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Álvarez-Gutiérrez FJ, Casas-Maldonado F, Soto-Campos G, Blanco-Aparicio M, Delgado J, Galo AP, Quirce S, Plaza V. Spanish Consensus on Remission in Asthma (REMAS). Arch Bronconeumol 2024:S0300-2896(24)00109-1. [PMID: 38697903 DOI: 10.1016/j.arbres.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/04/2024] [Accepted: 04/05/2024] [Indexed: 05/05/2024]
Abstract
The concept of "remission" in asthma has been around for a long time and it has been a controversial topic. Despite the attempts of some studies to characterize this entity, the discussion continues. In the case of asthma there is still no clear definition, either in terms of its meaning or the parameters that should be included or whether it should be divided into clinical or complete remission. To help defining these controversial concepts, SEPAR has advocated the multidisciplinary working group REMAS (REMission in ASthma). Following the Delphi methodology and with the involvement of more than 120 specialists in asthma management, this group has arrived at a consensus on the definitions of remission in asthma and establishing the criteria and characteristics that will be of use in future studies evaluating the efficacy or effectiveness of treatments.
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Affiliation(s)
| | | | - Gregorio Soto-Campos
- Unidad de Gestión Clínica de Neumología y Alergia, Hospital Universitario de Jerez, Jerez de la Frontera, Cádiz, Spain
| | | | - Julio Delgado
- Unidad de Gestión Clínica de Alergología, Hospital Virgen Macarena, Sevilla, Spain
| | | | - Santiago Quirce
- Servicio de Alergia, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - Vicente Plaza
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau de Barcelona, Barcelona, Spain
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Palones E, García-Rivero JL, Cisneros C, Almonacid-Sánchez C, Pérez-de Llano L, Plaza V, Crespo-Lessmann A. Methodology Employed to Develop the Airway Mucus Secretion Test (T-SEC): A Questionnaire to Evaluate Airway Mucus Hypersecretion in Patients With Asthma. Arch Bronconeumol 2024; 60:186-190. [PMID: 38290898 DOI: 10.1016/j.arbres.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/29/2023] [Accepted: 01/03/2024] [Indexed: 02/01/2024]
Affiliation(s)
- Esther Palones
- Department of Respiratory Medicine, Institute of Biomedical Research Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau & IIB Sant Pau, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Juan Luis García-Rivero
- Department of Respiratory Medicine, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Carolina Cisneros
- Department of Respiratory Medicine, Hospital Universitario de La Princesa, Madrid, Spain
| | - Carlos Almonacid-Sánchez
- Department of Respiratory Medicine, Hospital Universitario de Puerta del Hierro Majadahonda, Madrid, Spain
| | - Luis Pérez-de Llano
- Department of Respiratory Medicine, Hospital Universitario de Lucus Augusti, Lugo, Spain
| | - Vicente Plaza
- Department of Respiratory Medicine, Institute of Biomedical Research Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau & IIB Sant Pau, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Astrid Crespo-Lessmann
- Department of Respiratory Medicine, Institute of Biomedical Research Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau & IIB Sant Pau, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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Palones E, Curto E, Plaza V, Gonzalez-Quereda L, Segarra-Casas A, Querol L, Bertoletti F, Rodriguez MJ, Gallano P, Crespo-Lessmann A. Clinical and functional characteristics, possible causes, and impact of chronic cough in patients with cerebellar ataxia, neuropathy, and bilateral vestibular areflexia syndrome (CANVAS). J Neurol 2024; 271:1204-1212. [PMID: 37917234 PMCID: PMC10896788 DOI: 10.1007/s00415-023-12001-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/09/2023] [Accepted: 09/11/2023] [Indexed: 11/04/2023]
Abstract
Cerebellar ataxia with neuropathy and bilateral vestibular areflexia syndrome (CANVAS) is an hereditary autosomal recessive disease. Recent studies propose including chronic cough (CC) as a symptom of CANVAS. For 10 patients with CANVAS as genetically confirmed by biallelic expansion of the AAGG repeat motif (AAGGGexp) in intron 2 of replication factor C subunit 1 (RFC1), our aim was, as a multidisciplinary team, to describe clinical and functional characteristics and possible causes of CC following European Respiratory Society (ERS) recommendations, and to evaluate CC impact on quality of life (QoL) using self-administered questionnaires (Cough Severity Diary, Leicester Cough Questionnaire, Discrete Emotions Questionnaire, and EQ-5D-5L). In all 10 patients, the CC was a dry cough that developed several years prior to the neurological symptoms (mean 14.2 years); 7 patients had symptoms compatible with gastroesophageal reflux (GER), 5 with pathological GER diagnosed by 24-h esophageal pH testing, and 6 patients had impaired esophageal motility diagnosed by high-resolution esophageal manometry, most frequently ineffective peristalsis. Although further studies are required for confirmation, we conclude that CC may be a characteristic prodrome of CANVAS and may be related to GER and esophageal disorders. Furthermore, CC affects patients' QoL, especially in the psychosocial sphere.
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Affiliation(s)
- Esther Palones
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
- Department of Respiratory Medicine, Sant Pau Biomedical Research Institute (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
| | - Elena Curto
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Respiratory Medicine, Sant Pau Biomedical Research Institute (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Vicente Plaza
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Respiratory Medicine, Sant Pau Biomedical Research Institute (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Lidia Gonzalez-Quereda
- Genetics Department, Institute of Biomedical Research Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alba Segarra-Casas
- Genetics Department, Institute of Biomedical Research Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Luis Querol
- Neuromuscular Disease Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Federico Bertoletti
- Department of Digestive Pathology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - María José Rodriguez
- Genetics Department, Institute of Biomedical Research Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Pía Gallano
- Genetics Department, Institute of Biomedical Research Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Barcelona, Spain
- Networked Biomedical Research Centre for Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Astrid Crespo-Lessmann
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Respiratory Medicine, Sant Pau Biomedical Research Institute (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Plaza V, Trigueros JA, Carretero JA, Ojanguren Arranz I, Vega Chicote JM, Almonacid Sánchez C, Bartra Tomás J, Cisneros Serrano C, Domínguez Juncal L, Domínguez-Ortega J, Figueroa Rivero J, Soto Campos JG, Macías Fernández E, Martínez S, Montoro Lacomba J, Quirce S. The use of triple therapy in asthma. The GEMA-FORUM V task force. J Investig Allergol Clin Immunol 2024; 34:0. [PMID: 38334050 DOI: 10.18176/jiaci.0975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Affiliation(s)
- V Plaza
- Director del Comité Ejecutivo de la Guía Española para el Manejo del Asma (GEMA). Servei de Pneumologia i Al·lèrgia. Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau). Universitat Autònoma de Barcelona.Barcelo
| | - J A Trigueros
- Medicina de Familia. Centro de Salud Buenavista. Toledo, Spain
| | - J A Carretero
- Servicio de Neumología. Hospital Royo Villanova. Zaragoza, Spain
| | - I Ojanguren Arranz
- Servicio de Neumología. Hospital Universitari Vall d´Hebron. Barcelona, Spain
| | - J M Vega Chicote
- UGC de Alergología. Hospital Regional Universitario. Málaga, Spain
| | - C Almonacid Sánchez
- Servicio de Neumología. Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - J Bartra Tomás
- Servicio de Neumología y Alergia. Hospital Clínic de Barcelona. Barcelona, Spain
| | - C Cisneros Serrano
- Servicio de Neumología. Hospital Universitario de La Princesa. Instituto de Investigación La Princesa. Madrid, Spain
| | - L Domínguez Juncal
- Servicio de Neumología. Complejo Hospitalario Universitario A Coruña (CHUAC). A Coruña, Spain
| | - J Domínguez-Ortega
- Servicio de Alergología. Hospital Universitario La Paz. Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) y CIBER de Enfermedades Respiratorias (CIBERES). Madrid, Spain
| | - J Figueroa Rivero
- Sección de Alergología. Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria. Las Palmas, Spain
| | - J G Soto Campos
- UGC de Neumología y Alergia. Hospital Universitario de Jerez. Jerez de la Frontera, Spain
| | - E Macías Fernández
- Servicio de Neumología. Hospital Clínico Universitario de Valladolid. Valladolid, Spain
| | - S Martínez
- Servicio de Neumología. Hospital Comarcal de la Vega Baja. Alicante, Spain
| | - J Montoro Lacomba
- Servicio de Alergología. Hospital Arnau de Vilanova-Liria. Valencia, Spain
| | - S Quirce
- Servicio de Alergología. Hospital Universitario La Paz. Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) y CIBER de Enfermedades Respiratorias (CIBERES). Madrid, Spain
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Valverde-Monge M, Sánchez-Carrasco P, Betancor D, Barroso B, Rodrigo-Muñoz JM, Mahillo-Fernández I, Arismendi E, Bobolea I, Cárdaba B, Cruz MJ, Del Pozo V, Domínguez-Ortega J, González-Barcala FJ, Olaguibel JM, Luna-Porta JA, Martínez-Rivera C, Mullol J, Muñoz X, Peleteiro-Pedraza L, Picado Valles C, Plaza V, Quirce S, Rial MJ, Soto-Retes L, Valero A, Sastre J. Comparison of Long-term Response and Remission to Omalizumab and Anti-IL-5/IL-5R Using Different Criteria in a Real-life Cohort of Severe Asthma Patients. Arch Bronconeumol 2024; 60:23-32. [PMID: 38042707 DOI: 10.1016/j.arbres.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND Evaluation of biologic therapy response is vital to monitor its effectiveness. Authors have proposed various response criteria including good responder, super-responder, non-responder, and clinical remission. OBJECTIVES To ascertain the prevalence of response and clinical remission after long-term treatment (>6 months) of anti-IgE and anti-IL-5/IL-5Rα biologics, compare these results with existing criteria, and identify predictors for non-responders and clinical remission. METHODS A multicenter, real-life study involving severe asthma patients in Spain. Various outcomes were assessed to gauge response and clinical remission against established criteria. RESULTS The study included 429 patients, 209 (48.7%) omalizumab, 112 (26.1%) mepolizumab, 19 (4.4%) reslizumab and 89 (20.7%) benralizumab, with a mean treatment duration of 55.3±38.8 months. In the final year of treatment, 218 (50.8%) were super-responders, 173 (40.3%) responders, 38 (8.9%) non-responders, and clinical remission in 116 (27%), without differences among biologics. The short-term non-responders (<6 months) were 25/545 (4.6%). Substantial variations in response and clinical remission were observed when applying different published criteria. Predictors of non-response included higher BMI (OR:1.14; 95% CI:1.06-1.23; p<0.001), admissions at ICU (2.69; 1.30-5.56; p=0.01), high count of SAE (1.21; 1.03-1.42; p=0.02) before biologic treatment. High FEV1% (0.96; 0.95-0.98; p<0.001), a high ACT score (0.93; 0.88-0.99; p=0.01) before biologic treatment or NSAID-ERD (0.52; 0.29-0.91; p=0.02) showed strong associations with achieving clinical remission. CONCLUSION A substantial proportion of severe asthma patients treated long-term with omalizumab or anti-IL5/IL-5Rα achieved a good response. Differences in response criteria highlight the need for harmonization in defining response and clinical remission in biologic therapy to enable meaningful cross-study comparisons.
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Affiliation(s)
- Marcela Valverde-Monge
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
| | | | - Diana Betancor
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Blanca Barroso
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - José Manuel Rodrigo-Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Immunology Department, Instituto de Investigación Sanitaria Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Ignacio Mahillo-Fernández
- Epidemiology and Biostatistics Department, Instituto de Investigación Sanitaria Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Ebymar Arismendi
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Allergy Unit & Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain; IDIBAPS, Barcelona, Spain; Universitat de Barcelona, Barcelona, Spain
| | - Irina Bobolea
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Allergy Unit & Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain; IDIBAPS, Barcelona, Spain; Universitat de Barcelona, Barcelona, Spain
| | - Blanca Cárdaba
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Immunology Department, Instituto de Investigación Sanitaria Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - María Jesús Cruz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Cellular Biology, Physiology and Immunology Department, Universitat Autónoma de Barcelona, Barcelona, Spain; Pneumology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Victoria Del Pozo
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Faculty of Medicine, Universidad Autónoma de Madrid, Spain; Immunology Department, Instituto de Investigación Sanitaria Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Javier Domínguez-Ortega
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Pneumology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Francisco Javier González-Barcala
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Pneumology Department, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, La Coruña, Spain
| | - José María Olaguibel
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Allergy Department, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
| | - Juan Alberto Luna-Porta
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Allergy Department, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - Carlos Martínez-Rivera
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Pneumology Department, Hospital Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Barcelona, Spain; Universitat Autónoma de Barcelona, Spain
| | - Joaquim Mullol
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Universitat de Barcelona, Barcelona, Spain; Rhinology Unit & Smell Clinic, ENT Department, Hospital Clinic, Barcelona, Spain; Clinical and Experimental Respiratory Immunoallergy (IDIBAPS), Barcelona, Spain
| | - Xavier Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Pneumology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Lorena Peleteiro-Pedraza
- Pneumology Department, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, La Coruña, Spain
| | - Cesar Picado Valles
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Allergy Unit & Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain; IDIBAPS, Barcelona, Spain; Universitat de Barcelona, Barcelona, Spain
| | - Vicente Plaza
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Pneumology and Allergy Department, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Barcelona, Spain; Departamento de Medicina, Universidad de Autónoma, Barcelona, Spain
| | - Santiago Quirce
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Allergy Department, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - Manuel Jorge Rial
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Allergy Department, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - Lorena Soto-Retes
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Pneumology and Allergy Department, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Barcelona, Spain; Departamento de Medicina, Universidad de Autónoma, Barcelona, Spain
| | - Antonio Valero
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Allergy Unit & Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain; IDIBAPS, Barcelona, Spain; Universitat de Barcelona, Barcelona, Spain
| | - Joaquín Sastre
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Faculty of Medicine, Universidad Autónoma de Madrid, Spain
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Betancor D, Otal M, Olaguibel JM, Rodrigo-Muñoz JM, Alvarez Puebla JM, Arismendi E, Barranco P, Barroso B, Bobolea I, Cárdaba B, Cruz MJ, Curto E, Del Pozo V, Domínguez-Ortega J, González-Barcala FJ, Luna-Porta JA, Martínez-Rivera C, Mullol J, Muñoz X, Picado C, Plaza V, Quirce S, Rial MJ, Roibás-Veiga I, Soto-Retes L, Valero A, Valverde-Monge M, Sastre J. Global Lung Initiative as diagnostic criteria in Asthma-COPD overlap syndrome. Prevalence and characterization of the syndrome in a real-life asthma cohort. J Investig Allergol Clin Immunol 2023; 34:0. [PMID: 38131661 DOI: 10.18176/jiaci.0966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- D Betancor
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - M Otal
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - J M Olaguibel
- Servicio de Alergología, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - J M Rodrigo-Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Inmunología, Instituto de Investigación Sanitaria del Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - J M Alvarez Puebla
- Servicio de Alergología, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - E Arismendi
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pneumonology and Allergy Department, Hospital Clínic; Universitat de Barcelona, Barcelona, Spain
| | - P Barranco
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergia, Hospital Universitario La Paz, Madrid, Spain
| | - B Barroso
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - I Bobolea
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Pneumonology and Allergy Department, Hospital Clínic; Universitat de Barcelona, Barcelona, Spain
| | - B Cárdaba
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Inmunología, Instituto de Investigación Sanitaria del Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - M J Cruz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Departamento de Biología Celular, Fisiología e Inmunología, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - E Curto
- Servicio de Neumologia y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - V Del Pozo
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Inmunología, Instituto de Investigación Sanitaria del Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - J Domínguez-Ortega
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergia, Hospital Universitario La Paz, Madrid, Spain
| | - F J González-Barcala
- Department of Respiratory Medicine, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - J A Luna-Porta
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergia, Hospital Universitario La Paz, Madrid, Spain
| | - C Martínez-Rivera
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Neumología, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - J Mullol
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Rhinology Unit & Smell Clinic, ENT Department; Universitat de Barcelona. Barcelona, Spain
| | - X Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Neumología, Hospital Vall d'Hebron, Barcelona, Spain
| | - C Picado
- Pneumonology and Allergy Department, Hospital Clínic; Universitat de Barcelona, Barcelona, Spain
| | - V Plaza
- Servicio de Neumologia y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - S Quirce
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergia, Hospital Universitario La Paz, Madrid, Spain
| | - M J Rial
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergología, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - I Roibás-Veiga
- Servicio de Alergia. Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - L Soto-Retes
- Servicio de Neumologia y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - A Valero
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pneumonology and Allergy Department, Hospital Clínic; Universitat de Barcelona, Barcelona, Spain
| | - M Valverde-Monge
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - J Sastre
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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Barroso B, Valverde-Monge M, Alobid I, Olaguibel JM, Rial MJ, Quirce S, Arismendi E, Barranco P, Betancor D, Bobolea I, Cárdaba B, Cruz Carmona MJ, Curto E, Domínguez-Ortega J, González-Barcala FJ, Martínez-Rivera C, Mahíllo-Fernández I, Muñoz X, Picado C, Plaza V, Rodrigo Muñoz JM, Soto-Retes L, Valero A, Del Pozo V, Mullol J, Sastre J. Reply to "Olfactory Function and Biologic Treatments: A Comment on Available Real-life Studies". J Investig Allergol Clin Immunol 2023; 33:503-504. [PMID: 38095497 DOI: 10.18176/jiaci.0953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Affiliation(s)
- B Barroso
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - M Valverde-Monge
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - I Alobid
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic, Barcelona, Spain
- Clinical and Experimental Respiratory Immunoallergy, FRCB-IDIBAPS, Barcelona, Spain
| | - J M Olaguibel
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Allergy Department, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - M J Rial
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Allergy Department, Hospital Juan Canalejo, A Coruña, Spain
| | - S Quirce
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Department of Allergy, La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research (IDIPAZ), Madrid, Spain
| | - E Arismendi
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy, FRCB-IDIBAPS, Barcelona, Spain
- Allergy Unit and Severe Asthma Unit, Pulmonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - P Barranco
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Department of Allergy, La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research (IDIPAZ), Madrid, Spain
| | - D Betancor
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - I Bobolea
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy, FRCB-IDIBAPS, Barcelona, Spain
- Allergy Unit and Severe Asthma Unit, Pulmonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - B Cárdaba
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - M J Cruz Carmona
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pulmonology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - E Curto
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pulmonology and Allergy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J Domínguez-Ortega
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Department of Allergy, La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research (IDIPAZ), Madrid, Spain
| | - F J González-Barcala
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pulmonology Department, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, La Coruña, Spain
| | - C Martínez-Rivera
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pulmonology Department, Hospital Germans Trias i Pujol, Badalona, Spain
| | | | - X Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pulmonology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Picado
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy, FRCB-IDIBAPS, Barcelona, Spain
- Allergy Unit and Severe Asthma Unit, Pulmonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - V Plaza
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pulmonology and Allergy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J M Rodrigo Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - L Soto-Retes
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pulmonology and Allergy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - A Valero
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy, FRCB-IDIBAPS, Barcelona, Spain
- Allergy Unit and Severe Asthma Unit, Pulmonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - V Del Pozo
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - J Mullol
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic, Barcelona, Spain
- Clinical and Experimental Respiratory Immunoallergy, FRCB-IDIBAPS, Barcelona, Spain
| | - J Sastre
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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Crespo-Lessmann A, Curto E, Mateus Medina EF, Palones E, Belda Soler A, Sánchez Maza S, Soto-Retes L, Plaza V. Erratum: Characteristics of Induced-Sputum Inflammatory Phenotypes in Adults with Asthma: Predictors of Bronchial Eosinophilia [Corrigendum]. J Asthma Allergy 2023; 16:1267-1268. [PMID: 38022752 PMCID: PMC10675634 DOI: 10.2147/jaa.s449238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 11/10/2023] [Indexed: 12/01/2023] Open
Abstract
[This corrects the article DOI: 10.2147/JAA.S389402.].
