Article
Allergy
Fahad H. Alahmadi, Brian Keevil, Lynn Elsey, Kate George, Robert Niven, Stephen J. Fowler
Summary: LC-MS/MS can reliably detect commonly used ICSs in the blood at least 8 hours after dosing, providing a measure of adherence in severe asthma patients. Lower blood levels were associated with higher exacerbation rates and poorer lung function.
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE
(2021)
Article
Critical Care Medicine
Fahad H. Alahmadi, Andrew J. Simpson, Cristina Gomez, Magnus Ericsson, John-Olof Thorngren, Craig E. Wheelock, Dominic E. Shaw, Louise J. Fleming, Graham Roberts, John Riley, Stewart Bates, Ana R. Sousa, Richard Knowles, Aruna T. Bansal, Julie Corfield, Ioannis Pandis, Kai Sun, Per S. Bakke, Massimo Caruso, Pascal Chanez, Barbro Dahlen, Ildiko Horvath, Norbert Krug, Paolo Montuschi, Florian Singer, Scott Wagers, Ian M. Adcock, Ratko Djukanovic, Kian Fan Chung, Peter J. Sterk, Sven-Erik Dahlen, Stephen J. Fowler
Summary: Low adherence is a common issue in severe asthma patients, whether measured directly or self-reported. There is poor agreement between the two methods, suggesting a disassociation between self-assessment of medication adherence and actual oral corticosteroid use, indicating that each approach may provide complementary information in clinical practice.
Article
Allergy
Scott P. Ginebaugh, Matthias Hagner, Anuradha Ray, Serpil C. Erzurum, Suzy A. A. Comhair, Loren C. Denlinger, Nizar N. Jarjour, Mario Castro, Prescott G. Woodruff, Stephanie A. Christenson, Eugene R. Bleecker, Deborah A. Meyers, Annette T. Hastie, Wendy C. Moore, David T. Mauger, Elliot Israel, Bruce D. Levy, Sally E. Wenzel, Matthew J. Camiolo
Summary: This study investigated the transcriptional response of bronchial epithelial cells to inhaled corticosteroids. It was found that a subset of asthma patients with poor hormone treatment response had worse lung function and quality of life. Furthermore, the response to hormone treatment could be predicted using blood samples.
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
(2023)
Article
Allergy
Ye Sun, Sunit Jariwala, Marina Reznik
Summary: This study aimed to assess adherence rates to daily inhaled corticosteroids (ICS) using electronic monitoring devices (EMDs) in an inner-city, minority population in the Bronx, NY. The results showed that the adherence to ICS measured by EMDs was low, and self-reported adherence was highly overestimated.
Article
Pediatrics
Louise Mandrup Bach, Sune Rubak, Adam Holm-Weber, Julie Prahl, Mette Hermansen, Kirsten Skamstrup Hansen, Bo Chawes
Summary: This study aimed to determine the risk factors for non-adherence to asthma treatment in preschool children. The study found that 75% of children under 6 years old diagnosed with asthma were not adherent to their medication. Increasing adherence was associated with co-existing allergies and experiencing loss of control events, while lower adherence was associated with atopic predisposition.
Article
Allergy
Katsunori Masaki, Jun Miyata, Takashi Kamatani, Takae Tanosaki, Takao Mochimaru, Hiroki Kabata, Yusuke Suzuki, Koichiro Asano, Tomoko Betsuyaku, Koichi Fukunaga
Summary: This study investigated the characteristics of patients with moderate to severe asthma who showed poor adherence to inhaled corticosteroid therapy in order to identify barriers to optimal treatment. The study found that age at diagnosis is an independent risk factor for predicting poor adherence among adults with moderate to severe asthma.
ASIAN PACIFIC JOURNAL OF ALLERGY AND IMMUNOLOGY
(2023)
Review
Allergy
Fahad Alahmadi, Adam Peel, Brian Keevil, Rob Niven, Stephen J. Fowler
Summary: Although corticosteroid treatment is effective in controlling asthma, poor adherence undermines its efficacy. Studies have used blood prednisolone levels and FeNO as markers for adherence to oral and inhaled corticosteroids, but further research is needed to assess the impact of dose and timing on blood levels and explore FeNO suppression testing in prospective studies.
