Allan T Luskin1, Bradley E Chipps2, Lawrence Rasouliyan3, Dave P Miller3, Tmirah Haselkorn4, Alejandro Dorenbaum5. 1. Department of Medicine, University of Wisconsin, Madison, Wis. Electronic address: allan_luskin@hotmail.com. 2. Capital Allergy and Respiratory Disease Center, Sacramento, Calif. 3. Late Phase and Outcomes Research, ICON Clinical Research, San Francisco, Calif. 4. US Medical Affairs, Genentech, Inc., South San Francisco, Calif. 5. Department of Pediatric Immunology and Allergy, Stanford University School of Medicine, Stanford, Calif.
Abstract
BACKGROUND: Few data are available that evaluate the relationship among asthma exacerbations, asthma triggers, and asthma-related quality of life (QoL). OBJECTIVE: To evaluate the impact of asthma exacerbations and asthma triggers on QoL. METHODS: Patients with severe or difficult-to-treat asthma, ages ≥ 13 years (n = 2679) from the TENOR (The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens) 3-year observational study were included. Exacerbations were defined hierarchically in descending order of severity (hospitalization, emergency department [ED] visit, steroid burst, no exacerbation) by using data from months 6 and 12. The total number (frequency) of exacerbations was assessed. Asthma-related QoL was measured at month 12 by using the Mini-Asthma QoL Questionnaire (Mini-AQLQ); self-reported asthma triggers were collected at baseline and annually. We used 1-way ANOVA to test for differences in Mini-AQLQ domain scores across asthma exacerbation severity, the total number of asthma exacerbations, and the number of asthma triggers. RESULTS: A significant decrease (P < .001) in Mini-AQLQ domain scores was seen with increasing severity of asthma exacerbation (no exacerbation, steroid burst, ED visit, and hospitalization); symptom (5.5, 4.8, 4.3, and 4.2), activity (5.8, 5.2, 4.6, and 4.4), emotional (5.6, 5.0, 4.4, and 4.2), exposure (5.0, 4.5, 4.0, and 3.9); and overall (5.5, 4.9, 4.3, and 4.1). Increasing exacerbation frequency and the number of baseline asthma triggers also were associated with significant decreases in Mini-AQLQ domain scores. An increasing number of asthma triggers were associated with an increase in severity and frequency of exacerbations. CONCLUSION: Avoidance of asthma triggers may reduce exacerbation rates and improve asthma-related QoL in patients with severe or difficult-to-treat asthma. Interventional studies are warranted to further explore these outcomes.
BACKGROUND: Few data are available that evaluate the relationship among asthma exacerbations, asthma triggers, and asthma-related quality of life (QoL). OBJECTIVE: To evaluate the impact of asthma exacerbations and asthma triggers on QoL. METHODS:Patients with severe or difficult-to-treat asthma, ages ≥ 13 years (n = 2679) from the TENOR (The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens) 3-year observational study were included. Exacerbations were defined hierarchically in descending order of severity (hospitalization, emergency department [ED] visit, steroid burst, no exacerbation) by using data from months 6 and 12. The total number (frequency) of exacerbations was assessed. Asthma-related QoL was measured at month 12 by using the Mini-Asthma QoL Questionnaire (Mini-AQLQ); self-reported asthma triggers were collected at baseline and annually. We used 1-way ANOVA to test for differences in Mini-AQLQ domain scores across asthma exacerbation severity, the total number of asthma exacerbations, and the number of asthma triggers. RESULTS: A significant decrease (P < .001) in Mini-AQLQ domain scores was seen with increasing severity of asthma exacerbation (no exacerbation, steroid burst, ED visit, and hospitalization); symptom (5.5, 4.8, 4.3, and 4.2), activity (5.8, 5.2, 4.6, and 4.4), emotional (5.6, 5.0, 4.4, and 4.2), exposure (5.0, 4.5, 4.0, and 3.9); and overall (5.5, 4.9, 4.3, and 4.1). Increasing exacerbation frequency and the number of baseline asthma triggers also were associated with significant decreases in Mini-AQLQ domain scores. An increasing number of asthma triggers were associated with an increase in severity and frequency of exacerbations. CONCLUSION: Avoidance of asthma triggers may reduce exacerbation rates and improve asthma-related QoL in patients with severe or difficult-to-treat asthma. Interventional studies are warranted to further explore these outcomes.
Authors: Christopher S Ambrose; Bradley E Chipps; Wendy C Moore; Weily Soong; Jennifer Trevor; Dennis K Ledford; Warner W Carr; Njira Lugogo; Frank Trudo; Trung N Tran; Reynold A Panettieri Journal: Pragmat Obs Res Date: 2020-07-16
Authors: Ka Pang Chan; Fanny Wai San Ko; Kwun Cheung Ling; Pik Shan Cheung; Lee Veronica Chan; Yu Hong Chan; Yi Tat Lo; Chun Kong Ng; Macy Mei-Sze Lui; Kwok Sang Wilson Yee; Cee Zhung Steven Tseng; Pak Yiu Tse; Mo Lin Maureen Wong; Kah Lin Choo; Wai Kei Lam; Chun Man Wong; Sheng Sheng Ho; Chung Tat Lun; Christopher Kei Wai Lai Journal: Immun Inflamm Dis Date: 2021-03-03
Authors: Daniel P Henriksen; Uffe Bodtger; Kirsten Sidenius; Niels Maltbaek; Lars Pedersen; Hanne Madsen; Ehm A Andersson; Ole Norgaard; Louise Klokker Madsen; Bo L Chawes Journal: Eur Clin Respir J Date: 2018-11-07