Asthma Control and Asthma Medication Use among Swedish Elite Endurance Athletes

Background. Asthma is common in elite athletes. In this study, we examined the use of asthma medication and asthma control in endurance athletes in Sweden and compared the findings with those in a reference group of patients with asthma. Methods. The Asthma Control Test (ACT) and a questionnaire on asthma, respiratory symptoms, and medication use were posted to endurance athletes n=711 and the reference group of patients with asthma n=1026. Four hundred and sixty-nine athletes (66%) responded, of whom 141 (20%) reported physician-diagnosed asthma. In the reference group, 397 (39%) responded. Results. Seventy-seven percent of the athletes with asthma reported using asthma medication during the previous year; 39% used short/long-acting β2-agonists, 31% used inhaled corticosteroids, and 31% used both daily. According to the ACT scores, 19%, 24%, and 58% of athletes with asthma had uncontrolled, partially controlled, or well-controlled asthma, respectively. After adjustment, there was no difference in ACT scores or daily use of asthma medication between the study groups. Conclusions. Many endurance athletes had uncontrolled or partially controlled asthma, and one-third used inhaled corticosteroids and long-acting β2-agonists daily. Their adjusted ACT scores and use of asthma medication were similar to the values in the reference population.

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The Prevalence of Asthma and Respiratory Symptoms among Cross-Country Skiers in Early Adolescence

Canadian Respiratory Journal ◽

10.1155/2019/1514353 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

E. Lennelöv ◽

T. Irewall ◽

E. Naumburg ◽

A. Lindberg ◽

N. Stenfors

Keyword(s):

Asthma Control ◽

Early Adolescence ◽

Respiratory Symptoms ◽

Reference Group ◽

Population Based ◽

Postal Questionnaire ◽

Asthma Medication ◽

Control Test ◽

Asthma Control Test ◽

Cross Country

Objective. To determine the prevalence of asthma and respiratory symptoms among Swedish cross-country skiers in early adolescence in comparison to a population-based reference group of similar ages. Methods. A postal questionnaire on asthma, asthma medication, allergy, respiratory symptoms, and physical activity was distributed to Swedish competitive cross-country skiers aged 12–15 years (n = 331) and a population-based reference group (n = 1000). The level of asthma control was measured by the Asthma Control Test. Results. The response rate was 27% (n = 87) among skiers and 29% (n = 292) in the reference group. The prevalence of self-reported asthma (physician-diagnosed asthma and use of asthma medication in the last 12 months) and the prevalence of reported wheezing during the last 12 months were 23% and 25%, respectively, among skiers, which were significantly higher than the values reported in the reference group (12% and 14%). Skiers exercised more hours/week than the reference group. Among adolescents with self-reported asthma, neither the usage of asthma medications nor the level of asthma control according to the Asthma Control Test differed between skiers and the reference group. Conclusions. Adolescent competitive cross-country skiers have an increased prevalence of respiratory symptoms and asthma compared to nonskiers.

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Asthma and Asthma Medication Are Common among Recreational Athletes Participating in Endurance Sport Competitions

Canadian Respiratory Journal ◽

10.1155/2018/3238546 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Amanda Näsman ◽

Tommie Irewall ◽

Ulf Hållmarker ◽

Anne Lindberg ◽

Nikolai Stenfors

Keyword(s):

Inhaled Corticosteroids ◽

Asthma Medication ◽

Endurance Athletes ◽

Asthma Prevalence ◽

Swedish Population ◽

Endurance Sport ◽

Recreational Athletes ◽

Beta Agonists ◽

Cross Country ◽

Long Acting

Background. Asthma prevalence is high among elite endurance athletes, but little is known about its prevalence among competitive recreational athletes. The aim of this study was to determine the prevalence of self-reported asthma and asthma medication use among competitive recreational endurance athletes and their association with training. Methods. A web survey on asthma and medication was conducted among 38,603 adult participants of three Swedish endurance competitions (cross-country running, cross-country skiing, and swimming). Results. The overall response rate was 29%. The prevalence of self-reported asthma (physician-diagnosed asthma and use of asthma medication in the last 12 months) was 12%. Among those reporting asthma, 23% used inhaled corticosteroids and long-acting beta-agonists daily. We found no association between training volume and daily use of asthma medication, except a trend in relation to short-acting beta-agonists. Independent predictors of self-reported asthma were female sex, allergic rhinitis, previous eczema, family history of asthma, cycling, and training for >5 h 50 min/week. Conclusions. The prevalence of self-reported asthma among Swedish competitive recreational endurance athletes appears to be higher than that in the general Swedish population. A large proportion of recreational athletes were reported with asthma use medications, indicating an association between high physical activity and self-reported asthma among competitive recreational athletes.