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Plaza V, Domínguez-Ortega J, González-Segura Alsina D, Lo Re D, Sicras-Mainar A. Comprehensive Observational Study in a Large Cohort of Asthma Patients after Adding LAMA to ICS/LABA. Pharmaceuticals (Basel) 2023; 16:1609. [PMID: 38004474 PMCID: PMC10675027 DOI: 10.3390/ph16111609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/06/2023] [Accepted: 11/11/2023] [Indexed: 11/26/2023] Open
Abstract
INTRODUCTION Adding LAMA to LABA/ICS is recommended to improve control in patients with persistent asthma. METHODS This observational, retrospective, before-and-after study considered patients diagnosed with asthma who started LABA/ICS + LAMA treatment (triple therapy, TT) between 1 January 2017 and 31 December 2018 and had been treated with LABA/ICS (dual therapy, DT) in the year before. Changes in lung function and exacerbation rates, healthcare resource utilization, and healthcare and non-healthcare costs (€2019) were estimated in patients with asthma in clinical practices in Spain. Data from computerized medical records from seven Spanish regions were collected ±1 year of LAMA addition. RESULTS 4740 patients (64.1 years old [SD: 16.3]) were included. TT reduced the incidence of exacerbations by 16.7% (p < 0.044) and the number of patients with exacerbations by 8.5% (p < 0.001) compared to previous DT. The rate of patients with severe exacerbations requiring systemic corticosteroids and their hospitalization rates significantly decreased by 22.5% and 29.5%. TT significantly improved FEV1, FVC, and FEV1/FVC, saving €571/patient for society. Younger patients with asthma (18-44 years old) and patients with severe asthma (FEV1 < 60%) performed better upon the initiation of TT. CONCLUSIONS TT reduced asthma exacerbations, improved lung function and reduced healthcare costs vs. DT, particularly in patients requiring systemic corticosteroids to treat severe exacerbations.
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Affiliation(s)
- Vicente Plaza
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain;
| | - Javier Domínguez-Ortega
- Department of Allergy, La Paz University Hospital, Institute for Health Research (IdiPAZ), 28046 Madrid, Spain;
| | | | - Daniele Lo Re
- Department of Medicinal and Organic Chemistry, Faculty of Pharmacy, Universidad de Granada, 18071 Granada, Spain;
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Castillo JA, Plaza V, Rodrigo G, Juliá B, Picado C, Fernández C, Mullol J. Chronic rhinosinusitis with nasal polyps and allergic rhinitis as different multimorbid treatable traits in asthma. J Allergy Clin Immunol Glob 2023; 2:100134. [PMID: 37781668 PMCID: PMC10510007 DOI: 10.1016/j.jacig.2023.100134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/23/2023] [Accepted: 04/10/2023] [Indexed: 10/03/2023]
Abstract
Background Respiratory multimorbidities are linked to asthma, such as allergic rhinitis (AR) with early allergic asthma and chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) with late nonallergic asthma. Objective Our aim was to investigate the association of asthma severity and control with specific upper airway phenotypes. Method Patients with asthma were prospectively recruited from 23 pulmonology and ear, nose, and throat clinics. Asthma severity and control, as well as upper airway comorbidities (AR and non-AR [NAR], CRSwNP, and CRS without nasal polyps [CRSsNP]) were assessed according to international consensus guidelines definitions. Results A total of 492 asthmatic patients were included. Half of the asthmatic patients (49.6%) had associated rhinitis (37.0% had AR and 12.6% had NAR) and 36.2% had CRS (16.7% had CRSsNP and 19.5% had CRSwNP), whereas 14.2% had no sinonasal symptoms. Most cases of AR (78%) and NAR (84%) were present in patients with mild-to-moderate asthma, whereas CRSwNP was more frequent in patients with severe asthma (35% [P < .001]), mainly nonatopic asthma (44% [P < .001]). Patients with severe asthma with CRSwNP had worse asthma control, which was correlated (r = 0.249 [P = .034]) with sinus occupancy. Multiple logistic regression analysis showed that late-onset asthma, intolerance of aspirin and/or nonsteroidal anti-inflammatory drugs, and CRSwNP were independently associated with severe asthma. Conclusion Severe asthma is associated with CRSwNP, with sinus occupancy affecting asthma control. This study has identified 2 main different upper airway treatable traits, AR and CRSwNP, which need further evaluation to improve management and control of patients with asthma.
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Affiliation(s)
- José Antonio Castillo
- Pneumology Department, Hospital Universitari Dexeus, Barcelona, Spain
- CIBER of Respiratory Diseases, Spain
- Group of Rhinitis, Rhinosinusitis, and Nasal Polyps, Area of Asthma, SEPAR, Spain
| | - Vicente Plaza
- Pneumology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - Gustavo Rodrigo
- Emergency Departament, Hospital Central de las Fuerzas Armadas, Montevideo, Uruguay
| | | | - César Picado
- CIBER of Respiratory Diseases, Spain
- Pneumology Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Cristina Fernández
- Preventive Medicine Department, Complejo Hospitalario Universitario de Santiago de Compostela, Instituto de Investigación Sanitaria Santiago de Compostela, Fundación IMAS, Santiago de Compostela, Spain
| | - Joaquim Mullol
- CIBER of Respiratory Diseases, Spain
- Group of Rhinitis, Rhinosinusitis, and Nasal Polyps, Area of Asthma, SEPAR, Spain
- Clinical and Experimental Respiratory Immunoallergy, IDIBAPS & Rhinology Unite and Smell Clinic, ENT Department, Hospital Clínic Barcelona, Universitat de Barcelona, Spain
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11
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Romero-Mesones C, Cruz MJ, Alobid I, Barroso B, Arismendi E, Barranco P, Betancor D, Bobolea I, Cárdaba B, Curto E, Domenech G, Domínguez-Ortega J, Espejo D, González-Barcala FJ, Luna-Porta JA, Martínez-Rivera C, Méndez-Brea P, Mullol J, Olaguibel JM, Picado C, Plaza V, Del Pozo V, Quirce S, Rial MJ, Rodrigo-Muñoz JM, Sastre J, Serrano S, Soto-Retes L, Valero A, Valverde-Monge M, Munoz X. Disposition of Work-Related Asthma in a Spanish Asthma Cohort: Comparison of Asthma Severity Between Employed and Retired Workers. J Allergy Clin Immunol Pract 2023; 11:3407-3413.e1. [PMID: 37391017 DOI: 10.1016/j.jaip.2023.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND Exposure to certain agents in the workplace can trigger occupational asthma or work-exacerbated asthma, both of which come under the heading of work-related asthma (WRA). Understanding the burden that WRA represents can help in the management of these patients. OBJECTIVE To assess the influence of occupation on asthma in real life and analyze the characteristics of patients with WRA included in an asthma cohort. METHODS This was a prospective multicenter study of a cohort of consecutive patients with asthma. A standardized clinical history was completed. Patients were classified as having WRA or non-WRA. All patients underwent respiratory function tests, FeNO test, and methacholine challenge (methacholine concentration that causes a 20% drop in FEV1) at the beginning of the study. They were classified into two groups, depending on their employment status: employed (group 1) or unemployed (group 2). RESULTS Of the 480 patients included in the cohort, 82 (17%) received the diagnosis of WRA. Fifty-seven patients (70%) were still working. Mean age (SD) was 46 (10.69) years in group 1 and 57 (9.91) years in group 2 (P < .0001). Significant differences were observed in adherence to treatment (64.9% in group 1 vs 88% in group 2; P = .0354) and in severe asthma exacerbations (35.7% in group 1 vs 0% in group 2; P = .0172). No significant differences were observed in the rest of the variables analyzed. CONCLUSIONS The burden of WRA in specialized asthma units is not negligible. The absence of differences in the severity of asthma, the treatment administered, alterations in lung function, and the number of exacerbations in those working versus not working may support the idea that advice regarding changing jobs should be customized for individual patients.
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Affiliation(s)
- Christian Romero-Mesones
- Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Maria-Jesus Cruz
- Servicio de Neumología. Hospital Universitario Vall d'Hebron, Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER de Enfermedades Respiratorias, Madrid, Spain.
| | - Isam Alobid
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain; Clinical and Experimental Respiratory Immunoallergy, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Barcelona, Spain
| | - Blanca Barroso
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Ebymar Arismendi
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Allergy Unit and Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - Pilar Barranco
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Diana Betancor
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Irina Bobolea
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Allergy Unit and Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - Blanca Cárdaba
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz-Universidad Autónoma de Madrid, Madrid, Spain
| | - Elena Curto
- CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Gemma Domenech
- Medical Statistics Core Facility, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Hospital Clinic Barcelona, Barcelona, Spain
| | - Javier Domínguez-Ortega
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - David Espejo
- Servicio de Neumología. Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | | | - Juan-Alberto Luna-Porta
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Carlos Martínez-Rivera
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Pulmonology Department, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona Badalona, Barcelona, Spain
| | - Paula Méndez-Brea
- Allergy Department, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
| | - Joaquim Mullol
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Rhinology Unit and Smell Clinic, ENT Department, Clinical and Experimental Respiratory Immunoallergy (Instituto de Investigaciones Biomédicas August Pi i Sunyer), Universitat de Barcelona, Barcelona, Spain
| | | | - Cesar Picado
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain; Clinical and Experimental Respiratory Immunoallergy, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Barcelona, Spain
| | - Vicente Plaza
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Victoria Del Pozo
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz-Universidad Autónoma de Madrid, Madrid, Spain
| | - Santiago Quirce
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Manuel-Jorge Rial
- Allergy Department, Complexo Hospitalario Universitario, A Coruña, Spain
| | - José-María Rodrigo-Muñoz
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz-Universidad Autónoma de Madrid, Madrid, Spain
| | - Joaquin Sastre
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Sandra Serrano
- Medical Statistics Core Facility, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Hospital Clinic Barcelona, Barcelona, Spain
| | - Lorena Soto-Retes
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Antonio Valero
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Allergy Unit and Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - Marcela Valverde-Monge
- CIBER de Enfermedades Respiratorias, Madrid, Spain; Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Xavier Munoz
- Servicio de Neumología. Hospital Universitario Vall d'Hebron, Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER de Enfermedades Respiratorias, Madrid, Spain
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Perez de Llano L, Martínez Moragón E, Entrenas LM, Martínez-Rivera C, Cisneros C, Blanco-Aparicio M, Trisán A, Plaza V, Ramos J, Funenga Fitas E, Sanchez-Covisa J, Dominguez-Ortega J. Validation of the Asthma Impairment and Risk Questionnaire in Spain: A Useful Tool for Assessing Asthma Control in Adolescents and Adults. J Investig Allergol Clin Immunol 2023; 33:397-400. [PMID: 36520522 DOI: 10.18176/jiaci.0881] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Affiliation(s)
| | | | | | - C Martínez-Rivera
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
- Institut de Recerca Germans Trias i Pujol (IGTP), Badalona, Spain
- Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
| | - C Cisneros
- Hospital Universitario de La Princesa, Madrid, Spain
| | | | - A Trisán
- Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - V Plaza
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - J Ramos
- Hospital Universitario de Salamanca, Salamanca, Spain
| | | | | | - J Dominguez-Ortega
- Hospital Universitario La Paz, Madrid, Spain
- Institute for Health Research - Hospital La Paz (IdiPAZ), Madrid, Spain
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13
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Martinez Rivera C, Serra Mitjà P, Andreo García F, Crespo-Lessmann A, Solis Solis AJ, Torrego A, Garcia-Olive I, Ramos-Barbón D, Zapata Comas T, Plaza V, Abad J, Rosell A. Factors Associated With Large Airway Collapse in Severe Asthma. Arch Bronconeumol 2023; 59:605-607. [PMID: 37296031 DOI: 10.1016/j.arbres.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 06/12/2023]
Affiliation(s)
- Carlos Martinez Rivera
- Servicio de Neumología, Hospital Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Spain; Barcelona Respiratory Network (BRN), Spain.
| | - Pere Serra Mitjà
- Servicio de Neumología, Hospital Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Spain; Barcelona Respiratory Network (BRN), Spain
| | - Felipe Andreo García
- Servicio de Neumología, Hospital Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Spain; Barcelona Respiratory Network (BRN), Spain
| | - Astrid Crespo-Lessmann
- Barcelona Respiratory Network (BRN), Spain; Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Spain
| | - Alan Jhunior Solis Solis
- Servicio de Neumología, Hospital Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Spain; Barcelona Respiratory Network (BRN), Spain
| | - Alfons Torrego
- Barcelona Respiratory Network (BRN), Spain; Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Spain
| | - Ignasi Garcia-Olive
- Servicio de Neumología, Hospital Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Spain; Barcelona Respiratory Network (BRN), Spain
| | - David Ramos-Barbón
- Barcelona Respiratory Network (BRN), Spain; Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Spain
| | - Toni Zapata Comas
- Servicio de Neumología, Hospital Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Spain; Barcelona Respiratory Network (BRN), Spain
| | - Vicente Plaza
- Barcelona Respiratory Network (BRN), Spain; Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Spain
| | - Jorge Abad
- Servicio de Neumología, Hospital Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Spain; Barcelona Respiratory Network (BRN), Spain
| | - Antoni Rosell
- Servicio de Neumología, Hospital Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Spain; Barcelona Respiratory Network (BRN), Spain
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Betancor D, Villalobos-Vilda C, Olaguibel JM, Rodrigo-Muñoz JM, Puebla MJA, Arismendi E, Barranco P, Barroso B, Bobolea I, Cárdaba B, Cruz MJ, Curto E, Pozo VD, Domínguez-Ortega J, González-Barcala FJ, Luna-Porta JA, Martínez-Rivera C, Mullol J, Muñoz X, Picado C, Plaza V, Quirce S, Rial MJ, Soto-Retes L, Valero A, Valverde-Monge M, Sastre J. The New ERS/ATS 2022 Bronchodilator Response Recommendation: Comparison With the Previous Version in an Asthma Cohort. Arch Bronconeumol 2023; 59:608-611. [PMID: 37331901 DOI: 10.1016/j.arbres.2023.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 06/20/2023]
Affiliation(s)
- Diana Betancor
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
| | | | - José María Olaguibel
- Servicio de Alergología, Hospital Universitario de Navarra, Pamplona, Navarra, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - José Manuel Rodrigo-Muñoz
- Servicio de Inmunología, Instituto de Investigación Sanitaria Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - María Jose Alvarez Puebla
- Servicio de Alergología, Hospital Universitario de Navarra, Pamplona, Navarra, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Ebymar Arismendi
- Allergy Unit & Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Pilar Barranco
- Servicio de Alergia, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Blanca Barroso
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Irina Bobolea
- Allergy Unit & Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Blanca Cárdaba
- Servicio de Inmunología, Instituto de Investigación Sanitaria Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - María Jesús Cruz
- Departamento de Biología Celular, Fisiología e Inmunología, Universitat Autónoma de Barcelona, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Elena Curto
- Servicio de Neumologia y Alergia, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Departamento de Medicina, Barcelona, Spain
| | - Victoria Del Pozo
- Servicio de Inmunología, Instituto de Investigación Sanitaria Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Javier Domínguez-Ortega
- Servicio de Alergia, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | | | - Juan Alberto Luna-Porta
- Servicio de Alergia, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Carlos Martínez-Rivera
- Servicio de Neumología, Hospital Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Joaquim Mullol
- Rhinology Unit & Smell Clinic, ENT Department, Clinical and Experimental Respiratory Immunoallergy (IDIBAPS), Universitat de Barcelona, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Xavier Muñoz
- Servicio de Neumología, Hospital Vall d'Hebron, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Cesar Picado
- Allergy Unit & Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Vicente Plaza
- Servicio de Neumologia y Alergia, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Departamento de Medicina, Barcelona, Spain
| | - Santiago Quirce
- Servicio de Alergia, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Manuel Jorge Rial
- Servicio de Alergología, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Lorena Soto-Retes
- Servicio de Neumologia y Alergia, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Departamento de Medicina, Barcelona, Spain
| | - Antonio Valero
- Allergy Unit & Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Marcela Valverde-Monge
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Joaquín Sastre
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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Betancor D, Olaguibel JM, Rodrigo-Muñoz JM, Alvarez Puebla MJ, Arismendi E, Barranco P, Barroso B, Bobolea I, Cárdaba B, Cruz MJ, Curto E, Del Pozo V, Domínguez-Ortega J, González-Barcala FJ, Luna-Porta JA, Martínez-Rivera C, Mullol J, Muñoz X, Picado C, Plaza V, Quirce S, Rial MJ, Soto-Retes L, Valero A, Valverde-Monge M, Sastre J. Lung Function Abnormalities and Their Correlation With Clinical Characteristics and Inflammatory Markers in Adult Asthma. J Investig Allergol Clin Immunol 2023; 33:294-296. [PMID: 36331127 DOI: 10.18176/jiaci.0866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Affiliation(s)
- D Betancor
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - J M Olaguibel
- Servicio de Alergología, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - J M Rodrigo-Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Inmunología, Instituto de Investigación Sanitaria Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - M J Alvarez Puebla
- Servicio de Alergología, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - E Arismendi
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain
- Clinical and Experimental Respiratory Immunoallergy (IDIBAPS), Universitat de Barcelona. Barcelona, Spain
| | - P Barranco
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergia, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - B Barroso
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - I Bobolea
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain
- Clinical and Experimental Respiratory Immunoallergy (IDIBAPS), Universitat de Barcelona. Barcelona, Spain
| | - B Cárdaba
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Inmunología, Instituto de Investigación Sanitaria Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - M J Cruz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Departamento de Biología Celular, Fisiología e Inmunología, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - E Curto
- Servicio de Neumologia y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - V Del Pozo
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Inmunología, Instituto de Investigación Sanitaria Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - J Domínguez-Ortega
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergia, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - F J González-Barcala
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, La Coruña, Spain
| | - J A Luna-Porta
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergia, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - C Martínez-Rivera
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Neumología, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - J Mullol
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy (IDIBAPS), Universitat de Barcelona. Barcelona, Spain
- Rhinology Unit and Smell Clinic, ENT Department Hospital Clínic, Barcelona, Spain
| | - X Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Neumología, Hospital Vall d'Hebron, Barcelona, Spain
| | - C Picado
- Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - V Plaza
- Servicio de Neumologia y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - S Quirce
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergia, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - M J Rial
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergología, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - L Soto-Retes
- Servicio de Neumologia y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - A Valero
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - M Valverde-Monge
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - J Sastre
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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16
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Domínguez-Ortega J, Luna-Porta JA, Olaguibel JM, Barranco P, Arismendi E, Barroso B, Betancor D, Bobolea I, Caballero ML, Cárdaba B, Cruz MJ, Curto E, González-Barcala FJ, Losantos-García I, Martínez-Rivera C, Mendez-Brea P, Mullol J, Muñoz X, Picado C, Plaza V, Del Pozo V, Rial MJ, Sastre J, Soto L, Valero A, Valverde-Monge M, Quirce S. Exacerbations Among Patients With Asthma Are Largely Dependent on the Presence of Multimorbidity. J Investig Allergol Clin Immunol 2023; 33:281-288. [PMID: 35503227 DOI: 10.18176/jiaci.0816] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Comorbidities can influence asthma control and promote asthma exacerbations (AEs). However, the impact of multimorbidity in AEs, assessed based on long-term follow-up of patients with asthma of different degrees of severity, has received little attention in real-life conditions. To describe the epidemiological and clinical characteristics and predictors of AEs in patients who had presented at least 1 AE in the previous year in the MEchanism of Genesis and Evolution of Asthma (MEGA) cohort. METHODS The work-up included a detailed clinical examination, pulmonary function testing, fractional exhaled nitric oxide (FeNO), blood counts, induced sputum, skin prick-tests, asthma questionnaires, and assessment of multimorbidity. The number of moderate-severe AEs in the preceding year was registered for each patient. RESULTS The study population comprised 486 patients with asthma (23.7% mild, 35% moderate, 41.3% severe). Disease remained uncontrolled in 41.9%, and 47.3% presented ≥1 moderate-severe AE, with a mean (SD) annual exacerbation rate of 0.47 (0.91) vs 2.11 (2.82) in mild and severe asthma, respectively. Comorbidity was detected in 56.4% (66.6% among those with severe asthma). Bronchiectasis, chronic rhinosinusitis with nasal polyps, atopy, psychiatric illnesses, hyperlipidemia, and hypertension were significantly associated with AEs. No associations were found for FeNO, blood eosinophils, or total serum IgE. Sputum eosinophilia and a high-T2 inflammatory pattern were significantly associated with AEs. Multivariable regression analysis showed a significant association with asthma severity, uncontrolled disease, and low prebronchodilator FEV1/FVC. CONCLUSION Our study revealed a high frequency of AE in the MEGA cohort. This was strongly associated with multimorbidity, asthma severity, poor asthma control, airflow obstruction, higher sputum eosinophils, and a very high-T2 inflammatory pattern.
