Gilda Zarate-Gonzalez, Paul Brown, Ricardo Cisneros
Introduction: The San Joaquin Valley (SJV) is often recognized as one of the most polluted regions in the US. Periods of pollution exposure are associated with increased health burden related to respiratory inflammation and undermined lung function, which aggravates respiratory diseases such as asthma and leads to symptoms such as coughing, wheezing, or difficulty breathing. Asthma costs US&dollar 82 billion annually in healthcare costs, missed work and school in the US. Methods: Employing a societal perspective, a cost of illness design was combined with environmental epidemiological methods to analyze the economic impact of O3, NO2, and PM2.5-related adverse respiratory health outcomes amongst SJV residents who attended the emergency department (ED) or were hospitalized in 2016. Results: Asthma exacerbations monetized value ranged from US&dollar 3353 to US&dollar 5003 per ED visit and for hospital admissions US&dollar 2584 per inpatient day for adults 65 years and older to US&dollar 3023 per child. The estimated value to society in healthcare costs, productivity losses, school absences, and opportunity costs from air pollution adverse health outcomes totaled US&dollar 498,014,124 in ED visits and US&dollar 223,552,720 in hospital admissions for the SJV population in 2016. The marginal reduction in the background concentrations of pollutants would avert 21,786 ED adverse events and 19,328 hospitalizations from the health burden on the SJV population or US&dollar 8,024,505 cost savings due to O3, US&dollar 82,482,683 from NO2 reductions, and US&dollar 46,214,702 from decreased concentration of PM2.5. Conclusion: This study provides evidence that air pollution is a negative externality that imposes substantial social, environmental, and healthcare costs on the SJV. Furthermore, the region would avert significant adverse health outcomes realizing economic savings by reducing air pollution and exposures.
Keywords: health economics, air pollution, asthma, cost of illness, public health
{"title":"Costs of Air Pollution in California’s San Joaquin Valley: A Societal Perspective of the Burden of Asthma on Emergency Departments and Inpatient Care","authors":"Gilda Zarate-Gonzalez, Paul Brown, Ricardo Cisneros","doi":"10.2147/jaa.s455745","DOIUrl":"https://doi.org/10.2147/jaa.s455745","url":null,"abstract":"<strong>Introduction:</strong> The San Joaquin Valley (SJV) is often recognized as one of the most polluted regions in the US. Periods of pollution exposure are associated with increased health burden related to respiratory inflammation and undermined lung function, which aggravates respiratory diseases such as asthma and leads to symptoms such as coughing, wheezing, or difficulty breathing. Asthma costs US&dollar 82 billion annually in healthcare costs, missed work and school in the US.<br/><strong>Methods:</strong> Employing a societal perspective, a cost of illness design was combined with environmental epidemiological methods to analyze the economic impact of O<sub>3</sub>, NO<sub>2</sub>, and PM<sub>2.5</sub>-related adverse respiratory health outcomes amongst SJV residents who attended the emergency department (ED) or were hospitalized in 2016.<br/><strong>Results:</strong> Asthma exacerbations monetized value ranged from US&dollar 3353 to US&dollar 5003 per ED visit and for hospital admissions US&dollar 2584 per inpatient day for adults 65 years and older to US&dollar 3023 per child. The estimated value to society in healthcare costs, productivity losses, school absences, and opportunity costs from air pollution adverse health outcomes totaled US&dollar 498,014,124 in ED visits and US&dollar 223,552,720 in hospital admissions for the SJV population in 2016. The marginal reduction in the background concentrations of pollutants would avert 21,786 ED adverse events and 19,328 hospitalizations from the health burden on the SJV population or US&dollar 8,024,505 cost savings due to O<sub>3</sub>, US&dollar 82,482,683 from NO<sub>2</sub> reductions, and US&dollar 46,214,702 from decreased concentration of PM<sub>2.5</sub>.<br/><strong>Conclusion:</strong> This study provides evidence that air pollution is a negative externality that imposes substantial social, environmental, and healthcare costs on the SJV. Furthermore, the region would avert significant adverse health outcomes realizing economic savings by reducing air pollution and exposures.<br/><br/><strong>Keywords:</strong> health economics, air pollution, asthma, cost of illness, public health<br/>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"1 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140612998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yang Zhao, Hua Wang, Zhengjun Wu, Yunxiang Zhu, Jingsong Wang
Background: Adverse reactions induced by isoosmolar contrast medium (iodixanol) are mostly mild, with rashes and headaches being the most common. Although anaphylactic shock has been reported, no related incidents have been documented on cerebral angiography. Objective: This article reports a serious case of anaphylactic shock possibly induced by iodixanol and provides an overview of the case report. Case Summary: A 65-year-old female with persistent headaches for nearly six months and CTA examination revealed multiple intracranial aneurysms. After two treatments, she returned to the hospital for aneurysm of reexamination a month ago. Following a preoperative assessment, cerebral angiography was performed. Three minutes after the procedure, the patient experienced dizziness, increased heart rate, followed by hypotension (BP 90/43 mm Hg), a sudden drop-in heart rate (HR 68 bpm), and a drop in SpO2 to 92%. Intravenous dexamethasone for anti-allergic were administered immediately, along with therapy through oxygen-inhalation. However, the patient then developed limb convulsions, unresponsiveness, and was urgently given diazepam for sedation and sputum aspiration to maintain airway patency. Blood pressure decrease to 53/29 mm Hg, and SpO2 readings were unavailable. Intravenous dopamine to elevates blood pressure, and assists breathing by intubating in the endotracheal. After 3 minutes, as the blood pressure remained undetectable, intermittent intravenous epinephrine 1mg was administered to raise the blood pressure, gradually restoring it to 126/90 mm Hg, and SpO2 increased to 95%. The patient was diagnosed with iodixanol-induced anaphylactic shock and urgently transferred to the NICU for monitoring and treatment. The patient died despite immediate treatment. Conclusion: A 65-year-old female developed serious anaphylactic shock during cerebral angiography after receiving iodixanol. Although iodixanol is considered one of the safest iodinated contrast mediums (ICM), clinicians should be aware of its the potential for serious hypersensitivity reactions that can lead to fatal and life-threatening events.