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Asthma Control Test™ (ACT) Scores and FeNO Correlation.

10.1164/ajrccm-conference.2009.179.1_meetingabstracts.a1384 ◽

2009 ◽

Author(s):

B Gemicioglu ◽

I Dogan ◽

B Musellim ◽

K Guven

Keyword(s):

Asthma Control ◽

Control Test ◽

Act Scores ◽

Asthma Control Test

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Health-Related Effects of Home Nebulization With Glycopyrronium on Difficult-to-Treat Asthma: Post-Hoc Analyses of an Observational Study (Preprint)

10.2196/preprints.17863 ◽

2020 ◽

Author(s):

Deepak Talwar ◽

Salil Bendre

Keyword(s):

Adverse Events ◽

Asthma Control ◽

Inhaled Corticosteroids ◽

Moderate Intensity ◽

Serious Adverse Events ◽

Female Ratio ◽

Mean Values ◽

Control Score ◽

Long Acting ◽

Post Hoc

BACKGROUND Bronchial asthma remains a clinical enigma with poorly controlled symptoms or exacerbations despite regular use of inhaled corticosteroids. Home nebulization offers a simplified solution for the delivery of rescue and maintenance bronchodilators, which is especially true for patients with frequent exacerbations during management of uncontrolled or difficult-to-treat asthma. OBJECTIVE We aimed to assess the clinical impact and outcomes associated with home nebulization—delivered long-acting bronchodilators for uncontrolled or difficult-to-treat asthma. METHODS This observational, concurrent study was conducted with 60 patients at 2 centers during November 2018. Statistical analyses for prebronchodilator forced expiratory volume in one second (FEV1) and Global Initiative for Asthma (GINA) asthma control score in patients on long-acting bronchodilators and corticosteroids were conducted, with two-tailed P values <.05 considered statistically significant. RESULTS Per protocol analyses (53/60) for consecutive cases receiving home nebulization with long-acting bronchodilators and corticosteroids were conducted. The baseline demographics included a male-to-female ratio of 30:23 and mean values of the following: age, 60.3 years (SD 11.8 years); weight, 64 kg (SD 16.8 kg); FEV1, 43% (SD 16%); GINA asthma control score, 3.0 points (SD 0.8 points); serum eosinophil level, 4% (SD 3%); fractional exhaled nitric oxide (FeNO), 12.1 ppb (SD 6 ppb). Of the patients, 100% (53/53) had uncontrolled symptoms, 69.8% (37/53) had prior exacerbations, 100% (53/53) used formoterol/budesonide, and 75.5% (40/53) used glycopyrronium. The per protocol group (n=53) had significantly improved mean prebronchodilator FEV1 (23.7%, SD 29.8%; 0.46 L, SD 0.58 L; P<.001) and GINA asthma control score (2.1 points, SD 0.8 points, P<.001). At baseline, patients (n=40) receiving glycopyrronium/formoterol/budesonide (25/20/500 mcg) nebulization admixture had the following mean values: prebronchodilator FEV1, 38% (SD 15%); GINA asthma control score, 3.0 points (SD 0.8 points); reversibility, 12% (SD 6%); peripheral eosinophil level, 4% (SD 3%); FeNO, 12 ppb (SD 5.7 ppb). In the post hoc analyses, these patients had significantly improved mean prebronchodilator FEV1 of 27.7% (SD 26.2%; 0.54 L, SD 0.51 L; P<.001) at 8 weeks compared with baseline. At baseline, patients (n=13) receiving formoterol/budesonide (20/500 mcg) nebulization had the following mean values: FEV1, 55% (SD 12%); GINA asthma control score, 3.0 points (SD 1.2 points); reversibility, 14% (SD 7%); serum eosinophil level, 4% (SD 3%); FeNO, 13.3 ppb (SD 6.8 ppb). In the post hoc analyses, these patients showed a significant improvement in prebronchodilator FEV1 of 11.2% (SD 13.1%; 0.22 L, SD 0.25 L; P<.001) from baseline. Breathlessness of mild to moderate intensity was reported by 10 cases (10/53, 18.9%), with no other treatment-emergent adverse events or serious adverse events. CONCLUSIONS Home nebulization remains a viable option for symptomatic difficult-to-treat asthma cases with frequent use of rescue medications. Glycopyrronium as add-on therapy offers a synergistic response in patients on corticosteroids with difficult-to-treat asthma. CLINICALTRIAL Clinical Trial Registry of India CTRI/2018/11/016319; https://tinyurl.com/y78cctm3