CLINICAL AND EXPERIMENTAL ALLERGY
(2021)
Review
Pediatrics
Christina J. Pearce, Amy H. Y. Chan, Tracy Jackson, Louise Fleming, Holly Foot, Andy Bush, Rob Horne
Summary: Adherence interventions in children with asthma vary in effectiveness. Effective intervention studies are more likely to be of high quality, tailored to individual perceptual and practical adherence barriers, and utilize multiple behavior change techniques.
PEDIATRIC PULMONOLOGY
(2022)
Article
Health Care Sciences & Services
Priyadarshini Kachroo, Joanne E. Sordillo, Sharon M. Lutz, Scott T. Weiss, Rachel S. Kelly, Michael J. McGeachie, Ann Chen Wu, Jessica A. Lasky-Su
Summary: Metabolomic profiles associated with asthma exacerbations during inhaled corticosteroid treatment were analyzed in this study, revealing potential biomarkers of treatment response variability. Sex differences were observed in the levels of fatty acid metabolites during exacerbations, while interactions between age and metabolites on exacerbation were also detected. These findings suggest that plasma metabolites may play a role in elucidating metabolic pathways underlying variability in asthma treatment responses.
JOURNAL OF PERSONALIZED MEDICINE
(2021)
Letter
Allergy
Pinja Ilmarinen, Iida Vahatalo, Leena E. Tuomisto, Onni Niemela, Hannu Kankaanranta
Summary: The long-term adherence to inhaled corticosteroids was 75% or higher in phenotypes with the worst outcome, but did not vary significantly among clusters. Poor outcomes in the most severe phenotypes were not associated with poor adherence to inhaled corticosteroid medication.
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE
(2021)
Review
Respiratory System
Hetal Dhruve, David J. Jackson
Summary: Infrequent use of inhaled corticosteroids and over-reliance of short-acting beta-agonists are recognized as key contributors to increased morbidity and mortality in asthma. Electronic monitoring devices have the potential to improve asthma care by accurately tracking medication use and providing feedback to patients. This is a significant step forward in asthma management.
EUROPEAN RESPIRATORY REVIEW
(2022)
Article
Critical Care Medicine
Alexandra M. Nanzer, Adam Lawton, Grainne D'Ancona, Atul Gupta
Summary: Adolescent asthma patients require special attention and care, facing challenges in disease management and the need for transition during their adolescence.
Article
Pharmacology & Pharmacy
Claire D. Visser, Jip M. Linthorst, Esther Kuipers, Jacob K. Sont, Joyca P. W. Lacroix, Henk-Jan Guchelaar, Martina Teichert
Summary: The RACE questionnaire, developed and validated in this study, aims to identify individual barriers to self-management of ICS therapy in asthma patients, providing a reliable tool for tailored care.
FRONTIERS IN PHARMACOLOGY
(2021)
Review
Nursing
Jing Ru Lee, Siyan Leo, Suyue Liao, Wan Ring Ng, Tiffany Yu Ning Tay, Yutao Wang, Wei How Darryl Ang, Ying Lau
Summary: The study found that electronic adherence monitoring devices can improve inhaler adherence among children with asthma. The devices were found to be user-friendly and highly accessible. However, no significant differences were observed between the intervention and control groups for asthma exacerbations, lung function, and asthma control.
INTERNATIONAL JOURNAL OF NURSING STUDIES
(2021)
Article
Respiratory System
Carlyne M. Averell, Francois Laliberte, Guillaume Germain, Mei Sheng Duh, Matthew D. Rousculp, Sean D. MacKnight, David J. Slade
Summary: This study highlights the importance of adherence to inhaled corticosteroid/long-acting beta 2 agonist treatment in asthma patients. Adherent patients had lower rates of overall and severe exacerbations, reduced rescue medication use, and lower healthcare resource utilization and costs. The findings emphasize the short-term clinical and economic benefits of medication adherence in asthma management.
