scholarly journals Effectiveness and Safety of Bronchial Thermoplasty in Severe Asthma in Clinical Practice in Spain

2018 ◽  
Vol 3 (3) ◽  
pp. 1-9 ◽  
Author(s):  
Luis Puente-Maestu ◽  
Milagros Llanos Flores ◽  
Paola Benedetti ◽  
Ingrid Frías Benzant ◽  
Alicia Oliva Ramos ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Asthma Control ◽  
Severe Asthma ◽  
Inhaled Corticosteroids ◽  
Invasive Procedure ◽  
First Year ◽  
Asthma Control Test ◽  
Bronchial Thermoplasty ◽  
Oral Corticosteroids ◽  
Predominantly Female

Background: Bronchial thermoplasty (BT) is a minimally invasive procedure consisting of application of thermal energy into the airways to produce ablation of the hypertrophic smooth muscle. It was approved for use in moderate-severe asthma in Spain in 2010. Objectives: The aims of the present study are to analyze the effectiveness and the safety of BT in clinical practice in our center. Methods: Participants had a confirmed diagnosis of severe asthma and poor control without therapeutic alternative. Effectiveness was measured by comparing exacerbations, admissions rates, asthma control, and medication 1 year prior and 1 year after BT was completed. All complications appearing during the procedure and in the first year were recorded. Results: Patients had a mean age of 51 (SD 8) years and were predominantly female (17/23). The average number of activations per patient was 147 (16). The number of severe exacerbations was reduced by 75% (p < 0.001). A 38% reduction in admissions per year was also observed (p = 0.03). The Asthma Control Test improved by 7.1 (3.7) points (p = 0.018). Before BT, the dose of inhaled corticosteroids was 1,621 (1,015) µg of budesonide-equivalent and the dose of oral corticosteroids was 15 (13) mg of prednisone-equivalent. There was a reduction in 430 (731) µg of budesonide-equivalent (p = 0.02) and 4 (11) mg of prednisone (p = 0.094). No changes in lung function were observed. Complications were related mostly to exacerbation of asthma in the days following the procedure. Conclusions: BT is effective and safe for severe uncontrolled bronchial asthma in real clinical practice.

What lies beyond Asthma Control Test: Suggestions for clinical practice

2016 ◽  
Vol 53 (6) ◽  
pp. 559-562 ◽  
Author(s):  
Marco Caminati ◽  
Cristian Caimmi ◽  
Annarita Dama ◽  
Michele Schiappoli ◽  
Giovanni Passalacqua ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Asthma Control ◽  
Control Test ◽  
Asthma Control Test

scholarly journals Body Mass Index and Comorbidities in Adult Severe Asthmatics

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Andreina Bruno ◽  
Elisabetta Pace ◽  
Fabio Cibella ◽  
Pascal Chanez
Keyword(s):  
Asthma Control ◽  
Severe Asthma ◽  
Type Ii Diabetes ◽  
Cross Sectional Study ◽  
Poor Quality ◽  
Normal Weight ◽  
Type Ii ◽  
Asthma Control Questionnaire ◽  
Cross Sectional ◽  
Oral Corticosteroids

Both severe asthma and obesity are growing health problems. Severe asthma leads to a poor quality of life. The relationship among BMI, comorbidities, and severe asthma control in adults is still unclear. The aim of the study is to better understand the effect of the comorbidities as atopy, type II diabetes, OSAS, gastroesophageal reflux, hypertension, cardiovascular diseases, osteoporosis, infections, and psychological factors with BMI on asthma control in a cohort of adult severe asthmatics. One hundred and two patients were enrolled in a cross-sectional study assessing asthma control, treatments, pulmonary function, inflammatory markers, and comorbidities. Patients were divided into 3 classes according to BMI: normal weight, overweight, and obese. We found that the optimal state of asthma control is lower. whereas the score of Asthma Control Questionnaire, the number of asthma exacerbations during last year, the oral corticosteroids requirement during the previous year, and the LABA treatments are higher in obese than in overweight and normal weight severe asthmatics. The number of subjects with type II diabetes and OSAS are higher among obese and overweight patients than in normal weight asthmatics. In conclusion, BMI representsper sea factor for the deterioration in disease control in severe asthma.