{"title":"Case Report: A Rare Case of Iodixanol-Induced Anaphylactic Shock in Cerebral Angiography","authors":"Yang Zhao, Hua Wang, Zhengjun Wu, Yunxiang Zhu, Jingsong Wang","doi":"10.2147/jaa.s460263","DOIUrl":"https://doi.org/10.2147/jaa.s460263","url":null,"abstract":"<strong>Background:</strong> Adverse reactions induced by isoosmolar contrast medium (iodixanol) are mostly mild, with rashes and headaches being the most common. Although anaphylactic shock has been reported, no related incidents have been documented on cerebral angiography.<br/><strong>Objective:</strong> This article reports a serious case of anaphylactic shock possibly induced by iodixanol and provides an overview of the case report.<br/><strong>Case Summary:</strong> A 65-year-old female with persistent headaches for nearly six months and CTA examination revealed multiple intracranial aneurysms. After two treatments, she returned to the hospital for aneurysm of reexamination a month ago. Following a preoperative assessment, cerebral angiography was performed. Three minutes after the procedure, the patient experienced dizziness, increased heart rate, followed by hypotension (BP 90/43 mm Hg), a sudden drop-in heart rate (HR 68 bpm), and a drop in SpO2 to 92%. Intravenous dexamethasone for anti-allergic were administered immediately, along with therapy through oxygen-inhalation. However, the patient then developed limb convulsions, unresponsiveness, and was urgently given diazepam for sedation and sputum aspiration to maintain airway patency. Blood pressure decrease to 53/29 mm Hg, and SpO2 readings were unavailable. Intravenous dopamine to elevates blood pressure, and assists breathing by intubating in the endotracheal. After 3 minutes, as the blood pressure remained undetectable, intermittent intravenous epinephrine 1mg was administered to raise the blood pressure, gradually restoring it to 126/90 mm Hg, and SpO2 increased to 95%. The patient was diagnosed with iodixanol-induced anaphylactic shock and urgently transferred to the NICU for monitoring and treatment. The patient died despite immediate treatment.<br/><strong>Conclusion:</strong> A 65-year-old female developed serious anaphylactic shock during cerebral angiography after receiving iodixanol. Although iodixanol is considered one of the safest iodinated contrast mediums (ICM), clinicians should be aware of its the potential for serious hypersensitivity reactions that can lead to fatal and life-threatening events.<br/><br/>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"42 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140579411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Weiyi Wang, John Gulliver, Sean Beevers, Anna Freni Sterrantino, Bethan Davies, Richard W Atkinson, Daniela Fecht
Background: There is an increasing body of evidence associating short-term ambient nitrogen dioxide (NO2) exposure with asthma-related hospital admissions in children. However, most studies have relied on temporally resolved exposure information, potentially ignoring the spatial variability of NO2. We aimed to investigate how daily NO2 estimates from a highly resolved spatio-temporal model are associated with the risk of emergency hospital admission for asthma in children in England. Methods: We conducted a time-stratified case-crossover study including 111,766 emergency hospital admissions for asthma in children (aged 0– 14 years) between 1st January 2011 and 31st December 2015 in England. Daily NO2 levels were predicted at the patients’ place of residence using spatio-temporal models by combining land use data and chemical transport model estimates. Conditional logistic regression models were used to obtain the odds ratios (OR) and confidence intervals (CI) after adjusting for temperature, relative humidity, bank holidays, and influenza rates. The effect modifications by age, sex, season, area-level income deprivation, and region were explored in stratified analyses. Results: For each 10 μg/m³ increase in NO2 exposure, we observed an 8% increase in asthma-related emergency admissions using a five-day moving NO2 average (mean lag 0– 4) (OR 1.08, 95% CI 1.06– 1.10). In the stratified analysis, we found larger effect sizes for male (OR 1.10, 95% CI 1.07– 1.12) and during the cold season (OR 1.10, 95% CI 1.08– 1.12). The effect estimates varied slightly by age group, area-level income deprivation, and region. Significance: Short-term exposure to NO2 was significantly associated with an increased risk of asthma emergency admissions among children in England. Future guidance and policies need to consider reflecting certain proven modifications, such as using season-specific countermeasures for air pollution control, to protect the at-risk population.