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Affiliation(s)
- J Domínguez-Ortega
- Department of Allergy, La Paz University Hospital, Madrid, Spain
- Institute for Health Research IdiPAZ, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - J A Luna-Porta
- Department of Allergy, La Paz University Hospital, Madrid, Spain
- Institute for Health Research IdiPAZ, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - J M Olaguibel
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Severe Asthma Unit, Department of Allergy, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - P Barranco
- Department of Allergy, La Paz University Hospital, Madrid, Spain
- Institute for Health Research IdiPAZ, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - E Arismendi
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy (IDIBAPS), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
- Allergy Unit and Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - B Barroso
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Allergy, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - D Betancor
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Allergy, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - I Bobolea
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy (IDIBAPS), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
- Allergy Unit and Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - M L Caballero
- Department of Allergy, La Paz University Hospital, Madrid, Spain
- Institute for Health Research IdiPAZ, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - B Cárdaba
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Immunology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - M J Cruz
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Biología Celular, Fisiología e Inmunología, Universitat Autónoma de Barcelona, Barcelona, Spain
- Pneumology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - E Curto
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Respiratory Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Barcelona, Spain
- Universidad Autónoma de Barcelona, Departamento de Medicina, Barcelona, Spain
| | - F J González-Barcala
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Pneumology Department, Complejo Hospitalario Universitario de Santiago, La Coruña, Spain
- Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), La Coruña, Spain
- Universidad de Santiago de Compostela, La Coruña, Spain
| | - I Losantos-García
- Institute for Health Research IdiPAZ, Madrid, Spain
- Biostatistics Department, La Paz University Hospital, Madrid, Spain
| | - C Martínez-Rivera
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Universidad Autónoma de Barcelona, Departamento de Medicina, Barcelona, Spain
- Pneumology Department, Hospital Germans Trias i Pujol, Barcelona, Spain
- Institut d'Investigacio Germans Trias I Pujol (IGTP), Badalona, Barcelona, Spain
| | - P Mendez-Brea
- Department of Allergy, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, La Coruña, Spain
| | - J Mullol
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy (IDIBAPS), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, Barcelona, Spain
| | - X Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Pneumology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - C Picado
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy (IDIBAPS), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
- Allergy Unit and Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - V Plaza
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Respiratory Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Barcelona, Spain
- Universidad Autónoma de Barcelona, Departamento de Medicina, Barcelona, Spain
| | - V Del Pozo
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Immunology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - M J Rial
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Allergy, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - J Sastre
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Allergy, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - L Soto
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Respiratory Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Barcelona, Spain
- Universidad Autónoma de Barcelona, Departamento de Medicina, Barcelona, Spain
| | - A Valero
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy (IDIBAPS), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
- Allergy Unit and Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - M Valverde-Monge
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Allergy, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - S Quirce
- Department of Allergy, La Paz University Hospital, Madrid, Spain
- Institute for Health Research IdiPAZ, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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17
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Martín-González E, Hernández-Pérez JM, Pérez JAP, Pérez-García J, Herrera-Luis E, González-Pérez R, González-González O, Mederos-Luis E, Sánchez-Machín I, Poza-Guedes P, Sardón O, Corcuera P, Cruz MJ, González-Barcala FJ, Martínez-Rivera C, Mullol J, Muñoz X, Olaguibel JM, Plaza V, Quirce S, Valero A, Sastre J, Korta-Murua J, Del Pozo V, Lorenzo-Díaz F, Villar J, Pino-Yanes M, González-Carracedo MA. Alpha-1 antitrypsin deficiency and Pi*S and Pi*Z SERPINA1 variants are associated with asthma exacerbations. Pulmonology 2023:S2531-0437(23)00091-0. [PMID: 37236906 DOI: 10.1016/j.pulmoe.2023.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 05/04/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Asthma is a chronic inflammatory disease of the airways. Asthma patients may experience potentially life-threatening episodic flare-ups, known as exacerbations, which may significantly contribute to the asthma burden. The Pi*S and Pi*Z variants of the SERPINA1 gene, which usually involve alpha-1 antitrypsin (AAT) deficiency, had previously been associated with asthma. The link between AAT deficiency and asthma might be represented by the elastase/antielastase imbalance. However, their role in asthma exacerbations remains unknown. Our objective was to assess whether SERPINA1 genetic variants and reduced AAT protein levels are associated with asthma exacerbations. MATERIALS AND METHODS In the discovery analysis, SERPINA1 Pi*S and Pi*Z variants and serum AAT levels were analyzed in 369 subjects from La Palma (Canary Islands, Spain). As replication, genomic data from two studies focused on 525 Spaniards and publicly available data from UK Biobank, FinnGen, and GWAS Catalog (Open Targets Genetics) were analyzed. The associations between SERPINA1 Pi*S and Pi*Z variants and AAT deficiency with asthma exacerbations were analyzed with logistic regression models, including age, sex, and genotype principal components as covariates. RESULTS In the discovery, a significant association with asthma exacerbations was found for both Pi*S (odds ratio [OR]=2.38, 95% confidence interval [CI]= 1.40-4.04, p-value=0.001) and Pi*Z (OR=3.49, 95%CI=1.55-7.85, p-value=0.003)Likewise, AAT deficiency was associated with a higher risk for asthma exacerbations (OR=5.18, 95%CI=1.58-16.92, p-value=0.007) as well as AAT protein levels (OR= 0.72, 95%CI=0.57-0.91, p-value=0.005). The Pi*Z association with exacerbations was replicated in samples from Spaniards with two generations of Canary Islander origin (OR=3.79, p-value=0.028), and a significant association with asthma hospitalizations was found in the Finnish population (OR=1.12, p-value=0.007). CONCLUSIONS AAT deficiency could be a potential therapeutic target for asthma exacerbations in specific populations.
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Affiliation(s)
- Elena Martín-González
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), 38200 La Laguna, Tenerife, Spain
| | - José M Hernández-Pérez
- Department of Respiratory Medicine, Hospital Universitario de N.S de Candelaria, 38010 Santa Cruz de Tenerife, Spain; Respiratory Medicine, Hospital Universitario de La Palma, 38713 Breña Alta, Santa Cruz de Tenerife, Spain
| | - José A Pérez Pérez
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), 38200 La Laguna, Tenerife, Spain; Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna (ULL), La Laguna, Tenerife, Spain
| | - Javier Pérez-García
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), 38200 La Laguna, Tenerife, Spain
| | - Esther Herrera-Luis
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), 38200 La Laguna, Tenerife, Spain
| | - Ruperto González-Pérez
- Allergy Department, Hospital Universitario de Canarias, 38320 La Laguna, Tenerife, Spain; Severe Asthma Unit, Allergy Department, Hospital Universitario de Canarias, 38320 La Laguna, Spain
| | | | - Elena Mederos-Luis
- Allergy Department, Hospital Universitario de Canarias, 38320 La Laguna, Tenerife, Spain
| | | | - Paloma Poza-Guedes
- Allergy Department, Hospital Universitario de Canarias, 38320 La Laguna, Tenerife, Spain; Severe Asthma Unit, Allergy Department, Hospital Universitario de Canarias, 38320 La Laguna, Spain
| | - Olaia Sardón
- Division of Pediatric Respiratory Medicine, Hospital Universitario Donostia, San Sebastián, Spain; Department of Pediatrics, University of the Basque Country (UPV/EHU), San Sebastián, Spain
| | - Paula Corcuera
- Division of Pediatric Respiratory Medicine, Hospital Universitario Donostia, San Sebastián, Spain
| | - María J Cruz
- Department of Respiratory Medicine, Hospital Vall d'Hebron, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Francisco J González-Barcala
- Department of Respiratory Medicine, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, La Coruña, Spain
| | - Carlos Martínez-Rivera
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Department of Respiratory Medicine, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Joaquim Mullol
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Rhinology Unit & Smell Clinic, ENT Department, Clinical and Experimental Respiratory Immunoallergy (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Xavier Muñoz
- Department of Respiratory Medicine, Hospital Vall d'Hebron, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - José M Olaguibel
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Department of Allergy, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
| | - Vicente Plaza
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Santiago Quirce
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Department of Allergy, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - Antonio Valero
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Allergy Unit & Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Joaquín Sastre
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Department of Allergy, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Javier Korta-Murua
- Division of Pediatric Respiratory Medicine, Hospital Universitario Donostia, San Sebastián, Spain
| | - Victoria Del Pozo
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Department of Immunology, Instituto de Investigación Sanitaria Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Fabián Lorenzo-Díaz
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), 38200 La Laguna, Tenerife, Spain; Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna (ULL), La Laguna, Tenerife, Spain
| | - Jesús Villar
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Multidisciplinary Organ Dysfunction Evaluation Research Network (MODERN), Research Unit, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - María Pino-Yanes
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), 38200 La Laguna, Tenerife, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Tecnologías Biomédicas (ITB), Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Tenerife, Spain.
| | - Mario A González-Carracedo
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), 38200 La Laguna, Tenerife, Spain; Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna (ULL), La Laguna, Tenerife, Spain.
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18
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Blanco-Aparicio M, García-Río FJ, González-Barcala FJ, Jiménez-Ruiz CA, Muñoz X, Plaza V, Soto-Campos JG, Urrutia-Landa I, Almonacid C, Peces-Barba G, Álvarez-Gutiérrez FJ. [A Study of the Prevalence of Asthma in the General Population in Spain]. Open Respir Arch 2023; 5:100245. [PMID: 37496876 PMCID: PMC10369549 DOI: 10.1016/j.opresp.2023.100245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 03/29/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction Asthma is a disease with high prevalence, which affects all age groups and generates high health and social care costs. Studies carried out in a number of populations show great variability in its prevalence, even in geographically close populations, with data suggesting a relevant influence of socio-economic factors. At present, we do not have reliable data on the prevalence of this disease in the adult population of Spain. The objectives of this study are to estimate the prevalence of asthma in the Spanish population for those aged 18-79, to describe the variability between autonomous communities, to estimate the prevalence of under and overdiagnosis, to analyse the prevalence of uncontrolled asthma and steroid-dependent asthma, to evaluate the health care cost, to identify the most frequent phenotypes and to establish a starting point to evaluate the temporal trend with subsequent studies. Methods A cross-sectional, two-stage study will be carried out, including patients from 50 catchment areas. The study will be carried out in 3 phases: 1) screening and confirmation in the clinical history, in which patients with a previously correctly established diagnosis of asthma will be identified; 2) diagnosis of asthma to evaluate patients without a confirmed or excluded diagnosis; 3) characterization of asthma, where the characteristics of the asthmatic patients will be analysed, identifying the most frequent phenotypes. Discussion It seems necessary and feasible to carry out an epidemiological study of asthma in Spain to identify the prevalence of asthma, to optimize healthcare planning, to characterize the most frequent phenotypes of the disease, and to evaluate inaccurate diagnoses.
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Affiliation(s)
| | - Francisco José García-Río
- Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Madrid, España
- Universidad Autónoma de Madrid, Madrid, España
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Madrid, España
| | - Francisco Javier González-Barcala
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Madrid, España
- Grupo de Investigación Traslacional de Enfermedades de la Vía Aérea, Fundación Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, España
- Departamento de Medicina, Universidad de Santiago de Compostela, Santiago de Compostela, España
- Servicio de Neumología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España
| | | | - Xavier Muñoz
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Madrid, España
- Servicio de Neumología, Hospital Vall d’Hebron, Barcelona, España
- Departamento de Biología Celular, Fisiología e Inmonología, Universidad Autónoma de Barcelona, Barcelona, España
| | - Vicente Plaza
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Madrid, España
- Servicio de Neumología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
- Institut de Investigació Biomèdica Sant Pau-IIB Sant Pau, Barcelona, España
- Departamento de Medicina, Universidad Autónoma de Barcelona, Barcelona, España
| | | | - Isabel Urrutia-Landa
- Servicio de Neumología, Hospital de Galdakao, Bizkaia, España
- Instituto de Investigación Sanitaria Biocruces, Bizkaia, España
| | - Carlos Almonacid
- Servicio de Neumología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - Gregorio Peces-Barba
- Instituto de Investigación Sanitaria, Fundación Jiménez Díaz, Madrid, España
- Universidad Autónoma de Madrid, Madrid, España
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19
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Barroso B, Valverde-Monge M, Alobid I, Olaguibel JM, Rial MJ, Quirce S, Arismendi E, Barranco P, Betancor D, Bobolea I, Cárdaba B, Cruz Carmona MJ, Curto E, Domínguez-Ortega J, González-Barcala FJ, Martínez-Rivera C, Mahíllo-Fernández I, Muñoz X, Picado C, Plaza V, Rodrigo Muñoz JM, Soto-Retes L, Valero A, Del Pozo V, Mullol J, Sastre J. Improvement in Olfaction in Patients With CRSwNP and Severe Asthma Taking Anti-IgE and Anti-IL-5 Biologics: A Real-Life Study. J Investig Allergol Clin Immunol 2023; 33:37-44. [PMID: 35416154 DOI: 10.18176/jiaci.0812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Chronic rhinosinusitis with nasal polyps (CRSwNP), which is characterized by partial loss of smell (hyposmia) or total loss of smell (anosmia), is commonly associated with asthma and/or nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD). CRSwNP worsens disease severity and quality of life. The objective of this real-world study was to determine whether biological treatments prescribed for severe asthma can improve olfaction in patients with CRSwNP. A further objective was to compare the improvement in in olfaction in N-ERD and non-N-ERD subgroups. METHODS We performed a multicenter, noninterventional, retrospective, observational study of 206 patients with severe asthma and CRSwNP undergoing biological treatment (omalizumab, mepolizumab, benralizumab, or reslizumab). RESULTS Olfaction improved after treatment with all 4 monoclonal antibodies (omalizumab [35.8%], mepolizumab [35.4%], reslizumab [35.7%], and benralizumab [39.1%]), with no differences between the groups. Olfaction was more likely to improve in patients with atopy, more frequent use of short-course systemic corticosteroids, and larger polyp size. The proportion of patients whose olfaction improved was similar between the N-ERD (37%) and non-N-ERD (35.7%) groups. CONCLUSIONS This is the first real-world study to compare improvement in olfaction among patients undergoing long-term treatment with omalizumab, mepolizumab, reslizumab, or benralizumab for severe asthma and associated CRSwNP. Approximately 4 out of 10 patients reported a subjective improvement in olfaction (with nonsignificant differences between biologic drugs). No differences were found for improved olfaction between the N-ERD and non-N-ERD groups.
