Regular follow-up visits reduce the risk for severe asthma exacerbation required admission

2017 ◽  
Author(s):  
Min Kwang Byun ◽  
Hye Jung Park ◽  
Hyung Jung Kim ◽  
Chul Min Ahn ◽  
Chin Kook Rhee ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Asthma Exacerbation ◽  
Severe Asthma Exacerbation

scholarly journals Duration of the efficacy of omalizumab after treatment discontinuation in ‘real life’ severe asthma

Thorax ◽  
2017 ◽  
Vol 73 (8) ◽  
pp. 782-784 ◽  
Author(s):  
Maria del Carmen Vennera ◽  
Carlos Sabadell ◽  
Cesar Picado
Keyword(s):  
Prospective Study ◽  
Asthma Control ◽  
Severe Asthma ◽  
Asthma Exacerbation ◽  
Real Life ◽  
First Year ◽  
Severe Asthma Exacerbation ◽  
Optimal Duration ◽  
Open Prospective Study

Efficacy of omalizumab in severe asthma is well documented; however, the optimal duration of the treatment remains unclear. In an open prospective study, we sought to assess the persistence of response in subjects withdrawing from omalizumab treatment. We evaluated 49 patients who voluntarily accepted to discontinue omalizumab treatment after 6 years of therapy. Asthma relapse was defined as any severe asthma exacerbation associated with loss of asthma control. Twelve patients relapsed in the first year of follow-up, and 7 within 13 and 48 months. These results suggest that the effects of 6 years of omalizumab may persist after discontinuation of therapy in 60% of patients for at least 4 years.

scholarly journals Does the occurrence of a severe asthma exacerbation change the rate of subsequent events?

2021 ◽  
Author(s):  
Tae Yoon Lee ◽  
John Petkau ◽  
Mohsen Sadatsafavi
Keyword(s):  
Severe Asthma ◽  
Asthma Exacerbation ◽  
Failure Time ◽  
Asthma Management ◽  
Frailty Model ◽  
Severe Exacerbation ◽  
Adult Group ◽  
Old Patients ◽  
Severe Asthma Exacerbation

Background: Severe exacerbations requiring hospitalization are an important component of the natural history of asthma and a major source of its burden. Whether the occurrence of a severe exacerbation affects the rate of subsequent events has far-reaching implications in asthma management. Methods: Using the centralized administrative health databases of British Columbia, Canada (1997/01/01-2016/03/31), we created an incidence cohort of patients with at least one severe asthma exacerbation, defined as an episode of hospitalization with asthma as the primary diagnosis. We used an accelerated failure time joint frailty model for the time intervals between severe asthma exacerbations. Analyses were conducted separately for pediatric (< 14 years old) and adult (≥14 years old) patients. Results: There were 3,039 patients (mean age at baseline 6.4, 35% female) in the pediatric group and 5,459 patients (mean age at baseline 50.8, 68% female) in the adult group, with 16% and 15%, respectively, experiencing at least one severe asthma exacerbation during follow-up. The first follow-up severe asthma exacerbation was associated with an increase of 79% (95% CI: 15% - 186%) in the rate of the subsequent events for the pediatric group. The corresponding value was 186% (95% CI: 85% - 355%) for the adult group. For both groups, the effects of subsequent severe exacerbations were not statistically significant. Conclusion: Our findings suggest that among patients who have experienced their first severe asthma exacerbation, preventing the next event can drastically change the course of the disease and reduce the burden of future exacerbations.

scholarly journals Hormonal contraception and the risk of severe asthma exacerbation: 17-year population-based cohort study

Thorax ◽  
2020 ◽  
pp. thoraxjnl-2020-215540
Author(s):  
Bright I Nwaru ◽  
Holly Tibble ◽  
Syed A Shah ◽  
Rebecca Pillinger ◽  
Susannah McLean ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Severe Asthma ◽  
Asthma Exacerbation ◽  
Population Based ◽  
Emergency Department Visits ◽  
Reproductive Age ◽  
Hormonal Contraceptives ◽  
Reproductive Age Women ◽  
Severe Asthma Exacerbation