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First analysis of the Severe Paediatric Asthma Collaborative in Europe registry

ERJ Open Research ◽

10.1183/23120541.00566-2020 ◽

2020 ◽

Vol 6 (4) ◽

pp. 00566-2020

Author(s):

Norrice M. Liu ◽

Karin C.L. Carlsen ◽

Steve Cunningham ◽

Grazia Fenu ◽

Louise J. Fleming ◽

...

Keyword(s):

Asthma Control ◽

Severe Asthma ◽

Suboptimal Control ◽

High Dose ◽

Asthma Control Test ◽

European Respiratory Society ◽

Paediatric Asthma ◽

Global Initiative For Asthma ◽

Global Initiative ◽

Long Acting

New biologics are being continually developed for paediatric asthma, but it is unclear whether there are sufficient numbers of children in Europe with severe asthma and poor control to recruit to trials needed for registration. To address these questions, the European Respiratory Society funded the Severe Paediatric Asthma Collaborative in Europe (SPACE), a severe asthma registry. We report the first analysis of the SPACE registry, which includes data from 10 paediatric respiratory centres across Europe.Data from 80 children with a clinical diagnosis of severe asthma who were receiving both high-dose inhaled corticosteroid and long-acting β2-agonist were entered into the registry between January 2019 and January 2020. Suboptimal control was defined by either asthma control test, or Global Initiative for Asthma criteria, or ≥2 severe exacerbations in the previous 12 months, or a combination.Overall, 62 out of 80 (77%) children had suboptimal asthma control, of whom 29 were not prescribed a biologic. However, in 24 there was an option for starting a licensed biologic. 33 children with suboptimal control were prescribed a biologic (omalizumab (n=24), or mepolizumab (n=7), or dupilumab (n=2)), and for 29 there was an option to switch to a different biologic.We conclude that the SPACE registry provides data that will support the planning of studies of asthma biologics. Not all children on biologics achieve good asthma control, and there is need for new trial designs addressing biologic switching.

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Association of Inhaled Corticosteroids and Long-Acting Muscarinic Antagonists With Asthma Control in Patients With Uncontrolled, Persistent Asthma

JAMA ◽

10.1001/jama.2018.2757 ◽

2018 ◽

Vol 319 (14) ◽

pp. 1473 ◽

Cited By ~ 28

Author(s):

Diana M. Sobieraj ◽

William L. Baker ◽

Elaine Nguyen ◽

Erin R. Weeda ◽

Craig I. Coleman ◽

...

Keyword(s):

Asthma Control ◽

Inhaled Corticosteroids ◽

Persistent Asthma ◽

Muscarinic Antagonists ◽

Long Acting

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Yoga Education Program for Reducing Drug Dependency and Promoting Better Asthma Control for Chronic Asthmatic Children: A Multicity Experiment

Global Pediatric Health ◽

10.1177/2333794x19837455 ◽

2019 ◽

Vol 6 ◽

pp. 2333794X1983745 ◽

Cited By ~ 2

Author(s):

Samta Pandya

Keyword(s):