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Affiliation(s)
- B Barroso
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - M Valverde-Monge
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - I Alobid
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic, Barcelona, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
| | - J M Olaguibel
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Allergy Department, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - M J Rial
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Allergy Department, Hospital Juan Canalejo, A Coruña, Spain
| | - S Quirce
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Department of Allergy, La Paz University Hospital, Madrid, Spain.,Hospital La Paz Institute for Health Research (IDIPAZ), Madrid, Spain
| | - E Arismendi
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain.,Allergy Unit and Severe Asthma Unit, Pulmonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - P Barranco
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Department of Allergy, La Paz University Hospital, Madrid, Spain.,Hospital La Paz Institute for Health Research (IDIPAZ), Madrid, Spain
| | - D Betancor
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - I Bobolea
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain.,Allergy Unit and Severe Asthma Unit, Pulmonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - B Cárdaba
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - M J Cruz Carmona
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Pulmonology Department, Hospital Universitari Vall d´Hebron, Barcelona, Spain
| | - E Curto
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Pulmonology and Allergy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J Domínguez-Ortega
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Department of Allergy, La Paz University Hospital, Madrid, Spain.,Hospital La Paz Institute for Health Research (IDIPAZ), Madrid, Spain
| | - F J González-Barcala
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Pulmonology Department, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, La Coruña, Spain
| | - C Martínez-Rivera
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Pulmonology Department, Hospital Germans Trias i Pujol, Badalona, Spain
| | | | - X Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Pulmonology Department, Hospital Universitari Vall d´Hebron, Barcelona, Spain.,Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Picado
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain.,Allergy Unit and Severe Asthma Unit, Pulmonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - V Plaza
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Pulmonology and Allergy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J M Rodrigo Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - L Soto-Retes
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Pulmonology and Allergy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - A Valero
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain.,Allergy Unit and Severe Asthma Unit, Pulmonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - V Del Pozo
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - J Mullol
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic, Barcelona, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
| | - J Sastre
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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20
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Pérez de Llano L, Cisneros C, Domínguez-Ortega J, Martínez-Moragón E, Olaguibel JM, Plaza V, Quirce S, Dávila I. Response to Monoclonal Antibodies in Asthma: Definitions, Potential Reasons for Failure, and Therapeutic Options for Suboptimal Response. J Investig Allergol Clin Immunol 2023; 33:1-13. [PMID: 36040046 DOI: 10.18176/jiaci.0857] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Real-life data reveal that more than half of severe asthma patients treated with monoclonal antibodies (mAbs) do not achieve a complete response. Response to mAbs must be assessed holistically, considering all the clinically meaningful therapeutic goals, not only reduction of exacerbations and oral corticosteroids. There are 2 different ways of measuring the response to mAbs. One, qualitative, classifies patients according to the degree of disease control they have achieved, without explaining how much a given patient improves relative to the baseline (pre-mAb) clinical situation; the other, quantitative, scores the changes occurring after treatment. Both methods are complementary and essential to making clinical decisions on whether to continue treatment. The various potential causes of suboptimal response to mAbs include incorrect identification of the specific T2 pathways, comorbidities that reduce the room for improvement, insufficient dose, autoimmune phenomena, infections, change in the initial inflammatory endotype, and adverse events. Once a suboptimal response has been confirmed, a well-structured and multifaceted assessment of the potential causes of failure should be performed, with emphasis on the resulting inflammatory process of the airway after mAb therapy and the presence of chronic or recurrent infection. This investigation should guide the decision on the best therapeutic approach. The present review aims to help clinicians gain insights into how to measure response to mAbs and proceed in cases of suboptimal response.
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Affiliation(s)
- L Pérez de Llano
- Respiratory Medicine Department, Hospital Universitario Lucus Augusti, EOXI Lugo, Monforte, Cervo, Spain
| | - C Cisneros
- Respiratory Medicine Department, Hospital La Princesa, Madrid, Spain.,Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain
| | - J Domínguez-Ortega
- Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - E Martínez-Moragón
- Respiratory Medicine Department, Hospital Universitario Dr Peset, Valencia, Spain
| | - J M Olaguibel
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Allergy Department, Hospital Universitario de Navarra, Pamplona, Spain.,Instituto de Investigaciones de Navarra (IDISNA), Pamplona, Spain
| | - V Plaza
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Respiratory Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Institut de Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain.,Facultad de Medicina, Universitat Autònoma Barcelona, Spain
| | - S Quirce
- Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - I Dávila
- Allergy Department, Hospital Universitario de Salamanca, Spain.,Instituto de Investigación Biosanitaria de Salamanca (IBSAL), Salamanca, Spain.,Departamento de Ciencias Biomédicas y del Diagnóstico, Facultad de Medicina, Universidad de Salamanca, Salamanca, Spain
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21
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Crespo-Lessmann A, Curto E, Mateus Medina EF, Palones E, Belda Soler A, Sánchez Maza S, Soto-Retes L, Plaza V. Characteristics of Induced-Sputum Inflammatory Phenotypes in Adults with Asthma: Predictors of Bronchial Eosinophilia. J Asthma Allergy 2023; 16:95-103. [PMID: 36699564 PMCID: PMC9869783 DOI: 10.2147/jaa.s389402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/19/2022] [Indexed: 01/19/2023] Open
Abstract
Purpose The objectives of this study were, for patients attending a specialist asthma clinic at a tertiary care hospital, to determine, from sputum induction (SI), proportions of bronchial inflammatory phenotypes, demographic, clinical and functional characteristics of each phenotype, and the most accessible non-invasive inflammatory marker that best discriminates between phenotypes. Patients and Methods Included were 96 patients with asthma, attending a specialist asthma clinic at a tertiary care hospital, who underwent testing as follows: SI, spirometry, fractional exhaled nitric oxide (FeNO), blood eosinophilia, total immunoglobulin E (IgE), and a skin prick test. Results SI phenotypes were 46.9% eosinophilic, 33.3% paucigranulocytic, 15.6% neutrophilic, and 4.2% mixed. No significantly different clinical or functional characteristics were observed between the phenotypes. A positive correlation was observed between SI eosinophilia and both emergency visits in the last 12 months (p = 0.041; r = 0.214) and FeNO values (p = 0.000; r = 0.368). Blood eosinophilia correlated with SI eosinophilia (p = 0.001; r = 0.362) and was the best predictor of bronchial eosinophilia, followed by FeNO, and total blood IgE (area under the receiver operating characteristic curve (AUC-ROC) 72%, 65%, and 53%, respectively), although precision was only fair. Conclusion In consultations for severe asthma, the most frequent phenotype was eosinophilic. Peripheral blood eosinophilia is a reliable marker for discriminating between different bronchial inflammatory phenotypes, is useful in enabling doctors to select a suitable biologic treatment and so prevent asthma exacerbation, and is a better predictor of bronchial eosinophilia than FeNO and IgE values.
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Affiliation(s)
- Astrid Crespo-Lessmann
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigació Biomédica Sant Pau, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Curto
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigació Biomédica Sant Pau, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eder Freddy Mateus Medina
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigació Biomédica Sant Pau, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Esther Palones
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigació Biomédica Sant Pau, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alicia Belda Soler
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigació Biomédica Sant Pau, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Soraya Sánchez Maza
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigació Biomédica Sant Pau, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lorena Soto-Retes
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigació Biomédica Sant Pau, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Vicente Plaza
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigació Biomédica Sant Pau, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
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22
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Matabuena M, Salgado FJ, Nieto-Fontarigo JJ, Álvarez-Puebla MJ, Arismendi E, Barranco P, Bobolea I, Caballero ML, Cañas JA, Cárdaba B, Cruz MJ, Curto E, Domínguez-Ortega J, Luna JA, Martínez-Rivera C, Mullol J, Muñoz X, Rodriguez-Garcia J, Olaguibel JM, Picado C, Plaza V, Quirce S, Rial MJ, Romero-Mesones C, Sastre B, Soto-Retes L, Valero A, Valverde-Monge M, Del Pozo V, Sastre J, González-Barcala FJ. Identification of Asthma Phenotypes in the Spanish MEGA Cohort Study Using Cluster Analysis. Arch Bronconeumol 2023; 59:223-231. [PMID: 36732158 DOI: 10.1016/j.arbres.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 01/20/2023]
Abstract
INTRODUCTION The definition of asthma phenotypes has not been fully established, neither there are cluster studies showing homogeneous results to solidly establish clear phenotypes. The purpose of this study was to develop a classification algorithm based on unsupervised cluster analysis, identifying clusters that represent clinically relevant asthma phenotypes that may share asthma-related outcomes. METHODS We performed a multicentre prospective cohort study, including adult patients with asthma (N=512) from the MEGA study (Mechanisms underlying the Genesis and evolution of Asthma). A standardised clinical history was completed for each patient. Cluster analysis was performed using the kernel k-groups algorithm. RESULTS Four clusters were identified. Cluster 1 (31.5% of subjects) includes adult-onset atopic patients with better lung function, lower BMI, good asthma control, low ICS dose, and few exacerbations. Cluster 2 (23.6%) is made of adolescent-onset atopic asthma patients with normal lung function, but low adherence to treatment (59% well-controlled) and smokers (48%). Cluster 3 (17.1%) includes adult-onset patients, mostly severe non-atopic, with overweight, the worse lung function and asthma control, and receiving combination of treatments. Cluster 4 (26.7%) consists of the elderly-onset patients, mostly female, atopic (64%), with high BMI and normal lung function, prevalence of smokers and comorbidities. CONCLUSION We defined four phenotypes of asthma using unsupervised cluster analysis. These clusters are clinically relevant and differ from each other as regards FEV1, age of onset, age, BMI, atopy, asthma severity, exacerbations, control, social class, smoking and nasal polyps.
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Affiliation(s)
- Marcos Matabuena
- Centro Singular de Investigación en Tecnoloxías Intelixentes (CiTIUS), University of Santiago of Compostela, Santiago de Compostela, Spain
| | - Francisco Javier Salgado
- Department of Biochemistry and Molecular Biology, School of Biology-Biological Research Centre (CIBUS), University of Santiago de Compostela, Santiago de Compostela, Spain; Translational Research in Airway Diseases Group (TRIAD) - Health Research Institute of Santiago de Compostela (IDIS), Spain
| | - Juan José Nieto-Fontarigo
- Department of Biochemistry and Molecular Biology, School of Biology-Biological Research Centre (CIBUS), University of Santiago de Compostela, Santiago de Compostela, Spain; Translational Research in Airway Diseases Group (TRIAD) - Health Research Institute of Santiago de Compostela (IDIS), Spain; Department of Experimental Medical Science, Lund University, Sweden.
| | | | - Ebymar Arismendi
- Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain; Pneumology and Allergy Department, Hospital Clínic de Barcelona, Barcelona, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - Pilar Barranco
- Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain; Department of Allergy, La Paz University Hospital, IdiPAZ (Research Institute), Madrid, Spain
| | - Irina Bobolea
- Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Allergy Unit & Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - María L Caballero
- Department of Allergy, La Paz University Hospital, IdiPAZ (Research Institute), Madrid, Spain
| | - José Antonio Cañas
- Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain; Allergology Service, Jiménez Díaz Foundation University Hospital, Madrid, Spain; Department of Immunology, Health Research Institute Jiménez Díaz Foundation, Madrid, Spain
| | - Blanca Cárdaba
- Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain; Department of Immunology, Health Research Institute Jiménez Díaz Foundation, Madrid, Spain
| | - María Jesus Cruz
- Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain; Department of Cellular Biology, Physiology and Immunology, Autonomous University of Barcelona, Barcelona, Spain; Pneumology Department, Vall d'Hebron Hospital, Barcelona, Spain
| | - Elena Curto
- Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain; Department of Respiratory Medicine, Santa Creu i Sant Pau Hospital, Barcelona, Spain; Sant Pau Biomedical Research Institute, Sant Pau, Barcelona, Spain; Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Javier Domínguez-Ortega
- Department of Allergy, La Paz University Hospital, IdiPAZ (Research Institute), Madrid, Spain
| | - Juan Alberto Luna
- Department of Allergy, La Paz University Hospital, IdiPAZ (Research Institute), Madrid, Spain
| | - Carlos Martínez-Rivera
- Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain; Pneumology Service, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain
| | - Joaquim Mullol
- Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Ear, Nose and Throat (ENT) Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Xavier Muñoz
- Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain; Department of Cellular Biology, Physiology and Immunology, Autonomous University of Barcelona, Barcelona, Spain; Pneumology Department, Vall d'Hebron Hospital, Barcelona, Spain
| | - Javier Rodriguez-Garcia
- Department of Biochemistry and Molecular Biology, School of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - José María Olaguibel
- Allergology Department, Navarre University Hospital, Pamplona, Navarra, Spain; Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain
| | - César Picado
- Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain; Pneumology and Allergy Department, Hospital Clínic de Barcelona, Barcelona, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - Vicente Plaza
- Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain; Department of Respiratory Medicine, Santa Creu i Sant Pau Hospital, Barcelona, Spain; Sant Pau Biomedical Research Institute, Sant Pau, Barcelona, Spain; Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Santiago Quirce
- Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain; Department of Allergy, La Paz University Hospital, IdiPAZ (Research Institute), Madrid, Spain
| | - Manuel J Rial
- Allergology Department, A Coruña University Hospital, A Coruña, Spain
| | | | - Beatriz Sastre
- Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain; Allergology Service, Jiménez Díaz Foundation University Hospital, Madrid, Spain; Department of Immunology, Health Research Institute Jiménez Díaz Foundation, Madrid, Spain
| | - Lorena Soto-Retes
- Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain; Department of Respiratory Medicine, Santa Creu i Sant Pau Hospital, Barcelona, Spain; Sant Pau Biomedical Research Institute, Sant Pau, Barcelona, Spain; Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Antonio Valero
- Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain; Pneumology and Allergy Department, Hospital Clínic de Barcelona, Barcelona, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - Marcela Valverde-Monge
- Allergology Service, Jiménez Díaz Foundation University Hospital, Madrid, Spain; Department of Immunology, Health Research Institute Jiménez Díaz Foundation, Madrid, Spain
| | - Victoria Del Pozo
- Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain; Allergology Service, Jiménez Díaz Foundation University Hospital, Madrid, Spain; Department of Immunology, Health Research Institute Jiménez Díaz Foundation, Madrid, Spain
| | - Joaquín Sastre
- Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain; Allergology Service, Jiménez Díaz Foundation University Hospital, Madrid, Spain; Department of Immunology, Health Research Institute Jiménez Díaz Foundation, Madrid, Spain
| | - Francisco Javier González-Barcala
- Translational Research in Airway Diseases Group (TRIAD) - Health Research Institute of Santiago de Compostela (IDIS), Spain; Biomedical Research Centre Network - Respiratory Diseases (CIBERES), Madrid, Spain; Department of Respiratory Medicine, University Hospital of Santiago de Compostela, Spain; Department of Medicine, University of Santiago de Compostela, Spain
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Gil-Martínez M, Lorente-Sorolla C, Rodrigo-Muñoz JM, Lendínez MÁ, Núñez-Moreno G, de la Fuente L, Mínguez P, Mahíllo-Fernández I, Sastre J, Valverde-Monge M, Quirce S, Caballero ML, González-Barcala FJ, Arismendi E, Bobolea I, Valero A, Muñoz X, Cruz MJ, Martínez-Rivera C, Plaza V, Olaguibel JM, del Pozo V. Analysis of Differentially Expressed MicroRNAs in Serum and Lung Tissues from Individuals with Severe Asthma Treated with Oral Glucocorticoids. Int J Mol Sci 2023; 24:1611. [PMID: 36675122 PMCID: PMC9864670 DOI: 10.3390/ijms24021611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
Nowadays, microRNAs (miRNAs) are increasingly used as biomarkers due to their potential contribution to the diagnosis and targeted treatment of a range of diseases. The aim of the study was to analyze the miRNA expression profiles in serum and lung tissue from patients with severe asthma treated with oral corticosteroids (OCS) and those without OCS treatment. For this purpose, serum and lung tissue miRNAs of OCS and non-OCS asthmatic individuals were evaluated by miRNAs-Seq, and subsequently miRNA validation was performed using RT-qPCR. Additionally, pathway enrichment analysis of deregulated miRNAs was conducted. We observed altered expression by the next-generation sequencing (NGS) of 11 miRNAs in serum, of which five (hsa-miR-148b-3p, hsa-miR-221-5p, hsa-miR-618, hsa-miR-941, and hsa-miR-769-5p) were validated by RT-qPCR, and three miRNAs in lung tissue (hsa-miR-144-3p, hsa-miR-144-5p, and hsa-miR-451a). The best multivariate logistic regression model to differentiate individuals with severe asthma, treated and untreated with OCS, was to combine the serum miRNAs hsa-miR-221-5p and hsa-miR-769-5p. Expression of hsa-miR-148b-3p and hsa-miR-221-5p correlated with FEV1/FVC (%) and these altered miRNAs act in key signaling pathways for asthma disease and the regulated expression of some genes (FOXO3, PTEN, and MAPK3) involved in these pathways. In conclusion, there are miRNA profiles differentially expressed in OCS-treated individuals with asthma and could be used as biomarkers of OCS treatment.
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Affiliation(s)
- Marta Gil-Martínez
- Immunoallergy Laboratory, Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), Av. Reyes Católicos 2, 28040 Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Clara Lorente-Sorolla
- Immunoallergy Laboratory, Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), Av. Reyes Católicos 2, 28040 Madrid, Spain
| | - José M. Rodrigo-Muñoz
- Immunoallergy Laboratory, Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), Av. Reyes Católicos 2, 28040 Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Miguel Ángel Lendínez
- Immunoallergy Laboratory, Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), Av. Reyes Católicos 2, 28040 Madrid, Spain
| | - Gonzalo Núñez-Moreno
- Department of Genetics, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), 28040 Madrid, Spain
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Bioinformatics Unit, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), 28040 Madrid, Spain
| | - Lorena de la Fuente
- Department of Genetics, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), 28040 Madrid, Spain
| | - Pablo Mínguez
- Department of Genetics, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), 28040 Madrid, Spain
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Bioinformatics Unit, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), 28040 Madrid, Spain
| | - Ignacio Mahíllo-Fernández
- Biostatistics and Epidemiology Unit, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), 28040 Madrid, Spain
| | - Joaquín Sastre
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Marcela Valverde-Monge
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Santiago Quirce
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Department of Allergy, Hospital Universitario La Paz, IdiPAZ, 28046 Madrid, Spain
| | - María L. Caballero
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Department of Allergy, Hospital Universitario La Paz, IdiPAZ, 28046 Madrid, Spain
| | - Francisco J. González-Barcala
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Pulmonology Department, Complejo Hospitalario Universitario de Santiago, 15706 Santiago de Compostela, Spain
| | - Ebymar Arismendi
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Allergy Unit & Severe Asthma Unit, Pulmonology and Allergy Department, Hospital Clínic, 08036 Barcelona, Spain
| | - Irina Bobolea
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Allergy Unit & Severe Asthma Unit, Pulmonology and Allergy Department, Hospital Clínic, 08036 Barcelona, Spain
| | - Antonio Valero
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Allergy Unit & Severe Asthma Unit, Pulmonology and Allergy Department, Hospital Clínic, 08036 Barcelona, Spain
| | - Xavier Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Pulmonology Department, Hospital Vall d’Hebron, 08035 Barcelona, Spain
| | - María Jesús Cruz
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Pulmonology Department, Hospital Vall d’Hebron, 08035 Barcelona, Spain
| | - Carlos Martínez-Rivera
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Pulmonology Department, Hospital Germans Trias i Pujol, 08916 Badalona, Spain
| | - Vicente Plaza
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Respiratory Medicine Department, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
| | - José M. Olaguibel
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Severe Asthma Unit, Department of Allergy, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain
| | - Victoria del Pozo
- Immunoallergy Laboratory, Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), Av. Reyes Católicos 2, 28040 Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Department of Medicine, Faculty of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
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Plaza V, Cañete C, Domingo C, Rivera CM, Muñoz X. Efficacy And Potential Positioning Of Tezepelumab In The Treatment Of Severe Asthma. Open Respiratory Archives 2023. [PMID: 37496871 PMCID: PMC10369521 DOI: 10.1016/j.opresp.2022.100231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The excellent results for monoclonal antibodies in the treatment of severe uncontrolled asthma (SUCA) represent a milestone in current treatment of asthmatic disorders. Remaining, however, are several subsidiary areas for improvement in which new biologics are expected to make a decisive contribution. These biologics include tezepelumab, a monoclonal antibody that blocks thymic stromal lymphopoietin (TSLP). TSLP is an epithelial-release cytokine (alarmin) that plays a key role in initiating both the innate (group 2 innate lymphoid cell (ILC) pathway) and the acquired (T helper 2 (Th2) pathway) immune responses by activating the type 2 (T2) asthma inflammatory pathway through both. It is also thought that it may additionally intervene in the neutrophilic non-T2 inflammatory pathway (via interaction with ILC3 and interleukin-17). Six clinical trials that included 2187 patients with uncontrolled asthma, with 2 or more exacerbations in the previous year, on medium/high-dose inhaled corticosteroids and at least 1 other controller, have demonstrated - irrespective of T2 endotype (and possibly also non-T2 endotype) - the efficacy and safety of tezepelumab, as it significantly reduces exacerbations (61.7%-66%) and bronchial hyperresponsiveness, and improves lung function, disease control, and quality of life. Tezepelumab could be indicated for the treatment of patients with, independently of the T2 phenotype (eosinophilic and non-eosinophilic), and may even be the only biologic available for treatment of non-T2 SUCA.