背景：越来越多的证据表明，短期环境二氧化氮（NO2）暴露与儿童因哮喘入院有关。然而，大多数研究都依赖于时间分辨的暴露信息，可能忽略了二氧化氮的空间变异性。我们的目的是调查高度分辨的时空模型得出的每日二氧化氮估计值与英格兰儿童因哮喘而紧急入院的风险有何关联：我们进行了一项时间分层病例交叉研究，研究对象包括 2011 年 1 月 1 日至 2015 年 12 月 31 日期间因哮喘紧急入院的 111,766 名英格兰儿童（0-14 岁）。通过结合土地利用数据和化学迁移模型估计值，使用时空模型预测了患者居住地的每日二氧化氮水平。在对温度、相对湿度、银行假日和流感发病率进行调整后，使用条件逻辑回归模型得出了几率比（OR）和置信区间（CI）。在分层分析中，探讨了年龄、性别、季节、地区收入贫困程度和地区的影响修正：二氧化氮暴露量每增加 10 微克/立方米，使用五天移动二氧化氮平均值（平均滞后 0-4），我们观察到哮喘相关急诊入院率增加了 8%（OR 1.08，95% CI 1.06-1.10）。在分层分析中，我们发现男性（OR 1.10，95% CI 1.07-1.12）和寒冷季节（OR 1.10，95% CI 1.08-1.12）的影响更大。不同年龄组、地区收入水平和地区的效应估计值略有不同：短期暴露于二氧化氮与英格兰儿童哮喘急诊入院风险的增加密切相关。未来的指导意见和政策需要考虑反映某些已被证实的调整措施，如采用针对不同季节的空气污染控制对策，以保护高危人群。
{"title":"Short-Term Nitrogen Dioxide Exposure and Emergency Hospital Admissions for Asthma in Children: A Case-Crossover Analysis in England","authors":"Weiyi Wang, John Gulliver, Sean Beevers, Anna Freni Sterrantino, Bethan Davies, Richard W Atkinson, Daniela Fecht","doi":"10.2147/jaa.s448600","DOIUrl":"https://doi.org/10.2147/jaa.s448600","url":null,"abstract":"<strong>Background:</strong> There is an increasing body of evidence associating short-term ambient nitrogen dioxide (NO<sub>2</sub>) exposure with asthma-related hospital admissions in children. However, most studies have relied on temporally resolved exposure information, potentially ignoring the spatial variability of NO<sub>2</sub>. We aimed to investigate how daily NO<sub>2</sub> estimates from a highly resolved spatio-temporal model are associated with the risk of emergency hospital admission for asthma in children in England.<br/><strong>Methods:</strong> We conducted a time-stratified case-crossover study including 111,766 emergency hospital admissions for asthma in children (aged 0– 14 years) between 1st January 2011 and 31st December 2015 in England. Daily NO<sub>2</sub> levels were predicted at the patients’ place of residence using spatio-temporal models by combining land use data and chemical transport model estimates. Conditional logistic regression models were used to obtain the odds ratios (OR) and confidence intervals (CI) after adjusting for temperature, relative humidity, bank holidays, and influenza rates. The effect modifications by age, sex, season, area-level income deprivation, and region were explored in stratified analyses.<br/><strong>Results:</strong> For each 10 μg/m³ increase in NO<sub>2</sub> exposure, we observed an 8% increase in asthma-related emergency admissions using a five-day moving NO<sub>2</sub> average (mean lag 0– 4) (OR 1.08, 95% CI 1.06– 1.10). In the stratified analysis, we found larger effect sizes for male (OR 1.10, 95% CI 1.07– 1.12) and during the cold season (OR 1.10, 95% CI 1.08– 1.12). The effect estimates varied slightly by age group, area-level income deprivation, and region.<br/><strong>Significance:</strong> Short-term exposure to NO<sub>2</sub> was significantly associated with an increased risk of asthma emergency admissions among children in England. Future guidance and policies need to consider reflecting certain proven modifications, such as using season-specific countermeasures for air pollution control, to protect the at-risk population.<br/><br/>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"273 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140579409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Bronchial thermoplasty (BT) improves clinical outcomes and quality of life for patients with severe asthma and has shown sustained reductions in airway narrowing and air trapping in previous CT studies. However, there is a lack of a comprehensive analysis, including CT evaluation, of clinical outcomes in Japanese patients who have undergone BT for severe asthma. This study aimed to evaluate the impact of BT in Japanese asthma patients, with a focus on the CT metric “WA at Pi10” to assess airway disease. Methods: Twelve patients with severe persistent asthma who underwent BT were assessed using ACQ6, AQLQ, pulmonary function tests, FeNO measurement, blood sampling, and chest CT before BT and one year after the third procedure for the upper lobes. Results: The median age of the patient was 62.0 years, 7/12 (58.3%) were male, 4/12 (33.3%) used regular oral corticosteroids, and 8/12 (66.7%) received biologics. Median FEV1% was 73.6%, and median peripheral eosinophil count was 163.8/μL. After one year of BT, ACQ6 scores improved from 2.4 to 0.8 points (p = 0.007), and AQLQ scores improved from 4.3 to 5.8 points (p < 0.001). Significant improvements were also observed in asthma exacerbations, unscheduled visits due to exacerbations, FeNO, and √WA at Pi10 (p < 0.05). The baseline mucus score on the CT findings was negatively correlated with FEV1 (r = − 0.688, p = 0.013) and with the maximum mid-expiratory flow rate (r = − 0.631, p = 0.028), and positively correlated with the peripheral blood eosinophil count (r = − 0.719, p = 0.008). Changes in √WA at Pi10 after one year were positively correlated with changes in the mucus score (r = 0.742, p = 0.007). Conclusion: This study has limitations, including its single-arm observational design and the small sample size. However, BT led to a symptomatic improvement in patients with severe asthma. The validated “√WA at Pi10” metric on CT effectively evaluated the therapeutic response in Japanese asthma patients after BT.
