scholarly journals Blood granulocyte patterns as predictors of asthma phenotypes in adults from the EGEA study

2016 ◽  
Vol 48 (4) ◽  
pp. 1040-1051 ◽  
Author(s):  
Rachel Nadif ◽  
Valérie Siroux ◽  
Anne Boudier ◽  
Nicole le Moual ◽  
Jocelyne Just ◽  
...  
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Immunoglobulin E ◽  
Bronchial Hyperresponsiveness ◽  
Urgent Care ◽  
Asthma Exacerbations ◽  
Persistent Pattern ◽  
Oral Corticosteroids ◽  
Global Initiative ◽  
Blood Granulocyte

To what extent blood granulocyte patterns may predict asthma control remains under-studied. Our aim was to study associations between blood neutrophilia and eosinophilia and asthma control outcomes in adults.Analyses were conducted in 474 asthmatics from the first follow-up of the Epidemiological Study on the Genetics and Environment of Asthma (EGEA2), including 242 asthmatics who were adults a decade earlier (EGEA1). At EGEA2, asthma control was assessed using the Global Initiative for Asthma definition (2015), and asthma exacerbations by use of urgent care or courses of oral corticosteroids in the past year. Blood EOSlo/EOShi was defined as </≥250 eosinophils·mm−3, respectively, and NEUlo/NEUhi as </≥5000 neutrophils·mm−3, respectively. Estimates were adjusted for age, sex and smoking.At EGEA2, NEUhi was associated with asthma exacerbations and poor asthma control (OR >2.10). EOShi was associated with higher bronchial hyperresponsiveness (BHR) (OR (95% CI) 2.21 (1.24–3.97)), poor lung function (p=0.02) and higher total IgE level (p=0.002). Almost 50% of asthmatics had a persistent pattern between surveys. Persistent NEUhi was associated with poor asthma control at EGEA2 (OR (95% CI) 3.09 (1.18–7.05)). EOShi at EGEA1 and persistent EOShi were associated with higher BHR (OR (95% CI) 2.36 (1.10–5.07) and 3.85 (1.11–13.34), respectively), poor lung function (p<0.06) and higher immunoglobulin E level (p<10−4) at EGEA2.Granulocyte patterns were differently associated with asthma outcomes, suggesting specific roles for each one, which could be tested as predictive signatures.

scholarly journals Level of asthma control and its relationship with medication use in asthma patients in Brazil

2014 ◽  
Vol 40 (5) ◽  
pp. 487-494 ◽  
Author(s):  
Josiane Marchioro ◽  
Mariana Rodrigues Gazzotti ◽  
Oliver Augusto Nascimento ◽  
Federico Montealegre ◽  
James Fish ◽  
...  
Keyword(s):  
Asthma Control ◽  
Latin American ◽  
Rescue Medication ◽  
Uncontrolled Asthma ◽  
The Past ◽  
Global Initiative For Asthma ◽  
Asthma Patients ◽  
Oral Corticosteroids ◽  
Global Initiative ◽  
Asthma Group

OBJECTIVE: To assess asthma patients in Brazil in terms of the level of asthma control, compliance with maintenance treatment, and the use of rescue medication. METHODS: We used data from a Latin American survey of a total of 400 asthma patients in four Brazilian state capitals, all of whom completed a questionnaire regarding asthma control and treatment. RESULTS: In that sample, the prevalence of asthma was 8.8%. Among the 400 patients studied, asthma was classified, in accordance with the Global Initiative for Asthma criteria, as controlled, partially controlled, and uncontrolled in 37 (9.3%), 226 (56.5%), and 137 (34.3%), respectively. In those three groups, the proportion of patients on maintenance therapy in the past four weeks was 5.4%, 19.9%, and 41.6%, respectively. The use of rescue medication was significantly more common in the uncontrolled asthma group (86.9%; p < 0.001). CONCLUSIONS: Our findings suggest that, in accordance with the established international criteria, asthma is uncontrolled in the vast majority of asthma patients in Brazil. Maintenance medications are still underutilized in Brazil, and patients with partially controlled or uncontrolled asthma are more likely to use rescue medications and oral corticosteroids.

scholarly journals Assessment of asthma control and lung function in asthmatic children in Sokoto, North Western Nigeria