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Molina J, Plaza V, Nuevo J, Gutiérrez M, Sicras-Mainar A, Valero A. Clinical consequences of the overuse of short-acting β2-adrenergic agonists (SABA) in the treatment of asthma in Spain: the SABINA study. Open Respiratory Archives 2023. [PMID: 37496866 PMCID: PMC10369590 DOI: 10.1016/j.opresp.2023.100232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Dominguez-Ortega J, Plaza V, Nieto A, Delgado Romero J, Ancochea J, Mejia N, Pastor M, Blanco-Aparicio M. The ATLAS ASMA Study: Assessing the Impact of Asthma on Patients' Life - The Spanish Patients' Perspective. J Asthma Allergy 2023; 16:461-471. [PMID: 37163179 PMCID: PMC10164385 DOI: 10.2147/jaa.s404525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/05/2023] [Indexed: 05/11/2023] Open
Abstract
Purpose ATLAS ASMA described the psychosocial impact of asthma on patients' daily life from patients' perspectives (in terms of impaired personal and intimate relationships, sleep quality, leisure time, daily activities, and others) in Spain. Secondary objective includes description of time since diagnosis, expectations, and satisfaction of patients about disease, treatment and medical assistance received, adherence to treatment, perceived control of asthma, and health-related quality of life. Patients and Methods This was a cross-sectional, observational study, based on a self-administered online survey for adult patients (≥18 years) with asthma. Patients with asthma diagnosis of any type and severity who voluntarily participated in the survey through a web link were included consecutively. In the present manuscript, only adult patients' data are included. Results A total of 132 adults with asthma were included. Moderate/severe asthma constituted 59.1% of the patients (females 71.2%). Overall, most relevant areas affected due to asthma were leisure activities (67.0%) and the quality/quantity of sleep (52.3%). Moderate/severe patients perceived some degree of impairment in work, school, or at home due asthma more frequently vs mild patients (55.2% vs 10.9%). Poorly controlled asthma (ACT≤19) was reported in 41 (70.7%) and 10 (21.7%) moderate/severe and mild patients (p<0.000), respectively. Mild patients obtained higher mean (SD) Mini-AQLQ score than moderate/severe asthma patients (5.6 [1.0] vs 4.3 [1.1], p<0.000), likewise higher significant results for every individual dimension. Most patients cited little limitation to intense efforts (20.5%). Half of the patients mentioned needing more information about asthma. Topics those patients like to have more information were difficulties that may can have and legal topics (78.6%), asthma evolution (78.6%), secondary effects or issues related to the treatment (61.9%) and legal topics (61.9%). Conclusion The study reported important insights on psychosocial impact of asthma on patients' daily life from patients' perspectives along with health determinants in asthma-related health outcomes, sociodemographic and psychosocial factors.
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Affiliation(s)
- Javier Dominguez-Ortega
- Department of Allergy, La Paz University Hospital, Institute for Health Research (IdiPAZ), Madrid, Spain
- Correspondence: Javier Dominguez-Ortega, La Paz University Hospital, Institute for Health Research (IdiPAZ), Madrid, Spain, Tel +34 616 719 390, Email
| | - Vicente Plaza
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau, Barcelona, Spain
| | - Antonio Nieto
- Pediatric Pulmonology and Allergy Unit, Hospital Universitari i Politècnic La Fe, Health Research Institute La Fe, Valencia, Spain
| | | | - Julio Ancochea
- Pneumology Department, Instituto de Investigación Sanitaria de La Princesa, Madrid, Spain
- Pneumology Department, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Natalia Mejia
- Medical Department, Novartis Farmacéutica, Barcelona, Spain
| | - Mariano Pastor
- Fundación Española de Asociaciones de Pacientes Alérgicos y con Enfermedades Respiratorias (FENAER), Madrid, Spain
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Molina Paris J, Almonacid Sánchez C, Blanco-Aparicio M, Domínguez-Ortega J, Giner Donaire J, Sánchez Marcos N, Plaza V. Current expert opinion and attitudes to optimize telemedicine and achieve control in patients with asthma in post-pandemic era: The COMETA consensus. Aten Primaria 2022; 54:102492. [PMID: 36272223 PMCID: PMC9589141 DOI: 10.1016/j.aprim.2022.102492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/13/2022] [Accepted: 09/27/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To collect perspectives and explore consensus for expert recommendations related to asthma control and the use of telemedicine among professionals who manage patients with asthma. DESIGN A Delphi-like questionnaire was designed to analyse the level of agreement about several recommendations formulated by an expert scientific committee about asthma control and the use of telemedicine with this purpose. A dedicated scientific committee validated the questionnaire, which included questions about the participants' profile and the use of technological tools at a personal level or in clinical practice. The experts expressed their agreement with a Likert-scale of 9 values: 1-3 was considered no agreement, 4-6 neutral, and 7-9 agreement. A rate ≥70% with the same answer was considered consensus. SITE: The questionnaire was programmed and distributed as an internet-based survey. PARTICIPANTS A pre-selected sample of 75 experts with experience in telemedicine (pulmonology, allergology, family medicine, nursing and community pharmacy) responded to a Delphi-like questionnaire composed by six questions and 52 items. INTERVENTIONS Consultation was performed in two consecutive waves: the first wave was carried out from 12th of July to 8th of September of 2021; the second wave, from 25th of October to 12th of November of 2021. MAIN MEASUREMENTS Three questions about asthma control (actions for achieving or maintaining control of asthma at every visit, current problems that affect asthma control, and potential solutions to offset such problems), and three questions about the impact of telemedicine in asthma control (potential benefits of telemedicine, and potential reticence about telemedicine among both patients and healthcare professionals) were included. RESULTS From the 52 items inquired, 35 were agreed by consensus. The actions for achieving or maintaining control of asthma, the problems that affect asthma control, and their potential solutions were agreed by consensus. The potential benefits of telemedicine were validated by consensus. None of the potential reservations of patients about telemedicine were validated, while five out of 14 potential reservations of healthcare professionals were agreed by consensus. CONCLUSIONS The COMETA consensus provides a current picture of the main problems for achieving asthma control, the benefits and the reservations about the use of telemedicine in the Spanish setting, and offers solutions. A wide interest in implementing telemedicine has been observed, although current limitations need to be overcome.
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Affiliation(s)
- Jesús Molina Paris
- Healthcare Center Francia, Fuenlabrada, Madrid, Spain,Corresponding author.
| | | | | | | | - Jordi Giner Donaire
- Pulmonology and Allergy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Vicente Plaza
- Pulmonology and Allergy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Curto E, Mateus-Medina ÉF, Crespo-Lessmann A, Osuna-Gómez R, Ujaldón-Miró C, García-Moral A, Galván-Blasco P, Soto-Retes L, Ramos-Barbón D, Plaza V. Identification of Two Eosinophil Subsets in Induced Sputum from Patients with Allergic Asthma According to CD15 and CD66b Expression. Int J Environ Res Public Health 2022; 19:13400. [PMID: 36293979 PMCID: PMC9602830 DOI: 10.3390/ijerph192013400] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/08/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
Two subsets of eosinophils have been described: resident eosinophils with homeostatic functions (rEOS) in healthy subjects and in patients with nonallergic eosinophilic asthma, and inflammatory eosinophils (iEOS) in blood and lung samples from patients with allergic asthma. We explored if it would be possible to identify different subsets of eosinophils using flow cytometry and the gating strategy applied to induced sputum. We conducted an observational cross-sectional single-center study of 62 patients with persistent allergic asthma. Inflammatory cells from induced sputum samples were counted by light microscopy and flow cytometry, and cytokine levels in the supernatant were determined. Two subsets of eosinophils were defined that we call E1 (CD66b-high and CD15-high) and E2 (CD66b-low and CD15-low). Of the 62 patients, 24 were eosinophilic, 18 mixed, 10 paucigranulocytic, and 10 neutrophilic. E1 predominated over E2 in the eosinophilic and mixed patients (20.86% vs. 6.27% and 14.42% vs. 4.31%, respectively), while E1 and E2 were similar for neutrophilic and paucigranulocytic patients. E1 correlated with IL-5, fractional exhaled nitric oxide, and blood eosinophils. While eosinophil subsets have been identified for asthma in blood, we have shown that they can also be identified in induced sputum.
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Affiliation(s)
- Elena Curto
- Asthma Unit, Respiratory and Allergy Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Department of Medicine, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain
| | - Éder F. Mateus-Medina
- Asthma Unit, Respiratory and Allergy Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Department of Medicine, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain
| | - Astrid Crespo-Lessmann
- Asthma Unit, Respiratory and Allergy Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Department of Medicine, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain
| | - Rubén Osuna-Gómez
- Inflammatory Diseases Unit, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08041 Barcelona, Spain
| | - Cristina Ujaldón-Miró
- Cellular Immunotherapy and Gene Therapy Group (GITG), Oncology, Hematology and Transplantation Laboratory, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08041 Barcelona, Spain
| | - Alba García-Moral
- Pediatric Allergy Unit, Pediatric Allergy Section, Pediatric Pneumology and Cystic Fibrosis, Pediatrics Service, Hospital Universitari Vall d’Hebron, 08041 Barcelona, Spain
| | - Paula Galván-Blasco
- Allergology Section, Department of Internal Medicine, Hospital Universitari Vall d’Hebron, 08041 Barcelona, Spain
| | - Lorena Soto-Retes
- Asthma Unit, Respiratory and Allergy Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Department of Medicine, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain
| | - David Ramos-Barbón
- Asthma Unit, Respiratory and Allergy Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Department of Medicine, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain
| | - Vicente Plaza
- Asthma Unit, Respiratory and Allergy Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Department of Medicine, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain
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Perrot JC, Segura M, Beranuy M, Gich I, Nadal MJ, Pintor A, Terra J, Ramirez E, Paz LD, Bascuñana H, Plaza V, Güell-Rous MR. Comparison of post-COVID symptoms in patients with different severity profiles of the acute disease visited at a rehabilitation unit. PLoS One 2022; 17:e0274520. [PMID: 36112577 PMCID: PMC9481013 DOI: 10.1371/journal.pone.0274520] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/29/2022] [Indexed: 11/19/2022] Open
Abstract
Background and aim Studies in the literature suggest the severity of COVID-19 may impact on post-COVID sequelae. We retrospectively compared the different patterns of symptoms in relation to the severity of acute COVID-19 in patients visited at our post-COVID rehabilitation unit. Methods We compared respiratory, muscular, cognitive, emotional, and health-related-quality-of-life (HRQoL) measures in three groups of post-COVID patients: those who had not required hospitalization for the acute disease, those who had been admitted to a general hospital ward, and those who had been admitted to the ICU. The main inclusion criteria were persistent dyspnoea (mMRC ≥2) and/or clinical frailty (scale value ≥3). Results We analyzed data from 178 post-COVID patients (91 admitted to the ICU, 60 to the ward, and 27 who had not required admission) at first visit to our post-COVID rehabilitation unit. Most patients (85.4%) had at least one comorbidity. There were more males in all groups (58.1%). ICU patients were older (p<0.001). The most frequent symptoms in all groups were fatigue (78.2%) and dyspnea (75.4%). Muscle strength and effort capacity were lower in the ICU group (p<0.001). The SF36 mental component and level of anxiety were worse in patients not admitted to the ICU (p<0.001). No differences were found between groups regarding respiratory pressure but 30 of 57 patients with a decrease in maximum inspiratory pressure had not required mechanical ventilation. Conclusion Clinical profiles of post-COVID syndrome differed between groups. Muscle parameters were lower in the ICU group but patients who had not needed ICU admission had worse anxiety and HRQoL scores. Many patients who had not required mechanical ventilation had respiratory muscle weakness. Trial registration ClinicalTrials.gov Identifier: NCT04852718
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Affiliation(s)
- Jean Claude Perrot
- Physical Medicine and Rehabilitation Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | - Macarena Segura
- Physical Medicine and Rehabilitation Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
- Pneumology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | - Marta Beranuy
- Physical Medicine and Rehabilitation Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | - Ignasi Gich
- CIBER Epidemiology and Public Health (CIBERESP), Catalonia, Spain
| | - Mª Josepa Nadal
- Physical Medicine and Rehabilitation Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | - Alberto Pintor
- Physical Medicine and Rehabilitation Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | - Jimena Terra
- Physical Medicine and Rehabilitation Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | - Eliot Ramirez
- Physical Medicine and Rehabilitation Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | - Luis Daniel Paz
- Physical Medicine and Rehabilitation Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
- Pneumology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | - Helena Bascuñana
- Physical Medicine and Rehabilitation Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
- Pneumology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Catalonia, Spain
- Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Catalonia, Spain
| | - Vicente Plaza
- Physical Medicine and Rehabilitation Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
- Pneumology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Catalonia, Spain
- Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Catalonia, Spain
| | - Mª Rosa Güell-Rous
- Pneumology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
- * E-mail:
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Betancor D, Olaguibel JM, Rodrigo‐Muñoz JM, Arismendi E, Barranco P, Barroso B, Bobolea I, Cárdaba B, Cruz MJ, Curto E, Del Pozo V, González‐Barcala F, Martínez‐Rivera C, Mullol J, Muñoz X, Picado C, Plaza V, Quirce S, Rial MJ, Soto L, Valero A, Valverde‐Monge M, Sastre J. How reliably can algorithms identify eosinophilic asthma phenotypes using non-invasive biomarkers? Clin Transl Allergy 2022; 12:e12182. [PMID: 36000018 PMCID: PMC9391921 DOI: 10.1002/clt2.12182] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/06/2022] [Accepted: 07/01/2022] [Indexed: 11/14/2022] Open
Abstract
Background and Aims Asthma is a heterogeneous respiratory disease that encompasses different inflammatory and functional endophenotypes. Many non‐invasive biomarkers has been investigated to its pathobiology. Heany et al proposed a clinical algorithm that classifies severe asthmatic patients into likely‐eosinophilic phenotypes, based on accessible biomarkers: PBE, current treatment, FeNO, presence of nasal polyps (NP) and age of onset. Materials and Methods We assessed the concordance between the algorithm proposed by Heany et al. with sputum examination, the gold standard, in 145 asthmatic patients of the MEGA cohort with varying grades of severity. Results No correlation was found between both classifications 0.025 (CI = 0.013–0.037). Moreover, no relationship was found between sputum eosinophilia and peripheral blood eosinophilia count in the total studied population. Discussion and Conclusion In conclusion, our results suggest that grouping the biomarkers proposed by Heany et al. are insufficient to diagnose eosinophilic phenotypes in asthmatic patients. Sputum analysis remains the gold standard to assess airway inflammation.
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Almonacid Sánchez C, Blanco-Aparicio M, Domínguez-Ortega J, Giner Donaire J, Molina Paris J, Sánchez Marcos N, Plaza V. Validation of the algorithm for the monitoring and control of asthma through telemedicine. The Consensus COMETA Project. J Investig Allergol Clin Immunol 2022:0. [PMID: 35797114 DOI: 10.18176/jiaci.0841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - M Blanco-Aparicio
- Servicio de Neumología, Hospital Universitario A Coruña, A Coruña, España
| | - J Domínguez-Ortega
- Servicio de Alergia, Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), Madrid, España
| | - J Giner Donaire
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | | | - N Sánchez Marcos
- Sociedad Española de Farmacia Clínica Familiar y Comunitaria SEFAC, Madrid, España
| | - V Plaza
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, España
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Quirce S, Trigueros JA, Ausín P, Muñoz Cano R, Ramírez Hernández M, González-Barcala FJ, Gregorio Soto J, Padilla Galo A, Cisneros Serrano C, Domínguez-Ortega J, Pueyo Bastida A, Pascual Erquicia S, Dávila I, Martínez Moragón E, Plaza Zamora FJ, Sánchez Barbero F, Plaza V. Role of the different healthcare professionals in the management of asthma patients. The GEMA-FORUM IV task force. J Investig Allergol Clin Immunol 2022:0. [DOI: 10.18176/jiaci.0833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Herrera-Luis E, Ortega VE, Ampleford EJ, Sio YY, Granell R, de Roos E, Terzikhan N, Vergara EE, Hernandez-Pacheco N, Perez-Garcia J, Martin-Gonzalez E, Lorenzo-Diaz F, Hashimoto S, Brinkman P, Jorgensen AL, Yan Q, Forno E, Vijverberg SJ, Lethem R, Espuela-Ortiz A, Gorenjak M, Eng C, González-Pérez R, Hernández-Pérez JM, Poza-Guedes P, Sardón O, Corcuera P, Hawkins GA, Marsico A, Bahmer T, Rabe KF, Hansen G, Kopp MV, Rios R, Cruz MJ, González-Barcala FJ, Olaguibel JM, Plaza V, Quirce S, Canino G, Cloutier M, Del Pozo V, Rodriguez-Santana JR, Korta-Murua J, Villar J, Potočnik U, Figueiredo C, Kabesch M, Mukhopadhyay S, Pirmohamed M, Hawcutt DB, Melén E, Palmer CN, Turner S, Maitland-van der Zee AH, von Mutius E, Celedón JC, Brusselle G, Chew FT, Bleecker E, Meyers D, Burchard EG, Pino-Yanes M. Multi-ancestry genome-wide association study of asthma exacerbations. Pediatr Allergy Immunol 2022; 33:e13802. [PMID: 35754128 PMCID: PMC9671132 DOI: 10.1111/pai.13802] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/01/2022] [Accepted: 05/04/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Asthma exacerbations are a serious public health concern due to high healthcare resource utilization, work/school productivity loss, impact on quality of life, and risk of mortality. The genetic basis of asthma exacerbations has been studied in several populations, but no prior study has performed a multi-ancestry meta-analysis of genome-wide association studies (meta-GWAS) for this trait. We aimed to identify common genetic loci associated with asthma exacerbations across diverse populations and to assess their functional role in regulating DNA methylation and gene expression. METHODS A meta-GWAS of asthma exacerbations in 4989 Europeans, 2181 Hispanics/Latinos, 1250 Singaporean Chinese, and 972 African Americans analyzed 9.6 million genetic variants. Suggestively associated variants (p ≤ 5 × 10-5 ) were assessed for replication in 36,477 European and 1078 non-European asthma patients. Functional effects on DNA methylation were assessed in 595 Hispanic/Latino and African American asthma patients and in publicly available databases. The effect on gene expression was evaluated in silico. RESULTS One hundred and twenty-six independent variants were suggestively associated with asthma exacerbations in the discovery phase. Two variants independently replicated: rs12091010 located at vascular cell adhesion molecule-1/exostosin like glycosyltransferase-2 (VCAM1/EXTL2) (discovery: odds ratio (ORT allele ) = 0.82, p = 9.05 × 10-6 and replication: ORT allele = 0.89, p = 5.35 × 10-3 ) and rs943126 from pantothenate kinase 1 (PANK1) (discovery: ORC allele = 0.85, p = 3.10 × 10-5 and replication: ORC allele = 0.89, p = 1.30 × 10-2 ). Both variants regulate gene expression of genes where they locate and DNA methylation levels of nearby genes in whole blood. CONCLUSIONS This multi-ancestry study revealed novel suggestive regulatory loci for asthma exacerbations located in genomic regions participating in inflammation and host defense.