Evaluation of Asthma control and oral corticosteroids in Severe Asthma

2021 ◽  
Author(s):  
Claudio Micheletto ◽  
Maria Beatrice Bilò ◽  
Leonardo Antonicelli ◽  
Fausto De Michele ◽  
Antonino Musarra ◽  
...  
Keyword(s):  
Asthma Control ◽  
Severe Asthma ◽  
Oral Corticosteroids

scholarly journals First analysis of the Severe Paediatric Asthma Collaborative in Europe registry

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.

scholarly journals Predictive Properties of the Asthma Control Test and Its Component Questions for Severe Asthma Exacerbations

2017 ◽  
Vol 5 (1) ◽  
pp. 121-127.e2 ◽  
Author(s):  
Sonia Cajigal ◽  
Karen E. Wells ◽  
Edward L. Peterson ◽  
Brian K. Ahmedani ◽  
James J. Yang ◽  
...  
Keyword(s):  
Asthma Control ◽  
Severe Asthma ◽  
Control Test ◽  
Asthma Control Test ◽  
Asthma Exacerbations

A Budget Impact Analysis of Bronchial Thermoplasty for Severe Asthma in Clinical Practice

2014 ◽  
Vol 31 (7) ◽  
pp. 751-761 ◽  
Author(s):  
Francesco Menzella ◽  
Luigi Zucchi ◽  
Roberto Piro ◽  
Carla Galeone ◽  
Claudia Castagnetti ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Severe Asthma ◽  
Impact Analysis ◽  
Budget Impact ◽  
Budget Impact Analysis ◽  
Bronchial Thermoplasty

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 Barriers and determinants of asthma control in children and adolescents in Africa: a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e053100
Author(s):  
Reratilwe Ephenia Mphahlele ◽  
Omolemo Kitchin ◽  
R Masekela
Keyword(s):  
Systematic Review ◽  
Children And Adolescents ◽  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Control Test ◽  
Asthma Diagnosis ◽  
Asthma Control Test ◽  
Eligibility Criteria ◽  
Asthma Control Questionnaire ◽  
African Children

ObjectiveTo identify reasons for poor asthma control in African children and adolescents.DesignSystematic reviewData sourcesPubMed, Scopus, CINHAL, PsycINFO, MEDLINE and Web of Science databases were systematically searched up to 31 May 2020. Hand searching was done on Sabinet, African Journal online and Google Scholar.Eligibility criteriaStudies identifying barriers to asthma control, where asthma control was assessed by the validated Asthma Control Test/Child Asthma Control Test and/or Asthma Control Questionnaire were included.Data extraction and synthesisTwo reviewers independently selected studies for inclusion with disagreements resolved by a research team discussion, including a third reviewer. Data were extracted using the Cochrane Effective Practice and Organization of Care data collection form. The quality of the included studies was assessed using the modified Newcastle-Ottawa quality assessment scale. Identified barriers were reported in a thematic narrative synthesis.Primary outcomesPoorly controlled asthma and associated factors.ResultsFrom 914 records, three studies conducted between 2014 and 2019 in Nigeria, Uganda and South Africa met the inclusion criteria. A total of 883 children aged 4–19 years were analysed. Older age, concurrent allergy and city-dwelling significantly impacted asthma control. Few children with asthma symptoms in the community had ever used inhaled corticosteroids (6.7%) and identified reasons included lack of asthma diagnosis (38.8%) and no prescribed treatment (47.6%).ConclusionAsthma control in African children is impacted by age, allergy, urbanisation and lack of access to asthma diagnosis and treatment. More studies focusing on identifying barriers to asthma control in Africa are needed.PROSPERORegistration no: CRD42020196755)

scholarly journals Asthma control: actual problems and solutions in real clinical practice

2019 ◽  
Vol 29 (3) ◽  
pp. 346-352
Author(s):  
I. V. Leshchenko
Keyword(s):  
Clinical Practice ◽  
Asthma Control ◽  
Asthma Severity ◽  
Pharmacological Therapy ◽  
Inhalation Technique ◽  
Adherence To Treatment ◽  
Asthma Control Test ◽  
Problems And Solutions ◽  
Long Acting ◽  
Real Clinical Practice

Asthma control is still difficult to achieve. One of main tools for evaluating asthma control is a well-known Asthma Control Test (ACT). Common causes of insufficient asthma control include poor adherence to treatment and non-compliance of the patient with the dosing regimen. Correct inhalation technique significantly contributes to better adherence to treatment. Elliptа is a multi-dose powder inhaler with dose counter and indication of remaining dose number. Actuation of Ellipta inhaler requires only one movement. Inhaled glucocorticosteroids (ICS) and long-acting β2-agonists (LABA) are the key agents in the maintenance pharmacological therapy of asthma. A novel vilanterol/fluticasone furoate (VI/FF) combination is a highly effective combination for maintenance treatment of moderate to severe asthma with 24-hour effect providing once-daily dosing. The Salford study demonstrated advantages of VI/FF combination over ICS monotherapy and other combination of ICS/LABA in real clinical practice in patients with asthma out of dependence of asthma severity or comorbidities.

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