Risk of Comorbidities High in Severe Asthma, Despite Treatment
Patients with severe and/or difficult-to-treat asthma continue to experience high rates of comorbid conditions and poor asthma control despite treatment, according to the findings of a recent study that assessed data 10 years following the Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR I) study.
A cohort of 341 (27.7%) of the 1230 patients with severe/difficult-to-treat asthma enrolled in TENOR II (conducted a decade later) was included in the longitudinal analysis. The researchers assessed patient-reported and clinical outcomes, including incidence of very poorly controlled asthma (VPC).
____________________________________________________________________________________________________________________________________________________________________
Asthma Phenotype Impacts Omalizumab Effectiveness
____________________________________________________________________________________________________________________________________________________________________
Among the patients, rhinitis (84%), sinusitis (47.8%) and gastroesophageal reflux disease (46.3%) were the most frequently occurring comorbidities.
The mean (standard deviation [SD]) percent predicted pre- bronchodilator forced expiratory volume in 1 second (FEV1) was 72.7% (21.4%) and post-bronchodilator FEV1 was 78.2% (20.7%). The mean blood eosinophil count was 200 uL (144), and 231 (72.9%) of 317 patients tested positive for 1 or more allergen specific immunoglobulin E.
Overall, 88 patients (25.8%) experienced an asthma exacerbation that required hospital attention and/or oral corticosteroids in the 3 months prior to the start of the study, and 197 (58.1%) out of 339 patients had VPC asthma. Additionally, the researchers found that medication use suggested undertreatment among patients.
“TENOR II provides longitudinal data to characterize disease progression, heterogeneity and severity in severe/difficult-to-treat asthma,” the researchers concluded. “Findings show continued morbidity, including a high degree of comorbid conditions, allergic sensitization, exacerbations and VPC asthma, including reduced lung function.”
—Melissa Weiss
Reference:
Chipps BE, Haselkorn T, Paknis B, et al. More than a decade follow-up in severe or difficult-to-treat asthma: TENOR II [published online August 7, 2017]. J Allergy Clin Immunol. http://dx.doi.org/10.1016/j.jaci.2017.07.014.