2021 ◽  
Vol 0 ◽  
pp. 1-6
Author(s):  
Fatima Abubakar Ishaq ◽  
Bilkisu Ilah Garba ◽  
Nma Mohammad Jiya ◽  
Ahmed Hamidu
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Cross Sectional ◽  
Asthmatic Children ◽  
Children With Asthma ◽  
Global Initiative ◽  
Gina Guidelines ◽  
Study Participants

Objectives: This study aimed at assessing asthma control using Global Initiative for Asthma (GINA) asthma assessment, and determining its relationship with lung function parameters among asthmatic children in Usmanu Danfodiyo University Teaching hospital, Sokoto. Materials and Methods: This was a cross-sectional study among 60 children with asthma diagnosed based on GINA guidelines. It was conducted over a period of 4 months. The GINA asthma control assessment was administered to assess asthma control. Lung function was done using a portable spirometer. Results: Males accounted for 58.3% of the study population with M: F of 1.4:1 and median age of 9.47 years, with majority from urban domicile (91.7%). Well-controlled asthma accounted for 50.0% while 35.0% had partly controlled asthma and 15.0% had poorly controlled asthma. The median FEV1/FVC among the study participants was 0.856 (IQR: 0.170). There was no relationship between asthma control and LF parameters (FEV1: r = 0.044, P = 0.736, FVC: r = 0.010, P = 0.941, FEV1/FVC: r = 0.122, P = 0.352, and PEFR: r = 0.015, P = 0.911). Conclusion: Majority of the study participants had well-controlled asthma and no relationship was found between asthma control and lung function. Thus, serial monitoring of LF in addition to uniformly agreed standardized assessment of asthma control is required to objectively evaluate asthma control in children.

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

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 &ge;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, [&Delta;FEV1 (% pred.) =18.3, and similarly, &Delta;MEF50 (%) = 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&lt;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.

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

2017 ◽  
Vol 49 (3) ◽  
pp. 1501885 ◽  
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).

Relationship of the Asthma Control Test (ACT) with Lung Function, Levels of Exhaled Nitric Oxide and Control According to the Global Initiative for Asthma (GINA)

2010 ◽  
Vol 46 (7) ◽  
pp. 370-377 ◽  
Author(s):  
Francisco Javier Álvarez-Gutiérrez ◽  
Juan Francisco Medina-Gallardo ◽  
Pablo Pérez-Navarro ◽  
Juan José Martín-Villasclaras ◽  
Bernardo Martin Etchegoren ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Lung Function ◽  
Asthma Control ◽  
Exhaled Nitric Oxide ◽  
Control Test ◽  
Asthma Control Test ◽  
Global Initiative For Asthma ◽  
Global Initiative ◽  
And Control ◽  
Relationship Of

scholarly journals Clinical Experience with Anti-IgE Monoclonal Antibody (Omalizumab) in Pediatric Severe Allergic Asthma—A Romanian Perspective

Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1141
Author(s):  
Elena Camelia Berghea ◽  
Mihaela Balgradean ◽  
Carmen Pavelescu ◽  
Catalin Gabriel Cirstoveanu ◽  
Claudia Lucia Toma ◽  
...  
Keyword(s):  
Lung Function ◽  
Children And Adolescents ◽  
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, with a negative impact on their quality of life. Asthma is often associated with comorbid allergic diseases, and its severity may be modulated by immunoglobulin E (IgE)-mediated allergen sensitization. Omalizumab is a humanized monoclonal anti-IgE antibody, 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 Omalizumab in Romanian children with severe allergic asthma. Methods: In this observational real-life study, 12 children and adolescents aged 6 to 18 years (mean 12.4 years) with severe allergic asthma received Omalizumab as an add-on treatment. Asthma control, exacerbations, lung function, and adverse events were evaluated at baseline and after the first year of treatment. Results: We observed general improvement in total asthma symptom scores and reduction in the rate of exacerbation of severe asthma. Omalizumab treatment was associated with improvement in the measures of lung function, and no serious adverse reactions were reported. FEV1 improved significantly after one year of treatment with Omalizumab [ΔFEV1 (% pred.) = 18.3], and [similarly, ΔMEF50 (%) = 25.8]. The mean severe exacerbation rate of asthma decreased from 4.1 ± 2.8 to 1.15 ± 0.78 (p < 0.0001) during the year of treatment with Omalizumab. Conclusions: This study showed that Omalizumab can be an effective and safe therapeutic option for Romanian children and adolescents with severe allergic asthma, providing clinically relevant information on asthma control and exacerbation rate in children and adolescents. The results demonstrated the positive effect of Omalizumab in young patients with asthma, starting from the first year of treatment.