Asthma Control ◽

Education Program ◽

Intervention Group ◽

Control Group ◽

Act Scores ◽

Asthma Control Test ◽

Drug Dependency ◽

Asthmatic Children ◽

Standard Family ◽

Family Setups

This article reports a 1-year long yoga education program (YEP) experiment aimed at reducing drug dependency and promoting better asthma control for chronic asthmatic children. Participants were 450 chronic asthmatic children across 4 cities. Two measures were used: Pediatric Asthma Diary (PAD) and Childhood Asthma Control Test (C-ACT). Results indicated that intervention group children had better asthma control in terms of lower average PAD scores and higher C-ACT scores and reduced drug intake vis-à-vis the control group. Within the intervention cohort, asthma symptoms persistence was lower and control was higher for children from Asian cities, boys, Hindus, middle-class children, those whose mothers were their primary caregivers, who lived in standard family setups, who also attended the optional YEP rounds, and regularly self-practiced. The strongest predictor of lower posttest PAD scores and higher C-ACT scores was self-practice. The YEP can be used as an effective complementary treatment for chronic asthmatic children.

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17: OBESE ADIPOCYTE-DERIVED EXOSOMAL MIRNAS TARGETING TGF-β SIGNALING ARE ASSOCIATED WITH POOR ASTHMA CONTROL

Journal of Investigative Medicine ◽

10.1136/jim-2016-000080.33 ◽

2016 ◽

Vol 64 (3) ◽

pp. 813.2-814 ◽

Cited By ~ 1

Author(s):

S Epstein ◽

S Ferrante ◽

E Nadler ◽

M Barberio ◽

M Golberg ◽

...

Keyword(s):

Asthma Control ◽

Airway Remodeling ◽

Act Scores ◽

Asthma Control Test ◽

Mrna Targets ◽

Obese Youth ◽

Exosomal Mirnas ◽

Obese Subjects ◽

Visceral Adipose ◽

Serum And Urine

Purpose of StudyObesity is a major risk factor for difficult-to-control asthma. We reported obese visceral adipose-derived exosomes contain miRNAs capable of impairing TGF-β signaling, a pathway involved in airway remodeling, associated with poor asthma clinical outcomes. We hypothesized that adipose-derived exosomal miRNAs from obese youth with asthma would be associated with poor asthma control.Methods UsedAsthMaP-2 Subjects (youth with physician-diagnosed asthma) were selected at extremes of obesity (n=10) and leanness (n=10). We profiled RNA from adipose-derived exosomes from serum and urine and identified significant correlations (p≤0.05) between obese adipose-derived exosomal miRNAs and Asthma Control Test (ACT) scores. Ingenuity Pathway Analysis generated predicted mRNA targets and pathways.Summary of ResultsObese subjects had a BMI≥98th percentile and lean subjects had a BMI≤13th percentile for age and sex. Serum adipose-derived exosomes contained 12 ACT-correlated miRNAs predicted to target 2,963 mRNAs with TGF-β Signaling as the top pathway (ratio=36/87; p=3×10−9). Urinary adipose-derived exosomes contained 7 ACT-correlated miRNAs predicted to target 2,387 mRNAs with TGF-β Signaling among the top pathways (ratio=18/87; p=0.01). The serum exosomal miRNAs were predicted to target TGF-β signaling mediators' mRNAs: downregulation of ACVR2B, SMAD3, SMAD5, and SMAD7 by miR-15a-5p (Fold Change (FC)=1.5; p=0.039) and upregulation of TGFB2 and TGFBR2 by miR-153-3p (FC=−1.7; p=0.041). The urinary exosomal miRNAs were also predicted to target TGF-β signaling mediators' mRNAs, the net effects were the opposite direction: upregulation of ACVR2B and SMAD4 by miR-138-5p (FC=−1.2; p=0.033) and downregulation of TGFB2 and TGFBR2 by miR-153-3p (FC=1.6; p=0.026) and SMAD6 by miR-3187-5p (FC=2.3; p=0.008).ConclusionsPoor asthma control in obese youth is associated with adipose-derived exosomal miRNAs in both serum and urine, in particular those that are predicted to affect TGF-β signaling. Due to anatomic considerations, visceral adipose-derived exosomes are expected to predominate in urine, while serum will contain a mix of both visceral and subcutaneous adipose-derived exosomes. Therefore, adipose-derived exosomes derived from urine may be useful biomarkers in obese subjects with asthma.

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