Mechanisms of asthma and allergic inflammationCharacterization of the severe asthma phenotype by the National Heart, Lung, and Blood Institute's Severe Asthma Research Program
Section snippets
Methods
After establishing standard operating procedures, including a review by an independent Data Safety Monitoring Board and approval by the Institutional Review Boards at each site, subjects underwent a comprehensive phenotypic characterization.
Classification of disease severity
From August 2003 to May 16, 2005, the network enrolled 204 subjects with severe asthma, 70 subjects with moderate asthma receiving ICS, and 164 subjects with mild asthma (94 of whom were on ICS). Despite treatment with high doses of corticosteroids, the subjects with severe asthma had an average of 4 to 5 total minor criteria. Nearly all subjects with severe asthma were using a second controller medication, 78% had persistent airflow obstruction, and more than half were having frequent
Discussion
The overall goal of SARP is to investigate prospectively subjects with severe asthma to understand better the pathophysiologic and biologic mechanisms that result in this level of disease severity. This article describes the clinical and physiologic characteristics of the SARP cohort that consists of more than 400 subjects and includes the largest group of comprehensively characterized subjects with severe asthma published to date. This study presents a unique opportunity to confirm results of
References (43)
- et al.
Pathophysiology of severe asthma
J Allergy Clin Immunol
(2000) - et al.
Design and baseline characteristics of the epidemiology and natural history of asthma: outcomes and treatment regimens (TENOR) study-a large cohort of patients with severe or difficult-to-treat-asthma
Ann Allergy Asthma Immunol
(2004) - et al.
Severity assessment in asthma: an evolving concept
J Allergy Clin Immunol
(2005) - et al.
A comparison of the clinical characteristics of children and adults with severe asthma
Chest
(2003) - et al.
Distinguishing severe asthma phenotypes: role of age of onset and eosinophilic inflammation
J Allergy Clin Immunol
(2004) - et al.
Relationship of physician estimate of underlying asthma severity to asthma outcomes
Ann Allergy Asthma Immunol
(2004) - et al.
Near-fatal asthma: a population-based study of risk factors
Chest
(2002) - et al.
Efficacy of salmeterol xinafoate in the treatment of COPD
Chest
(1999) - et al.
Long-term oral corticosteroid therapy does not alter the results of immediate-type allergy skin prick tests
J Allergy Clin Immunol
(1996) - et al.
Exhaled nitric oxide identifies the persistent eosinophilic phenotype in severe refractory asthma
J Allergy Clin Immunol
(2005)
Exhaled nitric oxide in asthma: from bench to bedside
J Allergy Clin Immunol
Characterization of patients with frequent exacerbation of asthma
Respir Med
Causative and contributive factors to asthma severity and patterns of medication use in patients seeking specialized asthma care
Chest
Rhinosinusitis in severe asthma
J Allergy Clin Immunol
Inhaled corticosteroids for asthma therapy: patient compliance, devices and inhalation techniques
Chest
Improved refill persistence with fluticasone propionate and salmeterol in a single inhaler compared with other controller therapies
J Allergy Clin Immunol
Costs of asthma according to the degree of severity
Eur Respir J
Asthma severity and medical resource utilization
Eur Respir J
Costs of asthma are correlated with severity
Eur Respir J
Severe asthma in adults
Am J Respir Crit Care Med
Proceedings of the ATS workshop on refractory asthma: current understanding, recommendations, and unanswered questions. American Thoracic Society
Am J Respir Crit Care Med
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Supported by HL69116, HL69130, HL69149, HL69155, HL69167, HL69170, HL69174, HL69349, M01 RR018390, M01 RR007122-14, and M01 RR03186.
Disclosure of potential conflict of interest: S. C. Erzurum has received grant support from Alair. L. Bacharier is on the speakers' bureau for AstraZeneca, GlaxoSmithKline, Genentech, and Merck. W. J. Calhoun has consulting arrangements with Critical Therapeutics and Genentech. B. D. Levy has consulting arrangements with Critical Therapeutics. W. G. Teague is on the speakers' bureau for Merck. W. W. Busse has consulting arrangements with Genentech/Novartis, Isis, GlaxoSmithKline, Altana, Wyeth, Pfizer, Dynavax, and Centocor, has received grant support from Novartis, Wyeth, Dynavax, Centocor, and GlaxoSmithKline, and is on the speakers' bureau for GlaxoSmithKline, Novartis, Merck, and AstraZeneca. The rest of the authors have declared that they have no conflict of interest.