criteria and the Asthma Control Test (ACT). Treatment was optimised according to GINA 2010. At visit 2, 3 months later, we reassessed spirometry, asthma control and factors associated with failure to achieve control.We recruited 1299 patients with uncontrolled asthma (mean age 46.5±17.3 years, 60.7% women, 25.8% obese). The mean percentage of predicted forced expiratory volume in 1 s was 76.4±12.8% and the mean post-bronchodilator increase was 14.9±6.8%. We observed poor agreement between ACT and GINA 2010 when evaluating asthma control (kappa = −0.151). At visit 2, asthma in 71.2% of patients was still not fully controlled. Patients whose asthma remained uncontrolled were older, had a higher body mass index, greater disease severity, longer disease evolution and worse lung function.After treatment optimisation, most patients did not achieve optimal control according to GINA 2010. Risk factors for failure to achieve asthma control were time of disease evolution, severity, age, weight and lung function impairment (excluded in the GINA 2014).

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