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Affiliation(s)
- Esther Herrera-Luis
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Tenerife, Spain
| | - Victor E Ortega
- Division of Respiratory Medicine, Department of Internal Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | - Elizabeth J Ampleford
- Department of Internal Medicine, Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Yang Yie Sio
- Department of Biological Sciences, National University of Singapore, Singapore City, Singapore
| | - Raquel Granell
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Emmely de Roos
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Natalie Terzikhan
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Ernesto Elorduy Vergara
- Institute of Computation Biology, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Natalia Hernandez-Pacheco
- Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Javier Perez-Garcia
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Tenerife, Spain
| | - Elena Martin-Gonzalez
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Tenerife, Spain
| | - Fabian Lorenzo-Diaz
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Tenerife, Spain.,Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias (IUETSPC), Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Tenerife, Spain
| | - Simone Hashimoto
- Department of Respiratory Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Paul Brinkman
- Department of Respiratory Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Andrea L Jorgensen
- Department of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Qi Yan
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York, USA
| | - Erick Forno
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Susanne J Vijverberg
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Division of Pharmacoepidemiology and Clinical Pharmacology, Faculty of Science, Utrecht University, Utrecht, The Netherlands.,Department of Paediatric Respiratory Medicine and Allergy, Emma's Children Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ryan Lethem
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Antonio Espuela-Ortiz
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Tenerife, Spain
| | - Mario Gorenjak
- Center for Human Molecular Genetics and Pharmacogenomics, Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Celeste Eng
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Ruperto González-Pérez
- Allergy Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Tenerife, Spain.,Severe Asthma Unit, Allergy Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Tenerife, Spain
| | - José M Hernández-Pérez
- Pulmonary Medicine, Hospital Universitario de N.S de Candelaria, Santa Cruz de Tenerife, Spain.,Pulmonary Medicine, Hospital General de La Palma, La Palma, Santa Cruz de Tenerife, Spain
| | - Paloma Poza-Guedes
- Allergy Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Tenerife, Spain.,Severe Asthma Unit, Allergy Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Tenerife, Spain
| | - Olaia Sardón
- Division of Pediatric Respiratory Medicine, Hospital Universitario Donostia, San Sebastián, Spain.,Department of Pediatrics, University of the Basque Country (UPV/EHU), San Sebastián, Spain
| | - Paula Corcuera
- Division of Pediatric Respiratory Medicine, Hospital Universitario Donostia, San Sebastián, Spain
| | - Greg A Hawkins
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Annalisa Marsico
- Computational Health Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Thomas Bahmer
- LungenClinic Grosshansdorf, Pneumology, Grosshansdorf, Germany.,Airway Research Center North (ARCN), Members of the Germany Center for Lung Research (DZL), Grosshansdorf, Germany
| | - Klaus F Rabe
- LungenClinic Grosshansdorf, Pneumology, Grosshansdorf, Germany.,Airway Research Center North (ARCN), Members of the Germany Center for Lung Research (DZL), Grosshansdorf, Germany
| | - Gesine Hansen
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
| | - Matthias Volkmar Kopp
- Division of Pediatric Pneumology & Allergology, University Medical Center Schleswig-Holstein, Lübeck, Germany.,Airway Research Center North (ARCN), Members of the Germany Center for Lung Research (DZL), Lübeck, Germany.,Department of Paediatric Respiratory Medicine, Inselspital, University Children's Hospital of Bern, University of Bern, Bern, Switzerland
| | - Raimon Rios
- Programa de Pós Graduação em Imunologia (PPGIm), Instituto de Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador, Brazil
| | - Maria Jesus Cruz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Servicio de Neumología, Hospital Vall d'Hebron, Barcelona, Spain
| | | | - José María Olaguibel
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Servicio de Alergología, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - Vicente Plaza
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Departamento de Medicina Respiratoria, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Santiago Quirce
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Michelle Cloutier
- Department of Pediatrics, University of Connecticut, Farmington, Connecticut, USA
| | - Victoria Del Pozo
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Immunology Department, Instituto de Investigación Sanitaria Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | - Javier Korta-Murua
- Department of Pediatrics, University of the Basque Country (UPV/EHU), San Sebastián, Spain
| | - Jesús Villar
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Multidisciplinary Organ Dysfunction Evaluation Research Network, Research Unit, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Uroš Potočnik
- Laboratory for Biochemistry, Molecular Biology and Genomics, Faculty for Chemistry and Chemical Engineering, University of Maribor, Maribor, Slovenia
| | - Camila Figueiredo
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - Michael Kabesch
- Department of Paediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO), Regensburg, Germany
| | - Somnath Mukhopadhyay
- Academic Department of Paediatrics, Brighton and Sussex Medical School, Royal Alexandra Children's Hospital, Brighton, UK.,Population Pharmacogenetics Group, Biomedical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Munir Pirmohamed
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Daniel B Hawcutt
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK.,Alder Hey Children's Hospital, Liverpool, UK.,NIHR Alder Hey Clinical Research Facility, Alder Hey Children's Hospital, Liverpool, UK
| | - Erik Melén
- Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children's Hospital, South General Hospital, Stockholm, Sweden
| | - Colin N Palmer
- Population Pharmacogenetics Group, Biomedical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Steve Turner
- Child Health, University of Aberdeen, Aberdeen, UK
| | - Anke H Maitland-van der Zee
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Division of Pharmacoepidemiology and Clinical Pharmacology, Faculty of Science, Utrecht University, Utrecht, The Netherlands.,Department of Paediatric Respiratory Medicine and Allergy, Emma's Children Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Erika von Mutius
- Institute for Asthma and Allergy Prevention, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany.,Dr von Hauner Children's Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany
| | - Juan C Celedón
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Guy Brusselle
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.,Department of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Fook Tim Chew
- Department of Biological Sciences, National University of Singapore, Singapore City, Singapore
| | - Eugene Bleecker
- Division of Genetics, Genomics, and Precision Medicine, Department of Internal Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Deborah Meyers
- Division of Genetics, Genomics, and Precision Medicine, Department of Internal Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Esteban G Burchard
- Severe Asthma Unit, Allergy Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Tenerife, Spain.,Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, California, USA
| | - Maria Pino-Yanes
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Tenerife, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Instituto de Tecnologías Biomédicas (ITB), Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Tenerife, Spain
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Quint JK, Arnetorp S, Kocks JWH, Kupczyk M, Nuevo J, Plaza V, Cabrera C, Raherison-Semjen C, Walker B, Penz E, Gilbert I, Lugogo NL, van der Valk RJP. Short-Acting Beta-2-Agonist Exposure and Severe Asthma Exacerbations: SABINA Findings From Europe and North America. J Allergy Clin Immunol Pract 2022; 10:2297-2309.e10. [PMID: 35364341 DOI: 10.1016/j.jaip.2022.02.047] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 02/04/2022] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Expert national/global asthma management recommendations raise the issue whether a safe threshold of short-acting beta-2 agonist (SABA) use without concomitant inhaled corticosteroids (ICS) exists. OBJECTIVE To examine SABA and maintenance therapy associations with severe asthma exacerbations across North America and Europe. METHODS Observational analyses of 10 SABa use IN Asthma (SABINA) datasets involving 1,033,564 patients (≥12 y) from Canada, France, the Netherlands, Poland, Spain, the United Kingdom, and the United States. Negative binomial models (incidence rate ratio [IRR] [95% CI adjusted for prespecified-covariates]) evaluated associations between SABA and exacerbations. RESULTS Across severities, 40.2% of patients were prescribed/possessed 3 or more SABA canisters/y. Per the Global Initiative for Asthma (GINA) 2018 definitions, steps 3 to 5-treated patients prescribed/possessing 3 or more versus 1 or 2 SABAs experienced more severe exacerbations (IRR 1.08 [95% CI 1.04‒1.13], U.S. Medicare; IRR 2.11 [95% CI 1.96‒2.27], Poland). This association was not observed in all step 1 or 2-treated patients (the Netherlands, IRR 1.25 [95% CI 0.91‒1.71]; U.S. commercial, IRR 0.92 [95% CI 0.91‒0.93]; U.S. Medicare, IRR 0.74 [95% CI 0.71‒0.76]). We hypothesize that this inverse association between SABA and severe exacerbations in the U.S. datasets was attributable to the large patient population possessing fewer than 3 SABA and no maintenance therapy and receiving oral corticosteroid bursts without face-to-face health care provider encounters. In U.S. SABA monotherapy-treated patients, 3 or more SABAs were associated with more emergency/outpatient visits and hospitalizations (IRR 1.31 [95% CI 1.29‒1.34]). Most GINA 2 to 5-treated study patients (60.6%) did not have maintenance therapy for up to 50% of the time; however, the association of 3 or more SABAs and severe exacerbations persisted (IRR 1.32 [95% CI 1.18‒1.49]) after excluding these patients and the independent effect was further confirmed when U.K. SABA data were analyzed as a continuous variable in patients with up to 100% annual coverage for ICS-containing medications. CONCLUSIONS Increasing SABA exposure is associated with severe exacerbation risk, independent of maintenance therapy. As addressed by GINA, based on studies across asthma severities where as-needed fast-acting bronchodilators with concomitant ICS decrease severe exacerbations compared with SABA, our findings highlight the importance of avoiding a rescue/reliever paradigm utilizing SABA monotherapy.
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Affiliation(s)
- Jennifer K Quint
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, United Kingdom.
| | | | - Janwillem W H Kocks
- General Practitioners Research Institute, Groningen, The Netherlands; Department of Pulmonology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Observational and Pragmatic Research Institute, Singapore; Groningen Research Institute Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Maciej Kupczyk
- Department of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland; Center for Allergy Research, IMM, Karolinska Institutet, Stockholm, Sweden
| | | | - Vicente Plaza
- Executive Committee of GEMA, Spanish Society of Pulmonology and Thoracic Surgery (SEPAR); Pneumology and Allergy Service, Hospital Santa Creu i Sant, Barcelona, Spain
| | - Claudia Cabrera
- BioPharmaceuticals Medical (Evidence), AstraZeneca, Gothenburg, Sweden
| | - Chantal Raherison-Semjen
- Department of Pulmonary Medicine, CHU Bordeaux, INSERM U1219 Bordeaux University, Bordeaux, France
| | - Brandie Walker
- Department of Medicine, Division of Respirology, University of Calgary, Calgary, Alta, Canada
| | - Erika Penz
- Department of Medicine, Division of Respirology, Critical Care and Sleep Medicine, University of Saskatchewan, Saskatoon, Sask, Canada; Respiratory Research Center, University of Saskatchewan, Saskatoon, Sask, Canada
| | | | - Njira Lucia Lugogo
- Department of Pulmonary & Critical Care Medicine, University of Michigan, Ann Arbor, Mich
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Plaza V, Alobid I, Alvarez C, Blanco M, Ferreira J, García G, Gómez-Outes A, Gómez F, Hidalgo A, Korta J, Molina J, Pellegrini FJ, Pérez M, Plaza J, Praena M, Quirce S, Sanz J. [Translated article] Spanish Asthma Management Guidelines (GEMA) v.5.1. Highlights and Controversies. Arch Bronconeumol 2022; 58:T150-T158. [PMID: 35971814 DOI: 10.1016/j.arbres.2021.05.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 12/12/2022]
Abstract
In this fifth phase of development, the contents of the Spanish Asthma Management Guidelines (GEMA), which include versions 5.0 and 5.1, have undergone a thorough review. The aim here is to set the main changes in context. These could be summarized as follows: DIAGNOSIS: new FENO cut-off and severity classification based on treatment needed to maintain control; INTERMITTENT ASTHMA: a more restrictive concept and treatment extended to include a glucocorticoid/adrenergic combination as needed; MILD ASTHMA: glucocorticoid/adrenergic therapy as needed as an alternative in case of low therapeutic adherence to conventional fixed-dose steroids; SEVERE ASTHMA: readjustment of phenotypes, incorporation of triple therapy in a single inhaler, and criteria for selection of a biologic in severe uncontrolled asthma; OTHERS: specific scoring in childhood asthma, incorporation of certain organizational aspects (care circuits, asthma units, telemedicine), new sections on COVID-19 and nasal polyposis.
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Affiliation(s)
- Vicente Plaza
- Comité Ejecutivo GEMA, Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
| | - Isam Alobid
- Sociedad Española de Otorrinolaringología (SEORL), Hospital Clinic, Universidad de Barcelona, Barcelona, Spain
| | - Cesáreo Alvarez
- Sociedad Española de Medicina de Urgencias y Emergencias (SEMES), Hospital de Verín, Orense, Spain
| | - Marina Blanco
- Sociedad Española de Neumología y Cirugía Torácica (SEPAR), Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - Jorge Ferreira
- Sociedad Portuguesa de Pneumologia (SPP), Hospital de São Sebastião • CHEDV, Santa Maria da Feira, Portugal
| | - Gabriel García
- Asociación Latinoamericana del Tórax (ALAT), Hospital Rossi La Plata, Buenos Aires, Argentina
| | - Antonio Gómez-Outes
- Sociedad Española de Farmacología Clínica (SEFC), Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), Madrid, Spain
| | - Fernando Gómez
- Sociedad Española de Médicos Generales y de Familia (SEMG), Centro de Salud de Bargas, Toledo, Spain
| | - Antonio Hidalgo
- Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Centro de Salud Lucena I. Lucena, Córdoba, Spain
| | - Javier Korta
- Sociedad Española de Neumología Pediátrica (SENP), Hospital Universitario Donostia, Donostia-San Sebastián, Spain
| | - Jesús Molina
- Sociedad Española de Medicina Familiar y Comunitaria (semFYC) y Sociedad de Respiratorio de Atención Primaria (GRAP), Centro de Salud Francia, Fuenlabrada, Dirección Asistencial Oeste, Madrid, Spain
| | - Francisco Javier Pellegrini
- Sociedad Española de Pediatría Extrahospitalaria y Atención Primaria (SEPEAP), Centro de Salud de Pizarrales, Salamanca, Spain
| | - Montserrat Pérez
- Sociedad Española de Farmacia Hospitalaria (SEFH), Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Javier Plaza
- Sociedad Española de Farmacia Clínica, Familiar y Comunitaria (SEFAC), Farmacia Dres. Zamora Navarro, Mazarrón, Murcia, Spain
| | - Manuel Praena
- Asociación Española de Pediatría de Atención Primaria (AEPap), Centro de Salud La Candelaria, Sevilla, Spain
| | - Santiago Quirce
- Sociedad Española de Alergia e Inmunología Clínica (SEAIC), Hospital Universitario La Paz, Madrid, Spain
| | - José Sanz
- Sociedad Española de Inmunología Clínica•Alergología y Asma Pediátrica (SEICAP), Hospital Católico Universitario Casa de Salud, Valencia, Spain
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Domínguez-Ortega J, Plaza V, Li VW, Fonseca E, Cea-Calvo L, Martin A, Sánchez-Jareño M, Brady JE, Schelfhout J. Prevalence of chronic cough and patient characteristics in adults in Spain: A population-based cross-sectional survey. Chron Respir Dis 2022; 19:14799731221098722. [PMID: 35620851 PMCID: PMC9150240 DOI: 10.1177/14799731221098722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Chronic cough (CC) represents a significant health burden. This study assessed the prevalence of CC (defined as per international guidelines as cough duration >8 weeks) in Spanish adults and compared characteristics between CC and non-CC cohorts. Methods CC cohorts were compiled using data from adult respondents to the 2020 Spanish cross-sectional online National Health and Wellness Survey (NHWS). Using propensity scores, respondents experiencing CC during their lifetime and the previous 12 months were matched 3:1 to respondents without CC and their health characteristics were compared. The number of Spanish adults affected with CC was estimated using weighted CC prevalence. Results CC during their lifetime or the previous 12 months was experienced by 579 (8.2%) and 389 (5.5%) of 7074 NHWS respondents, of whom 233 (38.5%) and 171 (44.0%), respectively, had physician-diagnosed CC. Based on weighted prevalence rates, lifetime and 12-month CC were estimated to affect ≈3.3 million and ≈2.2 million Spanish adults, respectively. Relative to the non-CC cohort, the 12-month CC cohort consistently demonstrated poorer health status, poorer mental health, greater healthcare utilization, and lower productivity at work and home. Conclusion This study contributes novel data regarding the prevalence of CC in Spain, suggests that CC is underdiagnosed, and reflects that CC and related comorbidities inflict a significant health burden in the affected population.