{"title":"Usefulness of Computed Tomography for Evaluating the Effects of Bronchial Thermoplasty in Japanese Patients with Severe Asthma","authors":"Sumiko Abe, Mina Yasuda, Kazunori Tobino, Sonoko Harada, Hitoshi Sasano, Yuki Tanabe, Yuuki Sandhu, Tomohito Takeshige, Kei Matsuno, Tetsuhiko Asao, Takuto Sueyasu, Saori Nishizawa, Kohei Yoshimine, Yuki Ko, Yuki Yoshimatsu, Kosuke Tsuruno, Hiromi Ide, Haruhi Takagi, Jun Ito, Tetsutaro Nagaoka, Norihiro Harada, Kazuhisa Takahashi","doi":"10.2147/jaa.s452865","DOIUrl":"https://doi.org/10.2147/jaa.s452865","url":null,"abstract":"<strong>Background:</strong> Bronchial thermoplasty (BT) improves clinical outcomes and quality of life for patients with severe asthma and has shown sustained reductions in airway narrowing and air trapping in previous CT studies. However, there is a lack of a comprehensive analysis, including CT evaluation, of clinical outcomes in Japanese patients who have undergone BT for severe asthma. This study aimed to evaluate the impact of BT in Japanese asthma patients, with a focus on the CT metric “WA at Pi10” to assess airway disease.<br/><strong>Methods:</strong> Twelve patients with severe persistent asthma who underwent BT were assessed using ACQ6, AQLQ, pulmonary function tests, FeNO measurement, blood sampling, and chest CT before BT and one year after the third procedure for the upper lobes.<br/><strong>Results:</strong> The median age of the patient was 62.0 years, 7/12 (58.3%) were male, 4/12 (33.3%) used regular oral corticosteroids, and 8/12 (66.7%) received biologics. Median FEV<sub>1</sub>% was 73.6%, and median peripheral eosinophil count was 163.8/μL. After one year of BT, ACQ6 scores improved from 2.4 to 0.8 points (<em>p</em> = 0.007), and AQLQ scores improved from 4.3 to 5.8 points (<em>p</em> < 0.001). Significant improvements were also observed in asthma exacerbations, unscheduled visits due to exacerbations, FeNO, and √WA at Pi10 (<em>p</em> < 0.05). The baseline mucus score on the CT findings was negatively correlated with FEV<sub>1</sub> (r = − 0.688, <em>p</em> = 0.013) and with the maximum mid-expiratory flow rate (r = − 0.631, <em>p</em> = 0.028), and positively correlated with the peripheral blood eosinophil count (r = − 0.719, <em>p</em> = 0.008). Changes in √WA at Pi10 after one year were positively correlated with changes in the mucus score (r = 0.742, <em>p</em> = 0.007).<br/><strong>Conclusion:</strong> This study has limitations, including its single-arm observational design and the small sample size. However, BT led to a symptomatic improvement in patients with severe asthma. The validated “√WA at Pi10” metric on CT effectively evaluated the therapeutic response in Japanese asthma patients after BT.<br/><br/>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"31 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140579785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tham T Le, Benjamin Emmanuel, Rohit Katial, Trung N Tran, Justin Joseph Kwiatek, David S Cohen, Shoshana R Daniel, Yunhui Cao, Vivian H Shih, Maria Gil Melcón, Gilles Devouassoux, Girolamo Pelaia
Purpose: Real-world evidence of benralizumab effectiveness on nasal polyps (NP) and asthma outcomes in patients with severe eosinophilic asthma (SEA) and comorbid chronic rhinosinusitis with NP are limited. The objective of this study was to assess NP and asthma outcomes in benralizumab-treated patients with SEA and comorbid NP in a real-world setting. Patients and Methods: RANS was a retrospective, multi-country observational study (ClinicalTrials.gov: NCT05180357) using medical chart reviews of adults with SEA and comorbid NP. Total NP Score (NPS), SinoNasal Outcome Test-22 (SNOT-22) total score, annualized exacerbation rate (AER), and 6-item Asthma Control Questionnaire (ACQ-6) and Asthma Control Test (ACT) scores during the 12 months pre-index (baseline) and post-index (follow-up) were measured. Clinically meaningful improvement from baseline following treatment, in terms of total NPS (≥ 1-point reduction), SNOT-22 total (≥ 8.9-point reduction), ACQ-6 (≥ 0.5-point reduction) or ACT (≥ 3-point increase) scores, were reported. Results: A total of 233 patients were included. Baseline mean (standard deviation [SD]) NPS and SNOT-22 total scores were 3.8 (2.4) and 47.5 (22.6), respectively. The mean change (95% confidence interval [CI]) from baseline was – 1.2 (– 1.7, – 0.6) for NPS, and – 19.8 (– 23.6, – 15.9) for SNOT-22. The AER (95% CI) was 1.2 (0.96, 1.41) at baseline and 0.2 (0.13, 0.28) at follow-up. Mean (SD) ACQ-6 and ACT scores were 1.6 (1.3) and 15.0 (5.2) at baseline and 0.8 (1.0) and 22.0 (3.9) at follow-up, respectively. The proportion of patients who achieved clinically meaningful improvements in NPS, SNOT-22 total, ACQ-6, and ACT scores was 49.1%, 67.6%, 56.6%, and 81.1%, respectively. Conclusion: In this real-world study, improvements in NP and asthma outcomes in patients with SEA and comorbid NP were observed during the 12 months following benralizumab initiation.