THERAPEUTIC ADVANCES IN RESPIRATORY DISEASE
(2022)
Article
Obstetrics & Gynecology
Yasmin Salem, Marc-Alexander Oestreich, Oliver Fuchs, Jakob Usemann, Urs Frey, Daniel Surbek, Sofia Amylidi-Mohr, Philipp Latzin, Kathryn Ramsey, Sophie Yammine
Summary: This study found that the mode of delivery is not associated with respiratory and atopic outcomes during infancy and at school age. There were no significant differences in respiratory symptoms, lung function, and atopic outcomes between children born by cesarean delivery and those born by vaginal delivery.
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
(2022)
Article
Respiratory System
Nicole Tanner, Sejal Saglani, Albert M. Li, Andrew Bush, Louise Fleming
Summary: Recent studies suggest that acid GOR may be associated with worse control and differences in sputum proteomics in adult asthmatics, but in children with severe asthma, acid GOR does not appear to have a significant impact on asthma control or airway inflammation.
Article
Respiratory System
Marielle W. Pijnenburg, Urs Frey, Johan C. De Jongste, Sejal Saglani
Summary: In the pathogenesis of asthma in children, there are multiple factors involved including infections, atopy, genetic susceptibility, environmental exposures, and dysbiosis of the microbiome. Increased infant weight gain and preterm birth are also risk factors for asthma development. Identifying different phenotypes and endotypes can help improve diagnosis, prediction, and treatment of asthma in children.
EUROPEAN RESPIRATORY JOURNAL
(2022)
Review
Respiratory System
Ekaterina Khaleva, Anna Rattu, Chris Brightling, Andrew Bush, Apostolos Bossios, Arnaud Bourdin, Kian Fan Chung, Rekha Chaudhuri, Courtney Coleman, Sven-Erik Dahlen, Ratko Djukanovic, Antoine Deschildre, Louise Fleming, Stephen J. Fowler, Atul Gupta, Eckard Hamelmann, Simone Hashimoto, Gunilla Hedlin, Gerard H. Koppelman, Erik Melen, Clare S. Murray, Charles Pilette, Celeste Porsbjerg, Katharine C. Pike, Franca Rusconi, Clare Williams, Birgit Ahrens, Peter Alter, Freja Anckers, Maarten van den Berge, Katharina Blumchen, Guy Brusselle, Graham W. Clarke, Danen Cunoosamy, Barbro Dahlen, Piers Dixey, Andrew Exley, Urs Frey, Erol A. Gaillard, Lisa Giovannini-Chami, Jonathan Grigg, Diana Hartenstein, Liam G. Heaney, Bulent Karadag, Susanne Kaul, Inger Kull, Amelia Licari, Anke H. Maitland-van der Zee, Vera Mahler, Ann-Marie M. Schoos, Prasad Nagakumar, Jenny Negus, Hanna Nielsen, James Paton, Marielle Pijnenburg, Valeria Ramiconi, Sofia Romagosa Vilarnau, Stefania Principe, Niels Rutjes, Sejal Saglani, Paul Seddon, Florian Singer, Heribert Staudinger, Steve Turner, Susanne Vijverberg, Tonya Winders, Valentyna Yasinska, Graham Roberts
Summary: The COMSA Working Group developed two Core Outcome Measures (COM) sets for paediatric and adult severe asthma, including FEV1 as z-scores, frequency of severe exacerbations and oral corticosteroid use. These COM sets will inform future clinical trials, enhance comparability of biological therapies' efficacy and effectiveness, and assess their socioeconomic value.
