Paediatric severe asthma biologics service: from hospital to home

Children with severe asthma may be treated with biologic agents normally requiring 2–4 weekly injections in hospital. In March 2020, due to COVID-19, we needed to minimise hospital visits. We assessed whether biologics could be given safely at home. The multidisciplinary team identified children to be considered for home administration. This was virtually observed using a video link, and home spirometry was also performed. Feedback was obtained from carers and young people. Of 23 patients receiving biologics, 16 (70%) families agreed to homecare administration, 14 administered by parents/patients and 2 by a local nursing team. Video calls for omalizumab were observed on 56 occasions, mepolizumab on 19 occasions over 4 months (April–July). Medication was administered inaccurately on 2/75 occasions without any adverse events. Virtually observed home biologic administration in severe asthmatic children, supported by video calls and home spirometry, is feasible, safe and is positively perceived by children and their families

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Severe asthma and biologic therapies during COVID-19: supporting patients care with home administration of mepolizumab and omalizumab

10.1183/13993003.congress-2021.pa882 ◽

2021 ◽

Author(s):

Małgorzata Farnik ◽

Karolina Zawada-Drozd ◽

Adam Barczyk

Keyword(s):

Severe Asthma ◽

Biologic Therapies ◽

Home Administration

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A Review of Respiratory Biologic Agents in Severe Asthma

Cureus ◽

10.7759/cureus.5690 ◽

2019 ◽

Cited By ~ 2

Author(s):

Nathaniel Johnson ◽

Blessy Varughese ◽

Marianne A De La Torre ◽

Salim Surani ◽

George Udeani

Keyword(s):

Severe Asthma ◽

Biologic Agents

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Paediatric Severe Asthma Biologics Service: From Hospital to Home

PEDIATRICS ◽

10.1542/peds.2021-053843qqqq ◽

2021 ◽

Vol 148 (Supplement 3) ◽

pp. S64-S64

Author(s):

Omar Yamak ◽

Angela Duff Hogan

Keyword(s):

Severe Asthma ◽

Hospital To Home

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Severe Asthma in Children and Young People

Reference Module in Biomedical Sciences ◽

10.1016/b978-0-08-102723-3.00251-1 ◽

2021 ◽

Author(s):

Adam Lawton ◽

Emma Russell-Jones ◽

Atul Gupta

Keyword(s):

Young People ◽

Severe Asthma ◽

Children And Young People ◽

Asthma In Children

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Characteristics and treatment regimens across ERS SHARP severe asthma registries

European Respiratory Journal ◽

10.1183/13993003.01163-2019 ◽

2019 ◽

Vol 55 (1) ◽

pp. 1901163 ◽

Cited By ~ 12

Author(s):

Job J.M.H. van Bragt ◽

Ian M. Adcock ◽

Elisabeth H.D. Bel ◽

Gert-Jan Braunstahl ◽

Anneke ten Brinke ◽

...

Keyword(s):

Severe Asthma ◽

Research Collaboration ◽

Forced Expiratory Volume ◽

European Respiratory Society ◽

Cross Sectional ◽

Aggregated Data ◽

Treatment Regimens ◽

Severe Asthmatic ◽

Definition Of ◽

The Uk

Little is known about the characteristics and treatments of patients with severe asthma across Europe, but both are likely to vary. This is the first study in the European Respiratory Society Severe Heterogeneous Asthma Research collaboration, Patient-centred (SHARP) Clinical Research Collaboration and it is designed to explore these variations. Therefore, we aimed to compare characteristics of patients in European severe asthma registries and treatments before starting biologicals.This was a cross-sectional retrospective analysis of aggregated data from 11 national severe asthma registries that joined SHARP with established patient databases.Analysis of data from 3236 patients showed many differences in characteristics and lifestyle factors. Current smokers ranged from 0% (Poland and Sweden) to 9.5% (Belgium), mean body mass index ranged from 26.2 (Italy) to 30.6 kg·m−2 (the UK) and the largest difference in mean pre-bronchodilator forced expiratory volume in 1 s % predicted was 20.9% (the Netherlands versus Hungary). Before starting biologicals patients were treated differently between countries: mean inhaled corticosteroid dose ranged from 700 to 1335 µg·day−1 between those from Slovenia versus Poland when starting anti-interleukin (IL)-5 antibody and from 772 to 1344 µg·day−1 in those starting anti-IgE (Slovenia versus Spain). Maintenance oral corticosteroid use ranged from 21.0% (Belgium) to 63.0% (Sweden) and from 9.1% (Denmark) to 56.1% (the UK) in patients starting anti-IL-5 and anti-IgE, respectively.The severe asthmatic population in Europe is heterogeneous and differs in both clinical characteristics and treatment, often appearing not to comply with the current European Respiratory Society/American Thoracic Society guidelines definition of severe asthma. Treatment regimens before starting biologicals were different from inclusion criteria in clinical trials and varied between countries.

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Evaluation of Th17-related cytokines and IFNγproduction from blood mononuclear cells of moderate and severe asthmatic children reveals methylprednisolone does not decrease IL-22 levels

Journal of Asthma ◽

10.3109/02770903.2014.959129 ◽

2014 ◽

Vol 52 (3) ◽

pp. 227-231 ◽

Cited By ~ 3

Author(s):

Emanuel Sávio Cavalcanti Sarinho ◽

Adriana Azoubel-Antunes ◽

Moacyr Jesus Barreto de Melo Rêgo ◽

Mariana Brayner-Cavalcanti ◽

Thiago Ubiratan Lins e Lins ◽

...

Keyword(s):

Mononuclear Cells ◽

Asthmatic Children ◽

Severe Asthmatic ◽

Blood Mononuclear Cells

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Electronic monitoring of adherence to inhaled corticosteroids: an essential tool in identifying severe asthma in children

European Respiratory Journal ◽

10.1183/13993003.00910-2017 ◽

2017 ◽

Vol 50 (6) ◽

pp. 1700910 ◽

Cited By ~ 45

Author(s):

Anja Jochmann ◽

Luca Artusio ◽

Angela Jamalzadeh ◽

Prasad Nagakumar ◽

Edgar Delgado-Eckert ◽

...

Keyword(s):

Severe Asthma ◽

Electronic Monitoring ◽

Inhaled Corticosteroids ◽

Good Control ◽

Clinical Parameter ◽

Poor Adherence ◽

Poor Control ◽

Good Adherence ◽

Asthmatic Children ◽

Monitoring Devices

International guidelines recommend that severe asthma can only be diagnosed after contributory factors, including adherence, have been addressed. Accurate assessment of adherence is difficult in clinical practice. We hypothesised that electronic monitoring in children would identify nonadherence, thus delineating the small number with true severe asthma.Asthmatic children already prescribed inhaled corticosteroids were prospectively recruited and persistence of adherence assessed using electronic monitoring devices. Spirometry, airway inflammation and asthma control were measured at the start and end of the monitoring period.93 children (62 male; median age 12.4 years) were monitored for a median of 92 days. Median (range) monitored adherence was 74% (21–99%). We identified four groups: 1) good adherence during monitoring with improved control, 24% (likely previous poor adherence); 2) good adherence with poor control, 18% (severe therapy-resistant asthma); 3) poor adherence with good control, 26% (likely overtreated); and 4) poor adherence with poor control, 32%. No clinical parameter prior to monitoring distinguished these groups.Electronic monitoring is a useful tool for identifying children in whom a step up in treatment is indicated. Different approaches are needed in those who are controlled when adherent or who are nonadherent. Electronic monitoring is essential in a paediatric severe asthma clinic.

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