{"title":"Benralizumab in Severe Eosinophilic Asthma and Chronic Rhinosinusitis with Nasal Polyps: The Real-World, Multi-Country RANS Observational Study","authors":"Tham T Le, Benjamin Emmanuel, Rohit Katial, Trung N Tran, Justin Joseph Kwiatek, David S Cohen, Shoshana R Daniel, Yunhui Cao, Vivian H Shih, Maria Gil Melcón, Gilles Devouassoux, Girolamo Pelaia","doi":"10.2147/jaa.s437190","DOIUrl":"https://doi.org/10.2147/jaa.s437190","url":null,"abstract":"<strong>Purpose:</strong> Real-world evidence of benralizumab effectiveness on nasal polyps (NP) and asthma outcomes in patients with severe eosinophilic asthma (SEA) and comorbid chronic rhinosinusitis with NP are limited. The objective of this study was to assess NP and asthma outcomes in benralizumab-treated patients with SEA and comorbid NP in a real-world setting.<br/><strong>Patients and Methods:</strong> RANS was a retrospective, multi-country observational study (ClinicalTrials.gov: NCT05180357) using medical chart reviews of adults with SEA and comorbid NP. Total NP Score (NPS), SinoNasal Outcome Test-22 (SNOT-22) total score, annualized exacerbation rate (AER), and 6-item Asthma Control Questionnaire (ACQ-6) and Asthma Control Test (ACT) scores during the 12 months pre-index (baseline) and post-index (follow-up) were measured. Clinically meaningful improvement from baseline following treatment, in terms of total NPS (≥ 1-point reduction), SNOT-22 total (≥ 8.9-point reduction), ACQ-6 (≥ 0.5-point reduction) or ACT (≥ 3-point increase) scores, were reported.<br/><strong>Results:</strong> A total of 233 patients were included. Baseline mean (standard deviation [SD]) NPS and SNOT-22 total scores were 3.8 (2.4) and 47.5 (22.6), respectively. The mean change (95% confidence interval [CI]) from baseline was – 1.2 (– 1.7, – 0.6) for NPS, and – 19.8 (– 23.6, – 15.9) for SNOT-22. The AER (95% CI) was 1.2 (0.96, 1.41) at baseline and 0.2 (0.13, 0.28) at follow-up. Mean (SD) ACQ-6 and ACT scores were 1.6 (1.3) and 15.0 (5.2) at baseline and 0.8 (1.0) and 22.0 (3.9) at follow-up, respectively. The proportion of patients who achieved clinically meaningful improvements in NPS, SNOT-22 total, ACQ-6, and ACT scores was 49.1%, 67.6%, 56.6%, and 81.1%, respectively.<br/><strong>Conclusion:</strong> In this real-world study, improvements in NP and asthma outcomes in patients with SEA and comorbid NP were observed during the 12 months following benralizumab initiation.<br/><br/><strong>Keywords:</strong> exacerbations, comorbidity, biologics, patient-reported outcomes, SinoNasal Outcome Test-22, Nasal Polyps Score<br/>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"42 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140579516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Iman Bashir Hamid Abashar, Omaima Abdel Majeed Mohamed Salih, Tarteel Abbas Abaker Joda, Mai Fathi Awadalla Alsedig, Alaa T Omer, Hayat A Ahmed, Lina Hemmeda, Mariam Alazraa M Esmaeel, Khabab Abbasher Hussien Mohamed Ahmed
Background and Aims: It is essential to have proper treatment and management for asthma in order to minimise symptoms, lessen the burden, and lower the chance of exacerbations. To better control asthma, the purpose of this study was to evaluate and enhance paediatric registrars’ understanding and application of asthma treatment. Methods: The Sudan Medical Specialisation Board (SMSB) paediatric registrars provided data for this quasi-interventional study between April and September of 2021. Twice, both before to and following the intervention education sessions, the questionnaire was delivered. SPSS version 28 was used to analyse the data after it had been cleaned up in an Excel document. Results: 203 (or 77.8%) of the 261 were women. A substantial rise from 8.1 ± 4.12 SD to 18 ± 5.03 SD in the mean overall knowledge score of registrars between the pre-and post-intervention periods. A significant difference (p=0.001) was observed in the post-intervention phase, with first-year registrars (R1) demonstrating higher scores than their senior colleagues. The registrars’ total knowledge scores did not differ significantly from one another during the pre-intervention period. The Global Initiative of Asthma (GINA) guidelines of management were implemented to a certain extent, according to the study. Of the registrars, 148 (56.7%) and 203 (77.8%) evaluated step one management in children ages 5 and under; 66 (25.3%) and 213 (81.6%) evaluated step one management in children ages 6 to 11; and 66 (25.3%) and 213 (81.6%) evaluated step one management in children ages 6 to 11 in pre- and post-intervention, respectively. Conclusion: Given that the intervention in this study greatly increased registrars’ knowledge, doctors should obtain training on the GINA 2019 recommendations through conferences, workshops, and academic programmes. To find out why R1 outperforms their older counterparts, more investigation has to be done.
