Disease control and treatment pathways of asthma patients after initiating ICS/LABA

Introduction: GINA guidelines recommend medium dose (MED) and high dose (HD) ICS/LABA as the preferred controller for step 4 asthma patients and clinicians should consider step up/down based on their patients’ asthma control. Limited data is available on how step 4 patients respond to ICS/LABA and how they step up/down in clinical practice. Methods: We conducted a retrospective cohort study using UK Clinical Practice Research Datalink to assess control status of asthma patients in one year after initiating a MED or HD ICS/LABA between 2007 and 2015, and examined their treatment pathways within one year after the treatment initiation. Results: 29,229 and 16, 575 patients initiated MED and HD…

Gibt es Vorteile der ICS/LABA-Fixkombination hinsichtlich patientenrelevanter Parameter bei Asthma?

Moving from the Oslerian paradigm to the postgenomic era: Are asthma and COPD outdated terms?

In the majority of cases, asthma and chronic obstructive pulmonary disease (COPD) are two clearly distinct disease entities. However, in some patients there may be significant overlap between the two conditions. This constitutes an important area of concern because these patients are generally excluded from randomised controlled trials (mostly because of smoking history in the case of asthma or because of significant bronchodilator reversibility in the case of COPD). As a result, their pathobiology, prognosis and response to therapy are largely unknown. This may lead to suboptimal management and can limit the development of more personalised therapeutic options. Emerging genetic and molecul…

Correlation between work impairment, scores of rhinitis severity and asthma using the MASK-air ® App

Background: In allergic rhinitis, a relevant outcome providing information on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently. Methods: All consecutive MASK-air users in 23 countries from 1 June 2016 to 31 October 2018 were included (14 189 users; 205 904 days). Geolocalized users self-assessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 1…

Severe eosinophilic asthma: a roadmap to consensus

Asthma is widely accepted as a complex heterogeneous condition with diverse pathophysiological mechanisms, clinical presentations, comorbidities, physiological characteristics, pathology and outcomes that is typically best managed by a multidisciplinary team [1–4]. Severe asthma is recognised as a major unmet need with a high personal and social impact, as well as a high burden on healthcare resources [4]. As a consequence of advances in the development of precision medicines for patients with severe asthma, the need to identify asthma subtypes by phenotype based on clinical, functional or inflammatory parameters is becoming a mandatory part of management [4–6]. Severe eosinophilic asthma (…