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EAACI position statement on asthma exacerbations and severe asthma

EAACI position statement on asthma exacerbations and severe asthma
EAACI position statement on asthma exacerbations and severe asthma
Asthma exacerbations and severe asthma are linked with high morbidity, significant mortality and high treatment costs. Recurrent asthma exacerbations cause a decline in lung function and, in childhood, are linked to development of persistent asthma. This position paper, from the European Academy of Allergy and Clinical Immunology, highlights the shortcomings of current treatment guidelines for patients suffering from frequent asthma exacerbations and those with difficult-to-treat asthma and severe treatment-resistant asthma. It reviews current evidence that supports a call for increased awareness of (i) the seriousness of asthma exacerbations and (ii) the need for novel treatment strategies in specific forms of severe treatment-resistant asthma. There is strong evidence linking asthma exacerbations with viral airway infection and underlying deficiencies in innate immunity and evidence of a synergism between viral infection and allergic mechanisms in increasing risk of exacerbations. Nonadherence to prescribed medication has been identified as a common clinical problem amongst adults and children with difficult-to-control asthma. Appropriate diagnosis, assessment of adherence and other potentially modifiable factors (such as passive or active smoking, ongoing allergen exposure, psychosocial factors) have to be a priority in clinical assessment of all patients with difficult-to-control asthma. Further studies with improved designs and new diagnostic tools are needed to properly characterize (i) the pathophysiology and risk of asthma exacerbations, and (ii) the clinical and pathophysiological heterogeneity of severe asthma.
0105-4538
1520-1531
Custovic, A.
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Johnston, S. L.
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Pavord, I.
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Gaga, M.
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Fabbri, L.
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Bel, E. H.
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Le Souëf, P.
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Lötvall, J.
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Demoly, P.
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Akdis, C. A.
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Ryan, D.
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Mäkelä, M. J.
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Martinez, F.
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Holloway, J. W.
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Saglani, S.
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O'Byrne, P.
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Papi, A.
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Sergejeva, S.
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Magnan, A.
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Del Giacco, S.
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Kalayci, O.
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Hamelmann, E.
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Papadopoulos, N. G.
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Custovic, A.
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Johnston, S. L.
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Pavord, I.
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Gaga, M.
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Fabbri, L.
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Bel, E. H.
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Le Souëf, P.
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Lötvall, J.
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Demoly, P.
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Akdis, C. A.
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Ryan, D.
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Mäkelä, M. J.
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Martinez, F.
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Holloway, J. W.
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Saglani, S.
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O'Byrne, P.
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Papi, A.
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Sergejeva, S.
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Magnan, A.
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Del Giacco, S.
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Kalayci, O.
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Hamelmann, E.
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Papadopoulos, N. G.
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Custovic, A., Johnston, S. L., Pavord, I., Gaga, M., Fabbri, L., Bel, E. H., Le Souëf, P., Lötvall, J., Demoly, P., Akdis, C. A., Ryan, D., Mäkelä, M. J., Martinez, F., Holloway, J. W., Saglani, S., O'Byrne, P., Papi, A., Sergejeva, S., Magnan, A., Del Giacco, S., Kalayci, O., Hamelmann, E. and Papadopoulos, N. G. (2013) EAACI position statement on asthma exacerbations and severe asthma. Allergy, 68 (12), 1520-1531. (doi:10.1111/all.12275).

Record type: Article

Abstract

Asthma exacerbations and severe asthma are linked with high morbidity, significant mortality and high treatment costs. Recurrent asthma exacerbations cause a decline in lung function and, in childhood, are linked to development of persistent asthma. This position paper, from the European Academy of Allergy and Clinical Immunology, highlights the shortcomings of current treatment guidelines for patients suffering from frequent asthma exacerbations and those with difficult-to-treat asthma and severe treatment-resistant asthma. It reviews current evidence that supports a call for increased awareness of (i) the seriousness of asthma exacerbations and (ii) the need for novel treatment strategies in specific forms of severe treatment-resistant asthma. There is strong evidence linking asthma exacerbations with viral airway infection and underlying deficiencies in innate immunity and evidence of a synergism between viral infection and allergic mechanisms in increasing risk of exacerbations. Nonadherence to prescribed medication has been identified as a common clinical problem amongst adults and children with difficult-to-control asthma. Appropriate diagnosis, assessment of adherence and other potentially modifiable factors (such as passive or active smoking, ongoing allergen exposure, psychosocial factors) have to be a priority in clinical assessment of all patients with difficult-to-control asthma. Further studies with improved designs and new diagnostic tools are needed to properly characterize (i) the pathophysiology and risk of asthma exacerbations, and (ii) the clinical and pathophysiological heterogeneity of severe asthma.

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More information

Published date: December 2013
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 361285
URI: http://eprints.soton.ac.uk/id/eprint/361285
ISSN: 0105-4538
PURE UUID: 3b3c9c2f-5ce2-4f9e-852d-6616a3b01991
ORCID for J. W. Holloway: ORCID iD orcid.org/0000-0001-9998-0464

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Date deposited: 16 Jan 2014 14:24
Last modified: 08 Jan 2022 02:46

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Contributors

Author: A. Custovic
Author: S. L. Johnston
Author: I. Pavord
Author: M. Gaga
Author: L. Fabbri
Author: E. H. Bel
Author: P. Le Souëf
Author: J. Lötvall
Author: P. Demoly
Author: C. A. Akdis
Author: D. Ryan
Author: M. J. Mäkelä
Author: F. Martinez
Author: J. W. Holloway ORCID iD
Author: S. Saglani
Author: P. O'Byrne
Author: A. Papi
Author: S. Sergejeva
Author: A. Magnan
Author: S. Del Giacco
Author: O. Kalayci
Author: E. Hamelmann
Author: N. G. Papadopoulos

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