Keywords: asthma, GINA, management of asthma, Sudan
{"title":"Assessment of the Implementation of Global Initiative for Asthma (GINA) 2019 Guidelines for Treatment of Mild Asthma Among Pediatric Registrars: A Quasi-Interventional Study","authors":"Iman Bashir Hamid Abashar, Omaima Abdel Majeed Mohamed Salih, Tarteel Abbas Abaker Joda, Mai Fathi Awadalla Alsedig, Alaa T Omer, Hayat A Ahmed, Lina Hemmeda, Mariam Alazraa M Esmaeel, Khabab Abbasher Hussien Mohamed Ahmed","doi":"10.2147/jaa.s442573","DOIUrl":"https://doi.org/10.2147/jaa.s442573","url":null,"abstract":"<strong>Background and Aims:</strong> It is essential to have proper treatment and management for asthma in order to minimise symptoms, lessen the burden, and lower the chance of exacerbations. To better control asthma, the purpose of this study was to evaluate and enhance paediatric registrars’ understanding and application of asthma treatment.<br/><strong>Methods:</strong> The Sudan Medical Specialisation Board (SMSB) paediatric registrars provided data for this quasi-interventional study between April and September of 2021. Twice, both before to and following the intervention education sessions, the questionnaire was delivered. SPSS version 28 was used to analyse the data after it had been cleaned up in an Excel document.<br/><strong>Results:</strong> 203 (or 77.8%) of the 261 were women. A substantial rise from 8.1 ± 4.12 SD to 18 ± 5.03 SD in the mean overall knowledge score of registrars between the pre-and post-intervention periods. A significant difference (p=0.001) was observed in the post-intervention phase, with first-year registrars (R1) demonstrating higher scores than their senior colleagues. The registrars’ total knowledge scores did not differ significantly from one another during the pre-intervention period. The Global Initiative of Asthma (GINA) guidelines of management were implemented to a certain extent, according to the study. Of the registrars, 148 (56.7%) and 203 (77.8%) evaluated step one management in children ages 5 and under; 66 (25.3%) and 213 (81.6%) evaluated step one management in children ages 6 to 11; and 66 (25.3%) and 213 (81.6%) evaluated step one management in children ages 6 to 11 in pre- and post-intervention, respectively.<br/><strong>Conclusion:</strong> Given that the intervention in this study greatly increased registrars’ knowledge, doctors should obtain training on the GINA 2019 recommendations through conferences, workshops, and academic programmes. To find out why R1 outperforms their older counterparts, more investigation has to be done.<br/><br/><strong>Keywords:</strong> asthma, GINA, management of asthma, Sudan<br/>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"abs/2305.17196 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140579518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract: Atopic dermatitis (AD) may sometimes be comorbid with alopecia areata (AA). However, traditional treatments for AA show limited efficacy. New treatment options, such as dupilumab and Janus kinase inhibitors, have proven efficacy in addressing both AD and AA. This article highlights the challenging case of a 12-year-old boy experiencing severe refractory AD and comorbid AA treated with oral abrocitinib after dupilumab failure with 1-year follow-up. After 3 months of treatment, his skin manifestations improved and the hair completely regenerated. No adverse reactions were observed during the 1-year follow-up period. This case provides evidence of the efficacy and safety of using abrocitinib to treat pediatric patients with both AD and AA.
{"title":"Abrocitinib Improved Dupilumab-Resistant Severe Atopic Dermatitis with Comorbid Mild Alopecia Areata in a 12-Year-Old Boy: A Case Report with 1-Year Follow-Up","authors":"Xiaohan Liu, Biao Song, Hongzhong Jin","doi":"10.2147/jaa.s458684","DOIUrl":"https://doi.org/10.2147/jaa.s458684","url":null,"abstract":"<strong>Abstract:</strong> Atopic dermatitis (AD) may sometimes be comorbid with alopecia areata (AA). However, traditional treatments for AA show limited efficacy. New treatment options, such as dupilumab and Janus kinase inhibitors, have proven efficacy in addressing both AD and AA. This article highlights the challenging case of a 12-year-old boy experiencing severe refractory AD and comorbid AA treated with oral abrocitinib after dupilumab failure with 1-year follow-up. After 3 months of treatment, his skin manifestations improved and the hair completely regenerated. No adverse reactions were observed during the 1-year follow-up period. This case provides evidence of the efficacy and safety of using abrocitinib to treat pediatric patients with both AD and AA.<br/><br/><strong>Keywords:</strong> atopic dermatitis, alopecia areata, Janus kinase inhibitors, dupilumab<br/>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"49 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140579936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paolo Cameli, Maria Aliani, Elena Altieri, Pietro Bracciale, Luisa Brussino, Maria Filomena Caiaffa, Giorgio Walter Canonica, Cristiano Caruso, Stefano Centanni, Maria D'Amato, Fausto De Michele, Stefano Del Giacco, Fabiano Di Marco, Girolamo Pelaia, Paola Rogliani, Micaela Romagnoli, Pietro Schino, Jan Walter Schroeder, Gianenrico Senna, Alessandra Vultaggio, Marco Benci, Silvia Boarino, Francesco Menzella
Purpose: Severe eosinophilic asthma (SEA) patients often present overlapping inflammatory features rendering them eligible for multiple biologic therapies; switching biologic treatment is a strategy adopted to optimize asthma control when patients show partial or no response to previous biologics. Patients and Methods: ANANKE is a retrospective, multicenter Italian study (NCT04272463). Here, we outline the characteristics and long-term clinical outcomes in naïve-to-biologics and biologics-experienced patients treated with benralizumab for up to 96 weeks. Bio-experienced patients were split into omalizumab and mepolizumab subsets according to the type of biologic previously used. Results: A total of 124 (76.5%) naïve and 38 (23.5%) bio-experienced patients were evaluated at index date; 13 patients (34.2%) switched from mepolizumab, 21 patients (55.3%) switched from omalizumab, and four patients (10.5%) received both biologics. The mepolizumab subset was characterized by the longest SEA duration (median of 4.6 years), the highest prevalence of chronic rhinosinusitis with nasal polyposis (CRSwNP) (76.5%), and the greatest oral corticosteroid (OCS) daily dosage (median of 25 mg prednisone equivalent). The omalizumab group showed the highest severe annual exacerbation rate (AER) (1.70). At 96 weeks, treatment with benralizumab reduced any and severe AER by more than 87% and 94%, respectively, across all groups. Lung function was overall preserved, with major improvements observed in the mepolizumab group, which also revealed a 100% drop of the median OCS dose. Asthma Control Test (ACT) score improved in the naïve group while its increment was more variable in bio-experienced patients; among these, a marked difference was noticed between omalizumab and mepolizumab subsets (median ACT score of 23.5 and 18, respectively). Conclusion: Benralizumab promotes durable and profound clinical benefits in naïve and bio-experienced groups, indicating that a nearly complete depletion of eosinophils is highly beneficial in the control of SEA, independently of previous biologic use.