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Affiliation(s)
- Javier Domínguez-Ortega
- Allergy Department, La Paz University Hospital, IdiPAZ, Madrid, Spain.,CIBER of Respiratory Diseases, CIBERES, Madrid, Spain
| | - Vicente Plaza
- CIBER of Respiratory Diseases, CIBERES, Madrid, Spain.,Respiratory Medicine Department, Santa Creu i Sant Pau Hospital, Barcelona, Spain.,Medicine Department, University Autonomous of Barcelona (UAB), Barcelona, Spain
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Valero A, Molina J, Nuevo J, Simon S, Capel M, Sicras-Mainar A, Sicras-Navarro A, Plaza V. Economic consequences of the overuse of short-acting beta-adrenergic agonists (SABA) in the treatment of asthma in Spain. J Investig Allergol Clin Immunol 2021; 33:109-118. [PMID: 34825651 DOI: 10.18176/jiaci.0767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND To determine the relationship between short-acting beta-adrenergic agonist (SABA) overuse and healthcare resource use and costs in asthma patients in routine clinical practice. MATERIAL AND METHODS A longitudinal retrospective study in Spanish primary and specialized care using the BIG-PAC® Medical Records Database was conducted. Asthma patients ≥12 years of age who attended ≥ 2 consultations during 2017 and had 1-year follow-up data available were included. Main outcomes were demographics, comorbidities, medication, clinical and healthcare resource use and costs. The relationship between SABA overuseand healthcare costs, and between asthma severity and healthcare costs was determined. RESULTS This SABA use IN Asthma (SABINA) study included 39,555 patients, mean (standard deviation, SD) age 49.8 (20.7) years; 64.2% were female. Charlson comorbidity index was 0.7 (1.0). SABA overuse (≥ 3 canisters/year) was 28.7% (95% CI: 27.7-29.7), with an overall mean number of 3.3 (3.6) canisters/year. Overall, 5.1% of patients were prescribed ≥12 canisters/year. SABA overuse was correlated with healthcare costs (ρ = 0.621; p < 0.001).The adjusted mean annual cost/patient, according to the Global Initiative for Asthma (GINA 2019) classification of asthma severity, was €2,231, €2,345, €2,735, €3,473, and €4,243,for GINA steps 1-5, respectively (p < 0.001). Regardless of asthma severity, SABA overuse yielded a significant increase in healthcare costs per patient and year (€5,702 vs. €1,917, p < 0.001) compared with recommended use (< 2 canisters/year). CONCLUSIONS SABA overuse yields greater costs for the Spanish National Health System. Costs increased according to asthma severity.
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Affiliation(s)
- A Valero
- Sección de Alergología, Servicio de Neumología y Alergia, Hospital Clínic de Barcelona, Spain, Universitat de Barcelona, IDIBAPS, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - J Molina
- CS Francia, Dirección Asistencial Oeste, Fuenlabrada, Madrid, Spain
| | - J Nuevo
- Department of Medical Evidence and Health Economics, AstraZeneca, Madrid, Spain
| | - S Simon
- Department of Medical Evidence and Health Economics, AstraZeneca, Madrid, Spain
| | - M Capel
- Department of Medical Evidence and Health Economics, AstraZeneca, Madrid, Spain
| | - A Sicras-Mainar
- Health Economics and Outcomes Research, Real Life Data, Badalona, Barcelona, Spain
| | - A Sicras-Navarro
- Health Economics and Outcomes Research, Real Life Data, Badalona, Barcelona, Spain
| | - V Plaza
- Servei de Pneumologia i Al•lèrgia, Hospital de la Santa Creu i Sant Pau, Institut d´Investigació Biomèdica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
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Baptista-Serna L, Rodrigo-Muñoz JM, Mínguez P, Valverde-Monge M, Arismendi E, Barranco P, Barroso B, Bobolea I, Cañas JA, Cárdaba B, Cruz MJ, Curto E, Domínguez J, García-Latorre R, González-Barcala FJ, Martínez-Rivera C, Mullol J, Muñoz X, Olaguibel JM, Picado C, Plaza V, Quirce S, Rial MJ, Sastre B, Soto L, Valero A, Pozo VD, Sastre J. Anxiety and BMI affect asthma control: data from a prospective Spanish cohort. J Allergy Clin Immunol Pract 2021; 10:863-866.e1. [PMID: 34673289 DOI: 10.1016/j.jaip.2021.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/15/2021] [Accepted: 10/04/2021] [Indexed: 11/17/2022]
Affiliation(s)
| | - José Manuel Rodrigo-Muñoz
- Department of Immunology, IIS-Fundación Jiménez Díaz, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - Pablo Mínguez
- Department of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain; Bioinformatics Unit, IIS Fundación Jiménez Díaz, Madrid, Spain; Centre for Biomedical Network Research on rare diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Ebymar Arismendi
- Allergy Unit & Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic; IDIBAPS; Universitat de Barcelona. Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - Pilar Barranco
- Department of Allergy, Hospital La Paz-Institute for Health Research (IdiPAZ), Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - Blanca Barroso
- Department of Allergy, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - Irina Bobolea
- Allergy Unit & Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic; IDIBAPS; Universitat de Barcelona. Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - José Antonio Cañas
- Department of Immunology, IIS-Fundación Jiménez Díaz, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - Blanca Cárdaba
- Department of Immunology, IIS-Fundación Jiménez Díaz, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - María Jesús Cruz
- Departamento de Biología Celular, Fisiología e Inmunología, Universitat Autónoma de Barcelona, Barcelona, Spain; Servicio de Neumología, Hospital Vall d'Hebron, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - Elena Curto
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research (IBB Sant Pau), Universitat Autònoma de Barcelona. Department of Medicine, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - Javier Domínguez
- Department of Allergy, Hospital La Paz-Institute for Health Research (IdiPAZ), Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - Raquel García-Latorre
- Department of Immunology, IIS-Fundación Jiménez Díaz, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - Francisco J González-Barcala
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain; Department of Respiratory Medicine, University Hospital of Santiago de Compostela (CHUS), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Carlos Martínez-Rivera
- Servicio de Neumología, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - Joaquim Mullol
- Rhinology Unit & Smell Clinic, ENT Department; Clinical and Experimental Respiratory Immunoallergy (IDIBAPS); Universitat de Barcelona. Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - Xavier Muñoz
- Departamento de Biología Celular, Fisiología e Inmunología, Universitat Autónoma de Barcelona, Barcelona, Spain; Servicio de Neumología, Hospital Vall d'Hebron, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - José María Olaguibel
- Severe asthma unit, Department of Allergy, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - César Picado
- Allergy Unit & Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic; IDIBAPS; Universitat de Barcelona. Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - Vicente Plaza
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research (IBB Sant Pau), Universitat Autònoma de Barcelona. Department of Medicine, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - Santiago Quirce
- Department of Allergy, Hospital La Paz-Institute for Health Research (IdiPAZ), Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - Manuel J Rial
- Department of Allergy, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - Beatriz Sastre
- Department of Immunology, IIS-Fundación Jiménez Díaz, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - Lorena Soto
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research (IBB Sant Pau), Universitat Autònoma de Barcelona. Department of Medicine, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - Antonio Valero
- Allergy Unit & Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic; IDIBAPS; Universitat de Barcelona. Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - Victoria Del Pozo
- Department of Immunology, IIS-Fundación Jiménez Díaz, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
| | - Joaquín Sastre
- Department of Allergy, IIS-Fundación Jiménez Díaz, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III Madrid, Spain
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Milagro J, Soto-Retes L, Giner J, Varon C, Laguna P, Bailón R, Plaza V, Gil E. Asthmatic subjects stratification using autonomic nervous system information. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Crespo‐Lessmann A, Plaza V, Almonacid C, Caballero ML, Antonio Cañas J, Ángel Carretero Gracia J, Jesús Cruz M, Dacal Rivas D, Muñiz MDC, Pérez del Llano L, Del Pozo V, López Carrasco V, María Marín Trigo J, Mateus E, Muñoz X, María Olaguíbel J, Quirce S, Ramos D, Sanz Rubio D, Sastre J, Vázquez Martín S, Vera Solsona E. Multidisciplinary consensus on sputum induction biosafety during the COVID-19 pandemic. Allergy 2021; 76:2407-2419. [PMID: 33314245 DOI: 10.1111/all.14697] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/20/2020] [Accepted: 12/04/2020] [Indexed: 12/30/2022]
Abstract
Sputum induction (SI) is the gold standard approach to the non-invasive study of airway inflammation. The differential count of inflammatory cells for SI allows patients with asthma to be classified according to inflammatory phenotypes and predicted therapeutic responses. Since SI involves the generation of aerosols, there is a need to establish a protocol to ensure biosafety in clinical practice during the current COVID-19 pandemic. The multidisciplinary consensus on SI described in this article was developed by 22 experts in SI from different Spanish hospitals who drew on available scientific evidence in achieving consensuated opinions, compiled by means of an electronic survey. We hope that these unified criteria and recommendations will guide health professionals in implementing SI sampling and processing procedures as safely as possible during the COVID-19 pandemic.
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Affiliation(s)
| | - Vicente Plaza
- Pulmonology and Allergy Department Hospital de la Santa Creu i Sant Pau Barcelona Spain
| | - Carlos Almonacid
- Pulmonology and Anatomical Pathology Department Hospital Universitario Ramón y Cajal Madrid Spain
| | | | - José Antonio Cañas
- Immunology and Allergology Department Instituto de Investigación Sanitaria (IIS) Fundación Jiménez Díaz Madrid, CIBER‐Respiratory Diseases (CIBERES)Spain
- Pulmonology Department Hospital Royo Villanova Zaragoza Spain
| | - José Ángel Carretero Gracia
- Pulmonology Department Cellular Biology, Physiology and Immunology Department Hospital Vall d'HebronCIBER‐Respiratory Diseases (CIBERES)Universidad Autónoma de Barcelona (UAB)BarcelonaSpain
| | - María Jesús Cruz
- Hospital Universitario Lucus Augusti. EOXI Cervo Lugo Spain
- Pulmonology Department Hospital Miguel Servet ZaragozaIIS Aragón Spain
| | | | | | | | - Victoria Del Pozo
- Immunology and Allergology Department Instituto de Investigación Sanitaria (IIS) Fundación Jiménez Díaz Madrid, CIBER‐Respiratory Diseases (CIBERES)Spain
- Pulmonology Department Hospital Royo Villanova Zaragoza Spain
| | | | | | - Eder Mateus
- Pulmonology and Allergy Department Hospital de la Santa Creu i Sant Pau Barcelona Spain
| | - Xavier Muñoz
- Hospital Universitario Lucus Augusti. EOXI Cervo Lugo Spain
- Pulmonology Department Hospital Miguel Servet ZaragozaIIS Aragón Spain
| | | | - Santiago Quirce
- Allergology Department Hospital Universitario La Paz Madrid Spain
| | - David Ramos
- Pulmonology and Allergy Department Hospital de la Santa Creu i Sant Pau Barcelona Spain
| | - David Sanz Rubio
- Pulmonology Department Hospital Miguel Servet ZaragozaIIS Aragón Spain
| | - Joaquín Sastre
- Immunology and Allergology Department Instituto de Investigación Sanitaria (IIS) Fundación Jiménez Díaz Madrid, CIBER‐Respiratory Diseases (CIBERES)Spain
- Pulmonology Department Hospital Royo Villanova Zaragoza Spain
| | - Silvia Vázquez Martín
- Pulmonology and Anatomical Pathology Department Hospital Universitario Ramón y Cajal Madrid Spain
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Castillo D, Barril S, Rodrigo-Troyano A, Millan-Billi P, Suárez-Cuartín G, Alonso A, Franquet T, López-Vilaró L, Castellví I, Plaza V, Sibila O. Early hospital readmission increases short and long - term mortality in patients with interstitial lung disease. Sarcoidosis Vasc Diffuse Lung Dis 2021; 38:e2021021. [PMID: 34316260 PMCID: PMC8288207 DOI: 10.36141/svdld.v38i2.10709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 05/02/2021] [Indexed: 11/26/2022]
Abstract
Objective: To investigate the prognostic impact of early readmission (30 days) on hospitalized patients with Interstitial Lung Disease (ILD). Methods: Observational study analysing a cohort of patients hospitalized in a respiratory ward at a University Hospital. Demographic, clinical data and survival status were collected from patients’ records. Early readmission was defined as hospitalization within 30 days after patient’s discharge. The primary outcome was 90-day and 1-year all-cause mortality. Results: Between 2013 to 2016, a total of 2.238 patients were admitted to the respiratory ward and 98 (%) had a diagnosis of ILD. Among them, 74 patients were discharged (25% in-hospital mortality). Early readmission was observed in 15 cases (20.2%). Early readmitted patients were more frequently current smokers (20% vs. 2%, p=0.02). After a multivariate analysis, early readmission was found to be independently associated with 90-day and 1 year mortality (Odds Ratio (OR) 17.6, 95% Confidence Interval (CI) 4.5-69-2, p=0.001 and OR 4.5; 95CI 1.3-15.2, p=0.01, respectively). Conclusion: In patients with ILD, early readmission after hospitalization increases both short-term and long term mortality. Thus, preventing early readmission after discharge from hospital admission may have an impact in the clinical course of ILD patients. Further studies are required to identify factors contributing to early readmission.
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Affiliation(s)
- Diego Castillo
- Respiratory Department. Hospital de la Santa Creu i Sant Pau. Barcelona (Spain).,Sant Pau Biomedical Research Institute (IIB-SantPau). Barcelona (Spain)
| | - Silvia Barril
- Respiratory Department. Hospital de la Santa Creu i Sant Pau. Barcelona (Spain).,Respiratory Department. Hospital Universitari Arnau de Vilanova. Lleida (Spain)
| | - Ana Rodrigo-Troyano
- Respiratory Department. Hospital de la Santa Creu i Sant Pau. Barcelona (Spain).,Respiratory Deparment. Hospital Universitari Son Espases, Palma, Illes Balears (Spain)
| | - Paloma Millan-Billi
- Respiratory Department. Hospital de la Santa Creu i Sant Pau. Barcelona (Spain).,Respiratory Department. Hospital Germans Trias I Pujol. Badalona (Spain)
| | - Guillermo Suárez-Cuartín
- Respiratory Department. Hospital de la Santa Creu i Sant Pau. Barcelona (Spain).,Respiratory Department. Hospital Universitari Bellvitge. L'Hospitalet de Llobregat (Spain)
| | - Ana Alonso
- Respiratory Department. Hospital de la Santa Creu i Sant Pau. Barcelona (Spain).,Sant Pau Biomedical Research Institute (IIB-SantPau). Barcelona (Spain)
| | - Tomás Franquet
- Sant Pau Biomedical Research Institute (IIB-SantPau). Barcelona (Spain).,Radiology Department. Hospital de la Santa Creu i Sant Pau. Barcelona. (Spain)
| | - Laura López-Vilaró
- Sant Pau Biomedical Research Institute (IIB-SantPau). Barcelona (Spain).,Histopathology Department. Hospital de la Santa Creu i Sant Pau. Barcelona. (Spain)
| | - Iván Castellví
- Sant Pau Biomedical Research Institute (IIB-SantPau). Barcelona (Spain).,Rheumatology Department. Hospital de la Santa Creu i Sant Pau. Barcelona (Spain)
| | - Vicente Plaza
- Respiratory Department. Hospital de la Santa Creu i Sant Pau. Barcelona (Spain).,Sant Pau Biomedical Research Institute (IIB-SantPau). Barcelona (Spain)
| | - Oriol Sibila
- Respiratory Department. Hospital de la Santa Creu i Sant Pau. Barcelona (Spain).,Thorax Institute. Hospital Clínic. Barcelona (Spain)
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Plaza V, Arnedillo A, Blanco-Aparicio M, Ignacio JM, Urrutia I. Consensus on the treatment of allergic asthma with sublingual house dust mite immunotherapy in the field of Pneumology. Expert Rev Respir Med 2021; 15:1245-1249. [PMID: 34128758 DOI: 10.1080/17476348.2021.1942846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION : Many patients sensitized to mites remain symptomatic and uncontrolled despite traditional treatment. Sublingual immunotherapy (SLIT) has demonstrated to reduce the symptoms of allergic rhinitis, the need for additional drug treatments, and to reduce the number of moderate and severe exacerbations in patients with allergic asthma caused by mites that had not been adequately controlled. AREAS COVERED : After reviewing the most recent literature, a scientific committee composed by 5 pneumologists experts in asthma proposed 41 items that addressed the diagnosis of allergic asthma caused by mites, the role of house dust mite (HDM) SLIT tablet in the therapeutic plan and in the control of the disease, and the profile of patients with asthma candidates for this therapy. Through a modified Delphi method, the items were send to 106 pneumologists involved in asthma to be agreed. EXPERT OPINION : The high degree of consensus reached by the panel of pneumologists shows the importance of HDM SLIT tablet in the treatment of allergic asthma caused by mites, particularly taking into account that they barely use this therapy because until now they did not have a registered treatment with solid evidence of efficacy and safety.
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Affiliation(s)
- Vicente Plaza
- Director del Comité Ejecutivo de la Guía Española para el Manejo del Asma (GEMA). Servei de Pneumologia i Al·lèrgia. Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau). Universitat Autònoma de Barcelona. Barcelona, Spain
| | - Aurelio Arnedillo
- UGC de Neumología, Alergia y Cirugía torácica. Hospital Universitario Puerta del Mar. Cádiz, Spain
| | - Marina Blanco-Aparicio
- Coordinadora del Área de Asma de SEPAR. Servicio de Neumología. Complejo Hospitalario Universitario A Coruña. A Coruña. Spain
| | - José María Ignacio
- Servicio de Neumología. Hospital Quirónsalud Marbella. Marbella, Málaga, Spain
| | - Isabel Urrutia
- Unidad de Asma. Hospital Universitario de Galdakao. Galdakao, Bizkaia, Spain.
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Crespo-Lessmann A, Bernal S, del Río E, Rojas E, Martínez-Rivera C, Marina N, Pallarés-Sanmartín A, Pascual S, García-Rivero JL, Padilla-Galo A, Curto E, Cisneros C, Serrano J, Baiget M, Plaza V. Association of the CFTR gene with asthma and airway mucus hypersecretion. PLoS One 2021; 16:e0251881. [PMID: 34086689 PMCID: PMC8177500 DOI: 10.1371/journal.pone.0251881] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 05/05/2021] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Asthma with airway mucus hypersecretion is an inadequately characterized variant of asthma. While several studies have reported that hypersecreting patients may carry genetic variants in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, many of those studies have been questioned for their numerous limitations and contradictory results. OBJECTIVES (1) To determine the presence of genetic variants of the CFTR gene in patients with asthma with and without airway mucus hypersecretion. (2) To identify the clinical, inflammatory and functional characteristics of the asthma phenotype with airway mucus hypersecretion. METHOD Comparative multicentre cross-sectional descriptive study that included 100 patients with asthma (39 hypersecretors and 61 non-hypersecretors). Asthmatic hypersecretion was defined as the presence of cough productive of sputum on most days for at least 3 months in 2 successive years. The patients were tested for fractional exhaled nitric oxide, spirometry, induced sputum cell count, total immunoglobulin E (IgE), peripheral blood eosinophil count, C-reactive protein, blood fibrinogen and blood albumin and underwent a skin prick test. Asthma control and quality of life were assessed by the Asthma Control Test and Mini Asthma Quality of Life questionnaires, respectively. Blood DNA samples were collected from the patients and next-generation sequencing using a MiSeq sequencer and the Illumina platform was used for the CFTR gene analysis. RESULTS Genetic differences were observed in the c.1680-870T>A polymorphism of the CFTR gene, significantly more evident in hypersecretors than in non-hypersecretors: 78.94% vs. 59.32% in the majority allele and 21.05% vs. 40.67% in the minority allele (p = 0.036). Clinically, asthma hypersecretors compared to non-hypersecretors were older (57.4 years vs. 49.4 years; p = 0.004); had greater asthma severity (58.9% vs. 23.7%; p = 0.005); experienced greater airway obstruction (FEV1/FVC% 64.3 vs. 69.5; p = 0.041); had poorer asthma control (60% vs. 29%; p = 0.021); had lower IgE levels (126.4 IU/mL vs. 407.6 IU/mL; p = 0.003); and were less likely to have a positive prick test (37.5% vs. 68.85%; p = 0.011). CONCLUSION The results suggest that patients with asthma and with mucus hypersecretion (1) may have a different phenotype and disease mechanism produced by an intronic polymorphism in the CFTR gene (NM_000492.3:c.1680-870T>A), and (2) may have a poorer clinical outcome characterized by severe disease and poorer asthma control with a non-allergic inflammatory phenotype.