scholarly journals One time a day mometasone/indacaterol fixed-dose combination versus two times a day fluticasone/salmeterol in patients with inadequately controlled asthma: pooled analysis from PALLADIUM and IRIDIUM studies

2021 ◽  
Vol 8 (1) ◽  
pp. e000819
Author(s):  
Kenneth Chapman ◽  
Richard van Zyl-Smit ◽  
Jorge Maspero ◽  
Huib A M Kerstjens ◽  
Yasuhiro Gon ◽  
...  
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Pooled Analysis ◽  
Fixed Dose ◽  
High Dose ◽  
Asthma Control Questionnaire ◽  
Exacerbation Rate ◽  
Link Type ◽  
Asthma Exacerbations ◽  
Medium Dose

BackgroundDespite currently available standard-of-care inhaled corticosteroid (ICS)/long-acting β2-agonist therapies, a substantial proportion of patients with asthma remain inadequately controlled. This pooled analysis evaluated efficacy and safety of mometasone furoate/indacaterol acetate (MF/IND) versus fluticasone propionate/salmeterol xinafoate (FLU/SAL) in patients with inadequately controlled asthma.MethodsThis analysis included patients from PALLADIUM (NCT02554786) and IRIDIUM (NCT02571777) studies who received high-dose MF/IND (320/150 µg) or medium-dose MF/IND (160/150 µg) one time a day or high-dose FLU/SAL (500/50 µg) two times a day for 52 weeks. Reduction in asthma exacerbations, improvement in lung function, asthma control, and safety were evaluated for 52 weeks.ResultsIn total, 3154 patients (high-dose MF/IND, n=1054; medium-dose MF/IND, n=1044; high-dose FLU/SAL, n=1056) were included. High-dose MF/IND showed 26%, 22% and 19% reductions in rate of severe, moderate or severe, and all (mild, moderate and severe) exacerbations versus high-dose FLU/SAL, respectively, over 52 weeks (all, p<0.05). High-dose MF/IND improved trough FEV1 versus high-dose FLU/SAL at weeks 26 (Δ, 43 mL, p=0.001) and 52 (Δ, 51 mL, p<0.001). Reductions in asthma exacerbation rate and improvement in trough FEV1 with medium-dose MF/IND were comparable with high-dose FLU/SAL over 52 weeks. All treatments improved Asthma Control Questionnaire-7 score from baseline to 52 weeks with no difference between treatments. Safety was comparable between high-dose MF/IND and high-dose FLU/SAL.ConclusionsOne time a day, single-inhaler, high-dose MF/IND reduced asthma exacerbations and improved lung function versus two times a day, high-dose FLU/SAL in patients with inadequately controlled asthma. Similarly, improved outcomes were seen with one time a day, medium-dose MF/IND and two times a day, high-dose FLU/SAL, but at a lower ICS dose.

scholarly journals Efficacy of one time per day, single-inhaler indacaterol/glycopyrronium/mometasone in patients with inadequately controlled asthma: post hoc analysis of IRIDIUM study in Asian population

2021 ◽  
Vol 8 (1) ◽  
pp. e000856 ◽  
Author(s):  
Hironori Sagara ◽  
Nathalie Barbier ◽  
Tsuyoshi Ishii ◽  
Hajime Yoshisue ◽  
Ivan Nikolaev ◽  
...  
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
High Dose ◽  
Asthma Control Questionnaire ◽  
Post Hoc Analysis ◽  
Asian Patients ◽  
Asthma Exacerbations ◽  
Post Hoc ◽  
Medium Dose