{"title":"Sustained Effectiveness of Benralizumab in Naïve and Biologics-Experienced Severe Eosinophilic Asthma Patients: Results from the ANANKE Study","authors":"Paolo Cameli, Maria Aliani, Elena Altieri, Pietro Bracciale, Luisa Brussino, Maria Filomena Caiaffa, Giorgio Walter Canonica, Cristiano Caruso, Stefano Centanni, Maria D'Amato, Fausto De Michele, Stefano Del Giacco, Fabiano Di Marco, Girolamo Pelaia, Paola Rogliani, Micaela Romagnoli, Pietro Schino, Jan Walter Schroeder, Gianenrico Senna, Alessandra Vultaggio, Marco Benci, Silvia Boarino, Francesco Menzella","doi":"10.2147/jaa.s438981","DOIUrl":"https://doi.org/10.2147/jaa.s438981","url":null,"abstract":"<strong>Purpose:</strong> Severe eosinophilic asthma (SEA) patients often present overlapping inflammatory features rendering them eligible for multiple biologic therapies; switching biologic treatment is a strategy adopted to optimize asthma control when patients show partial or no response to previous biologics.<br/><strong>Patients and Methods:</strong> ANANKE is a retrospective, multicenter Italian study (NCT04272463). Here, we outline the characteristics and long-term clinical outcomes in naïve-to-biologics and biologics-experienced patients treated with benralizumab for up to 96 weeks. Bio-experienced patients were split into omalizumab and mepolizumab subsets according to the type of biologic previously used.<br/><strong>Results:</strong> A total of 124 (76.5%) naïve and 38 (23.5%) bio-experienced patients were evaluated at index date; 13 patients (34.2%) switched from mepolizumab, 21 patients (55.3%) switched from omalizumab, and four patients (10.5%) received both biologics. The mepolizumab subset was characterized by the longest SEA duration (median of 4.6 years), the highest prevalence of chronic rhinosinusitis with nasal polyposis (CRSwNP) (76.5%), and the greatest oral corticosteroid (OCS) daily dosage (median of 25 mg prednisone equivalent). The omalizumab group showed the highest severe annual exacerbation rate (AER) (1.70). At 96 weeks, treatment with benralizumab reduced any and severe AER by more than 87% and 94%, respectively, across all groups. Lung function was overall preserved, with major improvements observed in the mepolizumab group, which also revealed a 100% drop of the median OCS dose. Asthma Control Test (ACT) score improved in the naïve group while its increment was more variable in bio-experienced patients; among these, a marked difference was noticed between omalizumab and mepolizumab subsets (median ACT score of 23.5 and 18, respectively).<br/><strong>Conclusion:</strong> Benralizumab promotes durable and profound clinical benefits in naïve and bio-experienced groups, indicating that a nearly complete depletion of eosinophils is highly beneficial in the control of SEA, independently of previous biologic use.<br/><br/><strong>Keywords:</strong> benralizumab, asthma, eosinophils, switch, long-term<br/>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"33 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140297765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To explore the value of a new model based on CT radiomics in predicting the staging of patients with bronchial asthma (BA). Methods: Patients with BA from 2018 to 2021 were retrospectively analyzed and underwent plain chest CT before treatment. According to the guidelines for the prevention and treatment of BA (2016 edition), they were divided into two groups: acute attack and non-acute attack. The images were processed as follows: using Lung Kit software for image standardization and segmentation, using AK software for image feature extraction, and using R language for data analysis and model construction (training set: test set = 7: 3). The efficacy and clinical effects of the constructed model were evaluated with ROC curve, sensitivity, specificity, calibration curve and decision curve. Results: A total of 112 patients with BA were enrolled, including 80 patients with acute attack (range: 2– 86 years old, mean: 53.89± 17.306 years old, males of 33) and 32 patients with non-acute attack (range: 4– 79 years old, mean: 57.38± 19.223 years old, males of 18). A total of 10 imaging features are finally retained and used to construct model using multi-factor logical regression method. In the training group, the AUC, sensitivity and specificity of the model was 0.881 (95% CI:0.808– 0.955), 0.804 and 0.818, separately; while in the test group, it was 0.792 (95% CI:0.608– 0.976), 0.792 and 0.80, respectively. Conclusion: The model constructed based on radiomics has a good effect on predicting the staging of patients with BA, which provides a new method for clinical diagnosis of staging in BA patients.
