Influence of comorbid conditions on asthma

Lp, Boulet

doi:10.1183/09031936.00121308

Cited by 222 publications

(190 citation statements)

References 124 publications

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“…Although the causal link is unclear, co-existence of gastroesophageal reflux is very common in patients with asthma [89]. As the diagnosis of GERD may be difficult, with limited sensitivity of both gastric pH monitoring and endoscopy, a trial treatment with PPI may be used as the initial diagnostic step in symptomatic patients [90].…”

Section: Systematic Assessment Of Severe Asthmamentioning

confidence: 99%

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Porsbjerg

Ulrik

Skjold

et al. 2018

European Clinical Respiratory Journal

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Although a minority of asthma patients suffer from severe asthma, they represent a major clinical challenge in terms of poor symptom control despite high-dose treatment, risk of exacerbations, and side effects. Novel biological treatments may benefit patients with severe asthma, but are expensive, and are only effective in appropriately targeted patients. In some patients, symptoms are driven by other factors than asthma, and all patients with suspected severe asthma (‘difficult asthma’) should undergo systematic assessment, in order to differentiate between true severe asthma, and ‘difficult-to-treat’ patients, in whom poor control is related to factors such as poor adherence or co-morbidities. The Nordic Consensus Statement on severe asthma was developed by the Nordic Severe Asthma Network, consisting of members from Norway, Sweden, Finland, Denmark, Iceland and Estonia, including representatives from the respective national respiratory scientific societies with the aim to provide an overview and recommendations regarding the diagnosis, systematic assessment and management of severe asthma. Furthermore, the Consensus Statement proposes recommendations for the organization of severe asthma management in primary, secondary, and tertiary care.

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Section: Systematic Assessment Of Severe Asthmamentioning

confidence: 99%

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Porsbjerg

Ulrik

Skjold

et al. 2018

European Clinical Respiratory Journal

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“…COPD and asthma are conditions with many comorbidities, albeit asthma to a lesser extent than COPD [28][29][30][31]. To date, very limited data have been gathered on the association between asthma and CKD.…”

Section: Discussionmentioning

confidence: 99%

“…The results of a more recent study indicate that asthma is weakly associated with diabetes mellitus, dyslipidemia, and cardiovascular and hypertensive disease [32]. Although asthma has been proposed to have many comorbidities [29][30][31][32], its association with CKD has not been entirely elucidated, and the underlying mechanisms remain unknown. Further research is needed to determine the interrelationships between COPD, asthma, and CKD.…”

Section: Discussionmentioning

confidence: 99%

C-reactive protein levels, airflow obstruction, and chronic kidney disease

Funakoshi

Omori

Mihara

et al. 2011

Environ Health Prev Med

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Objectives There is some evidence that chronic obstructive pulmonary disease and chronic kidney disease (CKD) may be related, perhaps through systemic inflammation, which is common to both. However, this relationshiphas not yet been clearly demonstrated. The aim of this study was to investigate the association between airflow obstruction, CKD, and C-reactive protein (CRP) levels in Japanese men. Methods The study included 11,587 men, aged 40-88 years, who underwent a health check-up. Airflow obstruction was defined as a forced expiratory volume in 1 s/forced vital capacity of \70%, and its severity was based on the Global Initiative for Chronic Obstructive Lung Disease guidelines (GOLD). CKD was defined as an estimated glomerular filtration rate of \60 mL/min/1.73 m 2 . Results Airflow obstruction was present in 7.9% of the participants, and 10.6% of the participants had CKD. The average CRP levels were 0.11 ± 0.36, 0.13 ± 0.41, and 0.18 ± 0.41 mg/L for subjects with normal lung function, GOLD stage I, and GOLD stage II-IV, respectively. With regard to CKD, the average CRP levels were 0.11 ± 0.32 and 0.18 ± 0.6 mg/L for subjects without and with CKD, respectively. Analysis of covariance showed no significant differences between the CRP level and lung function status or CKD after age was adjusted for. Logistic regression analysis showed no association among subjects with the three different lung function statuses after age, body mass index, hypertension, diabetes, hyper-low-density-lipoprotein-cholesterolemia, smoking, physical activity, and alcohol intake were controlled for. Conclusions Based on the results of this study, we conclude that there is no interrelationship between CRP level, airflow obstruction, and CKD.

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“…The second subgroup is the difficult-to-treat asthma, in which patients have persistent uncontrolled asthma symptoms despite using inhaled controller therapy. These patients have increased exacerbation risks and significant comorbidities (like sinonasal disease, obesity, sleep apnea, gastroesophageal reflux disease, anxiety, and depression) [10]. The third class is treatment-resistant severe asthma, which is uncontrolled despite the use of highest level of recommended therapy.…”

Section: Definition Of Severe Asthmamentioning

confidence: 99%

Severe Asthma: Moving from Phenotype to Endotype Classification with Updates on Treatment

Noujeim¹,

Bou‐Khalil²

2016

J Nurs Care

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Asthma has classically been categorized into several phenotypes to address the complexities of this disease. However, phenotypes only cover the clinically relevant aspects of the disease, but do not address the relationship between the disease and its etiology and pathophysiology. This led to the development of the term "endotypes" which links key pathogenic mechanisms with asthma phenotypes, and ultimately leads to better selection of treatment resulting in improved response. Although the exact pathogenesis of asthma is still under investigation, targeted-therapy based on asthma phenotypes and endotypes has shown some success, and the future appears promising for patients suffering from severe asthma since treatment is being tailored according to individual biology. We review in this manuscript the best evidence and updates currently available in the classification and treatment recommendations for severe asthma.

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Influence of comorbid conditions on asthma

Cited by 222 publications

References 124 publications

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

C-reactive protein levels, airflow obstruction, and chronic kidney disease

Severe Asthma: Moving from Phenotype to Endotype Classification with Updates on Treatment

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