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Affiliation(s)
- Astrid Crespo-Lessmann
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research (IBB Sant Pau), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sara Bernal
- Department of Genetics, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research (IBB Sant Pau), Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U705), Barcelona, Spain
| | - Elisabeth del Río
- Department of Genetics, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research (IBB Sant Pau), Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U705), Barcelona, Spain
| | - Ester Rojas
- Department of Genetics, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research (IBB Sant Pau), Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U705), Barcelona, Spain
| | | | - Nuria Marina
- Department of Respiratory Medicine, H. de Cruces, Barakaldo, Vizcaya, Spain
| | | | - Silvia Pascual
- Department of Respiratory Medicine, H. de Galdakao, Vizcaya, Spain
| | | | - Alicia Padilla-Galo
- Department of Respiratory Medicine, H. Costa del Sol de Marbella, Málaga, Spain
| | - Elena Curto
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research (IBB Sant Pau), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carolina Cisneros
- Department of Respiratory Medicine, H. U. de La Princesa, Madrid, Spain
| | - José Serrano
- Department of Respiratory Medicine, Hospital Comarcal de Inca, Baleares, Spain
| | - Montserrat Baiget
- Department of Genetics, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research (IBB Sant Pau), Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U705), Barcelona, Spain
| | - Vicente Plaza
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research (IBB Sant Pau), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Universitat Autònoma de Barcelona, Barcelona, Spain
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Plaza V, Alobid I, Alvarez C, Blanco M, Ferreira J, García G, Gómez-Outes A, Gómez F, Hidalgo A, Korta J, Molina J, Pellegrini FJ, Pérez M, Plaza J, Praena M, Quirce S, Sanz J. Spanish Asthma Management Guidelines (GEMA) VERSION 5.1. Highlights and Controversies. Arch Bronconeumol 2021; 58:150-158. [PMID: 34167859 DOI: 10.1016/j.arbres.2021.05.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 12/24/2022]
Abstract
In this fifth phase of development, the contents of the Spanish Asthma Management Guidelines (GEMA), which include versions 5.0 and 5.1, have undergone a thorough review. The aim here is to set the main changes in context. These could be summarized as follows: DIAGNOSIS: new FENO cut-off and severity classification based on treatment needed to maintain control; INTERMITTENT ASTHMA: a more restrictive concept and treatment extended to include a glucocorticoid/adrenergic combination as needed; MILD ASTHMA: glucocorticoid/adrenergic therapy as needed as an alternative in case of low therapeutic adherence to conventional fixed-dose steroids; SEVERE ASTHMA: readjustment of phenotypes, incorporation of triple therapy in a single inhaler, and criteria for selection of a biologic in severe uncontrolled asthma; OTHERS: specific scoring in childhood asthma, incorporation of certain organizational aspects (care circuits, asthma units, telemedicine), new sections on COVID-19 and nasal polyposis.
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Affiliation(s)
- Vicente Plaza
- Comité Ejecutivo GEMA, Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
| | - Isam Alobid
- Sociedad Española de Otorrinolaringología (SEORL), Hospital Clinic, Universidad de Barcelona, Barcelona, España
| | - Cesáreo Alvarez
- Sociedad Española de Medicina de Urgencias y Emergencias (SEMES), Hospital de Verín, Orense, España
| | - Marina Blanco
- Sociedad Española de Neumología y Cirugía Torácica (SEPAR), Complejo Hospitalario Universitario A Coruña, A Coruña, España
| | - Jorge Ferreira
- Sociedad Portuguesa de Pneumologia (SPP), Hospital de São Sebastião - CHEDV, Santa Maria da Feira, Portugal
| | - Gabriel García
- Asociación Latinoamericana del Tórax (ALAT), Hospital Rossi La Plata, Buenos Aires, Argentina
| | - Antonio Gómez-Outes
- Sociedad Española de Farmacología Clínica (SEFC), Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), Madrid, España
| | - Fernando Gómez
- Sociedad Española de Médicos Generales y de Familia (SEMG), Centro de Salud de Bargas, Toledo, España
| | - Antonio Hidalgo
- Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Centro de Salud Lucena I. Lucena, Córdoba, España
| | - Javier Korta
- Sociedad Española de Neumología Pediátrica (SENP), Hospital Universitario Donostia, Donostia-San Sebastián, España
| | - Jesús Molina
- Sociedad Española de Medicina Familiar y Comunitaria (semFYC) y Sociedad de Respiratorio de Atención Primaria (GRAP), Centro de Salud Francia, Fuenlabrada, Dirección Asistencial Oeste, Madrid, España
| | - Francisco Javier Pellegrini
- Sociedad Española de Pediatría Extrahospitalaria y Atención Primaria (SEPEAP), Centro de Salud de Pizarrales, Salamanca, España
| | - Montserrat Pérez
- Sociedad Española de Farmacia Hospitalaria (SEFH), Hospital Universitario Fundación Alcorcón, Madrid, España
| | - Javier Plaza
- Sociedad Española de Farmacia Clínica, Familiar y Comunitaria (SEFAC), Farmacia Dres. Zamora Navarro, Mazarrón, Murcia, España
| | - Manuel Praena
- Asociación Española de Pediatría de Atención Primaria (AEPap), Centro de Salud La Candelaria, Sevilla, España
| | - Santiago Quirce
- Sociedad Española de Alergia e Inmunología Clínica (SEAIC), Hospital Universitario La Paz, Madrid, España
| | - José Sanz
- Sociedad Española de Inmunología Clínica-Alergología y Asma Pediátrica (SEICAP), Hospital Católico Universitario Casa de Salud, Valencia, España
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Curto E, Torrego A, Garin N, Crespo-Lessmann A, Plaza V. Reply to "Managing T2-high severe asthma in HIV-infected patients". J Allergy Clin Immunol Pract 2021; 9:1043. [PMID: 33551032 DOI: 10.1016/j.jaip.2020.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/06/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Elena Curto
- Department of Respiratory Medicine and Allergology, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Alfons Torrego
- Department of Respiratory Medicine and Allergology, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Noe Garin
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Astrid Crespo-Lessmann
- Department of Respiratory Medicine and Allergology, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Vicente Plaza
- Department of Respiratory Medicine and Allergology, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research, Universitat Autònoma de Barcelona, Barcelona, Spain
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Rial MJ, Álvarez-Puebla MJ, Arismendi E, Caballero ML, Cañas JA, Cruz MJ, González-Barcala FJ, Luna JA, Martínez-Rivera C, Mullol J, Muñoz X, Olaguibel JM, Picado C, Plaza V, Quirce S, Romero-Mesones C, Salgado FJ, Sastre B, Soto-Retes L, Valero A, Valverde M, Sastre J, Pozo VD. Clinical and inflammatory characteristics of patients with asthma in the Spanish MEGA project cohort. Clin Transl Allergy 2021; 11:e12001. [PMID: 33900052 PMCID: PMC8173588 DOI: 10.1002/clt2.12001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 12/03/2022] Open
Abstract
Introduction The MEGA (MEchanism underlying the Genesis and evolution of Asthma) project is a multicenter cohort study carried out in eight Spanish hospitals, gathering clinical, physiological, and molecular data from patients with asthma and multimorbidities in order to gain insight into the different physiopathological mechanisms involved in this disorder. Material and Methods We report the baseline clinical and physiological characteristics and biomarker measures of adult participants in the project with the aim of better understanding the natural history and underlying mechanisms of asthma as well as the associated multimorbidities across different levels of severity. We carried out a detailed clinical examination, pulmonary function testing, measurement of fractional exhaled nitric oxide (FeNO), blood counts, induced sputum, skin prick tests, chest computed tomography scan, asthma questionnaires, and multimorbidity assessment in 512 asthmatic patients. Results When compared to patients with milder disease, severe asthmatic patients showed greater presence of symptoms, more exacerbations, lower asthma control, increased airflow obstruction, and higher frequency of chronic rhinosinusitis with nasal polyps, severe rhinitis, anxiety and depression, gastroesophageal reflux, and bronchiectasis. Conclusion The MEGA project succeeded in recruiting a high number of asthma patients, especially those with severe disease, who showed lower control and higher frequency of multimorbidities.
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Affiliation(s)
- Manuel J Rial
- Servicio de Alergología, Departamento de Inmunología, Instituto de Investigación Sanitaria (IIS) Fundación Jiménez Díaz, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | - Ebymar Arismendi
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Servicio de Neumología y Alergia, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - María L Caballero
- Servicio de Alergia, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - José A Cañas
- Servicio de Alergología, Departamento de Inmunología, Instituto de Investigación Sanitaria (IIS) Fundación Jiménez Díaz, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - María J Cruz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Departamento de Biología Celular, Fisiología e Inmunología, Universitat Autónoma de Barcelona, Barcelona, Spain.,Servicio de Neumología, Hospital Vall d'Hebron, Barcelona, Spain
| | - Francisco J González-Barcala
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Servicio de Neumología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Juan A Luna
- Servicio de Alergia, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - Carlos Martínez-Rivera
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Servicio de Neumología, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - Joaquim Mullol
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,ENT Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Xavier Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Departamento de Biología Celular, Fisiología e Inmunología, Universitat Autónoma de Barcelona, Barcelona, Spain.,Servicio de Neumología, Hospital Vall d'Hebron, Barcelona, Spain
| | - José M Olaguibel
- Servicio de Alergología, Complejo Hospitalario de Navarra, Pamplona, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - César Picado
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Servicio de Neumología y Alergia, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Vicente Plaza
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Departamento de Medicina Respiratoria, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona. Departamento de Medicina, Barcelona, Spain
| | - Santiago Quirce
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Servicio de Alergia, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | | | - Francisco-Javier Salgado
- Department of Biochemistry and Molecular Biology, Faculty of Biology-Biological Research Centre (CIBUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Beatriz Sastre
- Servicio de Alergología, Departamento de Inmunología, Instituto de Investigación Sanitaria (IIS) Fundación Jiménez Díaz, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Lorena Soto-Retes
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Departamento de Medicina Respiratoria, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona. Departamento de Medicina, Barcelona, Spain
| | - Antonio Valero
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Servicio de Neumología y Alergia, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Marcela Valverde
- Servicio de Alergología, Departamento de Inmunología, Instituto de Investigación Sanitaria (IIS) Fundación Jiménez Díaz, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Joaquín Sastre
- Servicio de Alergología, Departamento de Inmunología, Instituto de Investigación Sanitaria (IIS) Fundación Jiménez Díaz, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Victora Del Pozo
- Servicio de Alergología, Departamento de Inmunología, Instituto de Investigación Sanitaria (IIS) Fundación Jiménez Díaz, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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Plaza V, Trigueros JA, Cisneros C, Domínguez-Ortega J, Cimbollek S, Fernández S, Hernández J, López JD, Ojanguren I, Padilla A, Pallarés A, Sánchez-Toril FJ, Torrego A, Urrutia I, Quirce S. The Importance of Small Airway Dysfunction in Asthma. The GEMA-FORUM III Task Force. J Investig Allergol Clin Immunol 2021; 31:433-436. [PMID: 33720836 DOI: 10.18176/jiaci.0686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- V Plaza
- Servei de Pneumologia i Al·lèrgia. Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau). Universitat Autònoma de Barcelona. Barcelona
| | - J A Trigueros
- Medicina de Familia. Centro de Salud de Menasalbas. Menasalbas, Toledo
| | - C Cisneros
- Servicio de Neumología. Hospital Universitario de La Princesa. Instituto de Investigación La Princesa Madrid
| | - J Domínguez-Ortega
- Servicio de Alergología. Instituto de Investigación Hospital Universitario La Paz (IdiPAZ). CIBER de Enfermedades Respiratorias (CIBERES). Madrid
| | - S Cimbollek
- Área de Alergología del Hospital Universitario Virgen del Rocío. Sevilla
| | - S Fernández
- Sevicio de Alergología. Hospital Universitario Río Hortega. Valladolid
| | - J Hernández
- Sección de Alergología. Hospital Nuestra Señora de la Montaña. Cáceres
| | - J D López
- Servicio de Alergología. Hospital Clínico Universitario Virgen de la Arrixaca. Murcia
| | - I Ojanguren
- Servicio de Neumología. Hospital Universitario Valld'Hebron. Barcelona
| | - A Padilla
- Unidad de Neumología. Agencia Sanitaria Costa del Sol. Marbella, Málaga
| | - A Pallarés
- Servicio de Neumología. Servizo Galego de Saúde
| | | | - A Torrego
- Servicio de Neumología. Hospital de la Santa Creu i Sant Pau. Barcelona
| | - I Urrutia
- Unidad de Asma y Enfermedades Ocupacionales-Medioambientales del Servicio de Neumología. Hospital Galdakao-Usansolo. Galdakao, Bizkaia
| | - S Quirce
- Servicio de Alergología. Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) y CIBER de Enfermedades Respiratorias (CIBERES). Madrid
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Almonacid C, Melero C, López Viña A, Cisneros C, Pérez de Llano L, Plaza V, García-Rivero JL, Romero Falcón A, Ramos J, Bazús González T, Andrés Prado M, Muriel A. Effectiveness of Text Message Reminders on Adherence to Inhaled Therapy in Patients With Asthma: Prospective Multicenter Randomized Clinical Trial. JMIR Form Res 2021; 5:e12218. [PMID: 33560235 PMCID: PMC7902182 DOI: 10.2196/12218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 07/20/2019] [Accepted: 10/28/2020] [Indexed: 01/15/2023] Open
Abstract
Background Poor adherence to inhaled medication in asthma patients is of great concern. It is one of the main reasons for inadequate asthma control. Objective The goal of the research was to determine if motivational messages using short message service (SMS, or text) improved adherence to inhaled medication in patients with asthma. Methods A prospective multicenter randomized parallel-group clinical trial was conducted in 10 asthma clinics in Spain. Adherence was assessed with electronic monitors (Smartinhaler, Adherium Ltd) connected to inhalers. Patients in the SMS group received psychologist-developed motivational messages every 3 days for 6 months. Results There were 53 patients in the SMS group and 88 patients in the control group. After 6 months, mean electronic adherence was 70% (SD 17%) in the intervention group and 69% (SD 17%) in the control group (P=.82). Significant differences between the study groups in morning and evening adherence to inhaled therapy, asthma control, exhaled nitric oxide levels, or improvement of lung functions were not observed. Conclusions Motivational messages were not useful to improve adherence to inhaled asthma medication compared with usual care.
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Affiliation(s)
- Carlos Almonacid
- Department of Respiratory Medicine, Instituto Ramón y Cajal de Investigación Sanitaria, University of Alcala de Henares, Madrid, Spain
| | - Carlos Melero
- Department of Respiratory Medicine, Hospital Universitario 12 de Octubre, Institute for Health Research (i+12), Complutense University of Madrid, Madrid, Spain
| | - Antolín López Viña
- Department of Respiratory Medicine, Hospital Universitario Puerta de Hierro, Autonoma University of Madrid, Majadahonda, Spain
| | - Carolina Cisneros
- Department of Respiratory Medicine, Hospital Universitario La Princesa, Autónoma University of Madrid, Madrid, Spain
| | - Luis Pérez de Llano
- Department of Respiratory Medicine, Hospital Universitario Lucus Augusti, University of Lugo, Lugo, Spain
| | - Vicente Plaza
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomédica Sant Pau, Autònoma University of Barcelona, Barcelona, Spain
| | | | - Auxiliadora Romero Falcón
- Department of Respiratory Medicine, Hospital Universitario Reina Sofia, University of Cordoba, Córdoba, Spain
| | - Jacinto Ramos
- Department of Respiratory Medicine, Hospital Universitario de Salamanca, University of Salamanca, Salamanca, Spain
| | - Teresa Bazús González
- Department of Respiratory Medicine, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Spain
| | - María Andrés Prado
- Department of Health Information Management, Fundación Jimenez Diaz, Madrid, Spain
| | - Alfonso Muriel
- Unit of Clinical Biostatistics, Instituto Ramón y Cajal de Investigación Sanitaria, Consorcio Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, University of Alcala de Henares, Madrid, Spain
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Abstract
BACKGROUND Asthma is managed by health professionals from different specialties. We aim to reach a consensus on the optimal use of inhaled therapy and the initial steps of asthma treatment, taking into account the opinions of the involved specialists. METHODS A modified Delphi approach was used. A scientific committee provided 52 controversial statements, which were submitted to primary care physicians, allergists, and pulmonologists. Discrepancies among specialties were evaluated. RESULTS A total of 209 specialists completed the questionnaire (20.2 ± 9.3 years of asthma management experience). A consensus was reached on 37 statements (71.1%), discrepancies among specialties were found in 14. The most recommended maintenance treatment for mild persistent asthma in adults/adolescents was low-dose-inhaled corticosteroids daily. MART (Maintenance and Reliever Therapy) was recommended as salvage treatment for moderate persistent asthma. Panelists agreed on the most frequent critical errors with pressurized Metered-Dose Inhalers or Dry-Powder Inhalers, and considered that Breath-Actuated Inhalers are a suitable option for all patients with the ability to inhale voluntarily. CONCLUSIONS The experts endorse the main guidelines recommendations; however, do not fully agree on recent GINA recommendations about the treatment of the initial steps of the disease. The experts value positively the differential characteristics of BAI over other devices.
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Affiliation(s)
- Antonio L Valero
- Allergy Unit, Pneumology Department, Hospital Clínic, IDIBAPS, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | | | - Vicente Plaza
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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50
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Almonacid C, Blanco-Aparicio M, Domínguez-Ortega J, Giner J, Molina J, Plaza V. Teleconsultation in the follow-up of the asthma patient. Lessons after COVID-19. Arch Bronconeumol 2020; 57:13-14. [PMID: 34629633 PMCID: PMC7577866 DOI: 10.1016/j.arbres.2020.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Carlos Almonacid
- Servicio de Neumología, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, España
| | | | - Javier Domínguez-Ortega
- Servicio de Alergia, Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), Madrid, España; CIBER de Enfermedades Respiratorias (CIBERES)
| | - Jordi Giner
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - Jesús Molina
- Centro de Salud Francia, Fuenlabrada, Madrid, España
| | - Vicente Plaza
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, España; Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Barcelona, España; Departamento de Medicina, Facultad de Medicina, Universidad Autónoma de Barcelona, Barcelona, España; CIBER de Enfermedades Respiratorias (CIBERES).
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