{"title":"Study on Predicting Clinical Stage of Patients with Bronchial Asthma Based on CT Radiomics","authors":"Xiaodong Chen, Xiangyuan Wang, Shangqing Huang, Wenxuan Luo, Zebin Luo, Zipan Chen","doi":"10.2147/jaa.s448064","DOIUrl":"https://doi.org/10.2147/jaa.s448064","url":null,"abstract":"<strong>Objective:</strong> To explore the value of a new model based on CT radiomics in predicting the staging of patients with bronchial asthma (BA).<br/><strong>Methods:</strong> Patients with BA from 2018 to 2021 were retrospectively analyzed and underwent plain chest CT before treatment. According to the guidelines for the prevention and treatment of BA (2016 edition), they were divided into two groups: acute attack and non-acute attack. The images were processed as follows: using Lung Kit software for image standardization and segmentation, using AK software for image feature extraction, and using R language for data analysis and model construction (training set: test set = 7: 3). The efficacy and clinical effects of the constructed model were evaluated with ROC curve, sensitivity, specificity, calibration curve and decision curve.<br/><strong>Results:</strong> A total of 112 patients with BA were enrolled, including 80 patients with acute attack (range: 2– 86 years old, mean: 53.89± 17.306 years old, males of 33) and 32 patients with non-acute attack (range: 4– 79 years old, mean: 57.38± 19.223 years old, males of 18). A total of 10 imaging features are finally retained and used to construct model using multi-factor logical regression method. In the training group, the AUC, sensitivity and specificity of the model was 0.881 (95% CI:0.808– 0.955), 0.804 and 0.818, separately; while in the test group, it was 0.792 (95% CI:0.608– 0.976), 0.792 and 0.80, respectively.<br/><strong>Conclusion:</strong> The model constructed based on radiomics has a good effect on predicting the staging of patients with BA, which provides a new method for clinical diagnosis of staging in BA patients.<br/><br/><strong>Keywords:</strong> bronchial asthma, BA, Radiomics, computed tomography, CT<br/>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"140 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140315609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jared Silver, Andrea Steffens, Benjamin Chastek, Arijita Deb
Purpose: Real-world data on mepolizumab in patients with severe asthma and allergic and non-allergic phenotypes are limited. This study investigated the effectiveness of mepolizumab treatment in patients with severe asthma with allergic and non-allergic phenotypes. Patients and Methods: This retrospective cohort study (GSK ID: 214148) used administrative claims data from the Optum Research Database. Eligible patients were ≥ 6 years of age with asthma and had ≥ 2 mepolizumab claims post-index. Index date was the first mepolizumab claim/administration (January 2016–December 2018). Patients were divided into two cohorts: allergic and non-allergic asthma, based on diagnosis codes, medication use and lab test results. Outcomes included the rate of asthma-related exacerbations and oral corticosteroid (OCS) use during the 12 months before (baseline period) and 12 months after (follow-up period) mepolizumab initiation. Study ended in December 2019. Results: Overall, 240 (44.6%) and 298 (55.4%) patients were included in the allergic and non-allergic asthma cohorts, respectively. Mean (standard deviation [SD]) counts of asthma-related exacerbations were significantly reduced from baseline to follow-up in both the allergic and non-allergic asthma cohorts (3.2 [2.5] to 2.1 [2.1], p < 0.001 and 2.5 [2.2] to 1.7 [1.9], p < 0.001, respectively). The mean number of OCS pharmacy claims was significantly decreased by 33.3% and 41.4% from baseline to follow-up in the allergic and non-allergic cohorts, respectively (p < 0.001); mean daily OCS dose significantly decreased by 30.6% and 45.4%, respectively (p < 0.001) as well as the mean number of OCS bursts, which decreased by 44.9% and 41.8%, respectively (p < 0.001). No significant differences were observed between cohorts in reductions in asthma exacerbations, counts of OCS pharmacy claims or OCS bursts (baseline to follow-up). Conclusion: Mepolizumab significantly reduced asthma exacerbations and OCS use in patients with allergic and non-allergic asthma, suggesting that mepolizumab provides real-world benefit in severe asthma irrespective of whether a patient has an allergic phenotype.
Keywords: severe asthma, phenotype, exacerbation, oral corticosteroid
{"title":"Real-World Effectiveness of Mepolizumab in Patients with Allergic and Non-Allergic Asthma","authors":"Jared Silver, Andrea Steffens, Benjamin Chastek, Arijita Deb","doi":"10.2147/jaa.s444693","DOIUrl":"https://doi.org/10.2147/jaa.s444693","url":null,"abstract":"<strong>Purpose:</strong> Real-world data on mepolizumab in patients with severe asthma and allergic and non-allergic phenotypes are limited. This study investigated the effectiveness of mepolizumab treatment in patients with severe asthma with allergic and non-allergic phenotypes.<br/><strong>Patients and Methods:</strong> This retrospective cohort study (GSK ID: 214148) used administrative claims data from the Optum Research Database. Eligible patients were ≥ 6 years of age with asthma and had ≥ 2 mepolizumab claims post-index. Index date was the first mepolizumab claim/administration (January 2016–December 2018). Patients were divided into two cohorts: allergic and non-allergic asthma, based on diagnosis codes, medication use and lab test results. Outcomes included the rate of asthma-related exacerbations and oral corticosteroid (OCS) use during the 12 months before (baseline period) and 12 months after (follow-up period) mepolizumab initiation. Study ended in December 2019.<br/><strong>Results:</strong> Overall, 240 (44.6%) and 298 (55.4%) patients were included in the allergic and non-allergic asthma cohorts, respectively. Mean (standard deviation [SD]) counts of asthma-related exacerbations were significantly reduced from baseline to follow-up in both the allergic and non-allergic asthma cohorts (3.2 [2.5] to 2.1 [2.1], p < 0.001 and 2.5 [2.2] to 1.7 [1.9], p < 0.001, respectively). The mean number of OCS pharmacy claims was significantly decreased by 33.3% and 41.4% from baseline to follow-up in the allergic and non-allergic cohorts, respectively (p < 0.001); mean daily OCS dose significantly decreased by 30.6% and 45.4%, respectively (p < 0.001) as well as the mean number of OCS bursts, which decreased by 44.9% and 41.8%, respectively (p < 0.001). No significant differences were observed between cohorts in reductions in asthma exacerbations, counts of OCS pharmacy claims or OCS bursts (baseline to follow-up).<br/><strong>Conclusion:</strong> Mepolizumab significantly reduced asthma exacerbations and OCS use in patients with allergic and non-allergic asthma, suggesting that mepolizumab provides real-world benefit in severe asthma irrespective of whether a patient has an allergic phenotype.<br/><br/><strong>Keywords:</strong> severe asthma, phenotype, exacerbation, oral corticosteroid<br/>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"40 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140204037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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