BackgroundLongitudinal studies investigating impact of exogenous sex steroids on clinical outcomes of asthma in women are lacking. We investigated the association between use of hormonal contraceptives and risk of severe asthma exacerbation in reproductive-age women with asthma.MethodsWe used the Optimum Patient Care Research Database, a population-based, longitudinal, anonymised primary care database in the UK, to construct a 17-year (1 January 2000–31 December 2016) retrospective cohort of reproductive-age (16–45 years, n=83 084) women with asthma. Using Read codes, we defined use, subtypes and duration of use of hormonal contraceptives. Severe asthma exacerbation was defined according to recommendations of the European Respiratory Society/American Thoracic Society as asthma-related hospitalisation, accident and emergency department visits due to asthma and/or oral corticosteroid prescriptions. Analyses were done using multilevel mixed-effects Poisson regression with QR decomposition.ResultsThe 17-year follow-up resulted in 456 803 person-years of follow-up time. At baseline, 34% of women were using any hormonal contraceptives, 25% combined (oestrogen/progestogen) and 9% progestogen-only contraceptives. Previous (incidence rate ratio (IRR) 0.94, 95% CI 0.92 to 0.97) and current (IRR 0.96, 95% CI 0.94 to 0.98) use of any, previous (IRR 0.92, 95% CI 0.87 to 0.97) and current use of combined (IRR 0.93, 95% CI 0.91 to 0.96) and longer duration of use (3–4 years: IRR 0.94, 95% CI 0.92 to 0.97; 5+ years: IRR 0.91, 95% CI 0.89 to 0.93) of hormonal contraceptives, but not progestogen-only contraceptives, were associated with reduced risk of severe asthma exacerbation compared with non-use.ConclusionsUse of hormonal contraceptives may reduce the risk of severe asthma exacerbation in reproductive-age women. Mechanistic studies investigating the biological basis for the influence of hormonal contraceptives on clinical outcomes of asthma in women are required.Protocol registration numberEuropean Union electronic Register of Post-Authorisation Studies (EUPAS22967).

PREDICTORS OF A FUTURE SEVERE ASTHMA EXACERBATION AFTER A DECADE FOLLOW-UP: RESULTS FROM TENOR II

2018 ◽  
Vol 121 (5) ◽  
pp. S44-S45
Author(s):  
T. Haselkorn ◽  
S. Szefler ◽  
B. Chipps ◽  
E. Bleecker ◽  
D. Mink ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Asthma Exacerbation ◽  
Severe Asthma Exacerbation

scholarly journals Management of severe asthma exacerbation: guidelines from the Société Française de Médecine d’Urgence, the Société de Réanimation de Langue Française and the French Group for Pediatric Intensive Care and Emergencies

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Philippe Le Conte ◽  
Nicolas Terzi ◽  
Guillaume Mortamet ◽  
Fekri Abroug ◽  
Guillaume Carteaux ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Intensive Care ◽  
Severe Asthma ◽  
Asthma Exacerbation ◽  
Pediatric Patients ◽  
Pediatric Intensive Care ◽  
Extensive Literature ◽  
Level Of Evidence ◽  
Severe Asthma Exacerbation ◽  
Evidence Grade

Abstract Background The French Emergency Medicine Society, the French Intensive Care Society and the Pediatric Intensive Care and Emergency Medicine French-Speaking Group edited guidelines on severe asthma exacerbation (SAE) in adult and pediatric patients. Results The guidelines were related to 5 areas: diagnosis, pharmacological treatment, oxygen therapy and ventilation, patients triage, specific considerations regarding pregnant women. The literature analysis and formulation of the guidelines were conducted according to the Grade of Recommendation Assessment, Development and Evaluation methodology. An extensive literature research was conducted based on publications indexed in PubMed™ and Cochrane™ databases. Of the 21 formalized guidelines, 4 had a high level of evidence (GRADE 1+/−) and 7 a low level of evidence (GRADE 2+/−). The GRADE method was inapplicable to 10 guidelines, which resulted in expert opinions. A strong agreement was reached for all guidelines. Conclusion The conjunct work of 36 experts from 3 scientific societies resulted in 21 formalized recommendations to help improving the emergency and intensive care management of adult and pediatric patients with SAE.

Emergency Management of Acute Severe Asthma Exacerbation in the Adult Population

2010 ◽  
Vol 1 (5) ◽  
pp. 174-179
Author(s):  
Sandra E. Marotta ◽  
Yuly Belchikov ◽  
Katherine Banker ◽  
Peter S. Marshall
Keyword(s):  
Emergency Management ◽  
Severe Asthma ◽  
Asthma Exacerbation ◽  
Adult Population ◽  
Acute Severe Asthma ◽  
Severe Asthma Exacerbation
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