EUROPEAN RESPIRATORY JOURNAL
(2023)
Review
Medicine, General & Internal
Daiana Stolz, Takudzwa Mkorombindo, Desiree M. Schumann, Alvar Agusti, Samuel Y. Ash, Mona Bafadhel, Chunxue Bai, James D. Chalmers, J. Criner Gerard, Shyamali C. Dharmage, Frits M. E. Franssen, Urs Frey, MeiLan Han, Nadia N. Hansel, Nathaniel M. Hawkins, Ravi Kalhan, Melanie Konigshoff, Fanny W. Ko, Trisha M. Parekh, Pippa Powell, Maureen Rutten-van Molken, Jodie Simpson, Don D. Sin, Yuanlin Song, Bela Suki, Thierry Troosters, George R. Washko, Tobias Welte, Mark T. Dransfield
Review
Respiratory System
Anna Rattu, Ekaterina Khaleva, Chris Brightling, Sven-Erik Dahlen, Apostolos Bossios, Louise Fleming, Kian Fan Chung, Erik Melen, Ratko Djukanovic, Rekha Chaudhuri, Andrew Exley, Gerard H. Koppelman, Arnaud Bourdin, Franca Rusconi, Celeste Porsbjerg, Courtney Coleman, Clare Williams, Hanna Nielsen, Elizabeth Davin, Phil Taverner, Sofia Romagosa Vilarnau, Graham Roberts
Summary: The recommendations of the National Institutes of Health (NIH) on outcome measurement instruments for asthma are widely used in clinical practice and research. However, there is no consensus on which outcome measures are important to patients with severe asthma and are valid for this population. Guidelines recommend the use of patient-reported outcome measures (PROMs) to evaluate treatment response, but do not provide specific instruments. Additionally, the outcomes that patients consider important, such as quality of life, are not consistently considered by physicians when evaluating treatment response.
EUROPEAN RESPIRATORY JOURNAL
(2023)
Letter
Allergy
Olga Gorlanova, Heide Oller, Andrea Marten, Loretta Mueller, Jessica Laine-Carmelli, Fabienne Decrue, Yasmin Salem, Danielle Vienneau, Kees de Hoogh, Amanda Gisler, Jakob Usemann, Insa Korten, Sophie Yammine, Uri Nahum, Noemi Kuenstle, Pablo Sinues, Sven Schulzke, Philipp Latzin, Oliver Fuchs, Martin Roeoesli, Bianca Schaub, Urs Frey
PEDIATRIC ALLERGY AND IMMUNOLOGY
(2023)
Article
Multidisciplinary Sciences
Amanda Gisler, Kapil Dev Singh, Jiafa Zeng, Martin Osswald, Mo Awchi, Fabienne Decrue, Felix Schmidt, Noriane A. Sievi, Xing Chen, Jakob Usemann, Urs Frey, Malcolm Kohler, Xue Li, Pablo Sinues
Summary: Exhaled breath analysis provides valuable molecular-level information and has promising potential for precision medicine. However, the lack of validation in multicenter trials hinders the transition of breath tests into routine clinical practice. In this study, an interoperability framework was developed and applied, revealing a technical variability of approximately 20% and identifying a core signature of the human exhaled metabolome. The results showed high inter-subject variability for certain metabolic classes but relative stability in other regions, such as the TCA cycle. This framework and the overview of metabolic coverage will pave the way for future large-scale multicenter trials.