Background and objectiveThe 52-week IRIDIUM study demonstrated the efficacy of indacaterol acetate/glycopyrronium bromide/mometasone furoate (IND/GLY/MF) versus IND/MF and salmeterol xinafoate/fluticasone propionate (SAL/FLU) in patients with symptomatic asthma, despite long-acting β2-agonist/inhaled corticosteroids (LABA/ICS) medium-dose or high-dose, predicted forced expiratory volume in 1 s (FEV1) <80% and at least one exacerbation in the previous year. Here, we present data from a post hoc analysis of the IRIDIUM study in the Asian subpopulation.MethodsThis post hoc analysis evaluated improvements in lung function, asthma control and reduction in asthma exacerbations with IND/GLY/MF medium- (150/50/80 µg) and high-dose (150/50/160 µg) versus IND/MF medium- (150/160 µg) and high-dose (150/320 µg), all one time per day and SAL/FLU high-dose (50/500 µg) two times per day, in Asian patients from the IRIDIUM study.ResultsIn total, 258 patients (IND/GLY/MF medium-dose, 52; IND/GLY/MF high-dose, 52; IND/MF medium-dose, 51; IND/MF high-dose, 51; SAL/FLU high-dose, 52) were included. IND/GLY/MF medium- and high-dose showed greater improvement in trough FEV1 at week 26 versus respective doses of IND/MF (Δ, 100 mL and 101 mL; both p<0.05, respectively), and SAL/FLU high-dose (Δ, 125 mL; p=0.0189, and 136 mL; p=0.0118, respectively), which were maintained over 52 weeks. Both doses of IND/GLY/MF showed greater improvement in morning and evening peak expiratory flow versus respective doses of IND/MF and SAL/FLU high-dose at week 52. The changes in Asthma Control Questionnaire-7 scores from baseline were comparable in all treatment groups. IND/GLY/MF medium- and high-dose showed greater reductions in severe (34%, 69%), moderate or severe (18%, 54%) and all exacerbations (21%, 34%) compared with SAL/FLU high-dose over 52 weeks.ConclusionOne time per day, single-inhaler IND/GLY/MF improved lung function, reduced asthma exacerbations and provided comparable asthma control versus IND/MF and SAL/FLU in Asian patients with inadequately controlled asthma despite LABA/ICS. The results of this analysis were consistent with the overall population in the IRIDIUM study.

scholarly journals Depression Levels Influence the Rate of Asthma Exacerbations in Females

2021 ◽  
Vol 11 (6) ◽  
pp. 586
Author(s):  
Papaporfyriou Anastasia ◽  
Tseliou Eleni ◽  
Mizi Eleftheria ◽  
Ntontsi Xenia ◽  
Papathanasiou Eygenia ◽  
...  
Keyword(s):  
Control Level ◽  
Depression Scale ◽  
Low Frequency ◽  
Anxiety And Depression ◽  
Asthmatic Patients ◽  
Asthma Exacerbations ◽  
Depression Subscale ◽  
Global Initiative For Asthma ◽  
Asthma Patients ◽  
Global Initiative

Background: Anxiety and depression are common psychological disturbances among asthmatic patients. The aim of the present study is the assessment of anxiety and depression in asthmatic patients and their correlation with symptoms control level and number of exacerbations per year. Methods: One hundred patients with asthma diagnosis, according to the Global Initiative for Asthma (GINA), aged > 18 years old, having a stable disease, were included. Emotional status was evaluated using the Hospital Anxiety Depression Scale (HADS). Patients were followed up for a year to assess the number and severity of exacerbations. Results: Most of our patients were female (58%), middle-aged (mean = 54 ± 13), and married (81%), with low frequency of smoking habits (smokers, ex-smokers and non-smokers were 26%, 30% and 37%, respectively) and low levels of both anxiety and depression [median (interquartile range (IQR)) = 4(2) and median (IQR) = 4(2), respectively]. At the low and moderate level of the depression subscale, female patients experienced asthma exacerbations more frequently compared to male patients (adjusted Incidence Rate Ratio (aIRR) = 4.30; 95% Confidence Interval (CI): 1.94–9.53 and aIRR = 1.82; 95% CI: 1.07–3.13, respectively). Conclusions. Clinicians should evaluate asthma patients for depression, as gender differentially influences outcomes among those with low and moderate levels of depression, with female asthmatics presenting more frequent exacerbations.

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