Article
Critical Care Medicine
Mahmoud I. Abdel-Aziz, Jonathan Thorsen, Simone Hashimoto, Susanne J. H. Vijverberg, Anne H. Neerincx, Paul Brinkman, Wim van Aalderen, Jakob Stokholm, Morten Arendt Rasmussen, Michael Roggenbuck-Wedemeyer, Nadja H. Vissing, Martin Steen Mortensen, Asker Daniel Brejnrod, Louise J. Fleming, Clare S. Murray, Stephen J. Fowler, Urs Frey, Andrew Bush, Florian Singer, Gunilla Hedlin, Bjorn Nordlund, Dominick E. Shaw, Kian Fan Chung, Ian M. Adcock, Ratko Djukanovic, Charles Auffray, Aruna T. Bansal, Ana R. Sousa, Scott S. Wagers, Bo Lund Chawes, Klaus Bonnelykke, Soren Johannes Sorensen, Aletta D. Kraneveld, Peter J. Sterk, Graham Roberts, Hans Bisgaard, Anke H. Maitland-van der Zee
Summary: By analyzing the oropharyngeal microbiota of children with asthma or wheezing, four distinct clusters with unique clinical characteristics were identified, and the enrichment scores of transcriptomic pathways associated with exacerbation risk and airway remodeling varied among these clusters.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2023)
Article
Biochemical Research Methods
Mo Awchi, Kapil Dev Singh, Patricia E. Dill, Urs Frey, Alexandre N. Datta, Pablo Sinues
Summary: Therapeutic drug monitoring (TDM) is a common clinical practice that monitors the systemic blood concentrations of drugs in order to minimize toxic effects and improve clinical outcomes. This study demonstrates the potential of using exhaled breath analysis to predict the blood concentrations of the anti-seizure medication valproic acid (VPA). A new method using breath sample collection bags and secondary electrospray ionization coupled to high-resolution mass spectrometry (SESI-HRMS) was developed to overcome the limitation of patients having to exhale directly into the mass spectrometer. This opens up new possibilities for breath-based TDM in clinical settings, particularly for pediatric patients.
JOURNAL OF BREATH RESEARCH
(2023)
Review
Respiratory System
Sormeh Salehian, Louise Fleming, Sejal Saglani, Adnan Custovic
EXPERT REVIEW OF RESPIRATORY MEDICINE
(2023)
Review
Respiratory System
Sara Warraich, Andrew Bush, Mark L. Levy, Louise Fleming
Summary: In the past 20 years, asthma weaning plans on discharge after an attack have become common practice. However, the precise origin of these plans is unclear. Overuse of short-acting β2-agonists (SABAs) may lead to tolerance and diminish their efficacy during acute attacks. Additionally, these plans may mask warning signs of asthma control deterioration and encourage over-reliance on SABAs, potentially causing harmful side effects. Asthma education at discharge, personal action plans, and adherence to maintenance therapy are important, but prescribing regular salbutamol after an acute attack is deemed a dangerous myth.
Article
Respiratory System
Jonathan Thorsen, Jakob Stokholm, Morten Arendt Rasmussen, Michael Roggenbuck-Wedemeyer, Nadja H. Vissing, Martin S. Mortensen, Asker D. Brejnrod, Louise Fleming, Andrew Bush, Graham Roberts, Florian Singer, Urs Frey, Gunilla Hedlin, Bjorn Nordlund, Clare S. Murray, Mahmoud Abdel-Aziz, Simone Hashimoto, Wim van Aalderen, Anke H. Maitland-van der Zee, Dominick Shaw, Stephen J. Fowler, Ana Sousa, Peter J. Sterk, Kian Fan Chung, Ian M. Adcock, Ratko Djukanovic, Charles Auffray, Aruna T. Bansal, Scott Wagers, Bo Chawes, Klaus Bonnelykke, Soren Johannes Sorensen, Hans Bisgaard
Summary: There is a major unmet need for improving the care of children and adolescents with severe asthma and wheeze. Identifying factors contributing to disease severity, such as the airway microbiota, may lead to improved diagnostics, biomarkers, or therapies. In this study, the oropharyngeal airway microbiota of children and adolescents with severe and mild/moderate asthma/wheeze were compared. The results showed a modest difference in the microbiota between children with severe and mild/moderate asthma/wheeze across all age groups, and a strong association between the microbiota and age. However, the microbiota may not be a strong enough biomarker for targeted intervention.
ANNALS OF THE AMERICAN THORACIC SOCIETY
(2022)
Article
Respiratory System
Jacqueline Huvanandana, Chinh D. Nguyen, Juliet M. Foster, Urs Frey, Helen K. Reddel, Cindy Thamrin
Summary: This study examined new time- and dose-based adherence variability metrics and found that low time adherence was associated with an increased risk of decline in asthma symptom control, suggesting that adherence patterns may be relevant to future clinical status.
ANNALS OF THE AMERICAN THORACIC SOCIETY
(2022)