liens utiles
outils et ressources

Diagnostiquer un patient asthmatique sévère

Retrouvez ci-dessous les références, questionnaires et liens utiles pour chacune des sections.

Références
  • Source de Groot JC et al. Management of the patient with eosinophilic asthma: a new era begins. ERJ Open Research 2015 1: 00024-2015.
  • Source Zeiger RS et al. High Blood Eosinophil Count Is a Risk Factor for Future Asthma Exacerbations in Adult Persistent Asthma. J Allergy Clin Immunol Pract. 2014 Nov-Dec;2(6):741-50.

Références
Ressources

Je vérifie le contrôle

Références

J'élimine les diagnostics différentiels

  • 1 Masi AT et al. The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum. 1990 Aug;33(8):1094-100.
  • 2 Agarwal R et al. Allergic bronchopulmonary aspergillosis: review of literature and proposal of new diagnostic and classification criteria. Clin Exp Allergy. 2013 Aug;43(8):850-73.

J'évalue l'observance et les techniques de prises de traitements

  • 1 Version française du questionnaire de Morisky (Morisky et al. 2008) validée (Korb-Savoldelli V et al. 2012)

Je pose le diagnostic d'asthme sévère à éosinophiles

  • 1 Figure adaptée de l’ouvrage "POCKET GUIDE FOR ASTHMA MANAGEMENT AND PREVENTION", 2018.
    Available from www.ginasthma.org (Traduit de la Box 3-5A)
  • * Buhl R et al. Severe eosinophils asthma: a roadmap to consensus. Eur Respir J 2017;49:1700534.
Ressources

Je confirme le diagnostic d'asthme

J'élimine les diagnostics différentiels

J'évalue l'observance et les techniques de prises de traitements

J'évalue et traite les comorbidités

J'élimine les facteurs de risque evironnementaux

Je soumets une fiche de réunion de concertation

L'asthme sévère à éosinophiles

Retrouvez ci-dessous les références, questionnaires et liens utiles pour chacune des sections.

Références
  • 1 Prévalence Asthme sévère stade GINA 5 issue de Raherison-Semjen C et al. Late Breaking Abstract - Asthma prevalence and management in adults in France in 2018: ASTHMAPOP survey, European Respiratory Journal 2018 52: OA292.
  • 2 Schleich F et al. Heterogeneity of phenotypes in severe asthmatics. The Belgian Severe Asthma Registry (BSAR). Respir Med. 2014 Dec;108(12):1723-32.
  • 3 Analyse IqVia - Données internes AstraZeneca.

Références
  • 1 Salter BM et al. The role of type 2 innate lymphoid cells in eosinophilic asthma. J Leukoc Biol. 2019 May 7.
  • 2 Louis R et al. The Relationship between Airways Inflammation and Asthma Severity. Am J Respir Crit Care Med 2000;161:9–16.
  • 3 Wang G et al. Sputum mast cell subtypes relate to eosinophilia and corticosteroid response in asthma. Eur Respir J. 2016 Apr;47(4):1123-33.
  • 4 Rakowski E et al. Variability of blood eosinophils in patients in a clinic for severe asthma. Clin Exp Allergy.2019;49:163–170.

Références
  • 1 Chung KF et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J. 2014 Feb;43(2):343-73.
  • 2 Brusselle GG et al. Eosinophils in the Spotlight: Eosinophilic airway inflammation in nonallergic asthma. Nat Med. 2013 Aug;19(8):977-9.

Références
  • 1 Possa SS et al. Eosinophilic inflammation in allergic asthma. Front Pharmacol. 2013 Apr 17;4:46.
  • 2 Price DB et al. Blood eosinophil count and prospective annual asthma disease burden: a UK cohort study. Lancet Respir Med 2015;3: 849–58.
  • 3 Wenzel SE et al. Evidence that severe asthma can be divided pathologically into two inflammatory subtypes with distinct physiologic and clinical characteristics. Am J Respir Crit Care Med 1999; 160: 1001–1008.
  • 4 Bel EH et al. Oral glucocorticoid-sparing effect of mepolizumab in eosinophilic asthma. N Engl J Med 2014; 371: 1189–1197.

Références

L’éosinophilie sanguine est associée à une fonction respiratoire altérée

  • Ref Bumbacea D et al. Parameters associated with persistent airflow obstruction in chronic severe asthma. Eur Respir J 2004; 24: 122–128.

L’éosinophilie sanguine est associée à un risque accru d’exacerbations sévères

  • Ref Figure adaptée de Price D et al. Blood eosinophil count and prospective annual asthma disease burden: a UK cohort study. Lancet Respir Med 2015;3(11):849-58.

L’éosinophilie sanguine est associée à un risque accru de mauvais contrôle

  • Ref Figure adaptée de Price D et al. Blood eosinophil count and prospective annual asthma disease burden: a UK cohort study. Lancet Respir Med 2015;3(11):849-58.

Vivre avec un asthme sévère à éosinophiles

Retrouvez ci-dessous les références, questionnaires et liens utiles pour chacune des sections.

Références
  • 1 Wenzel SE. Asthma phenotypes: the evolution from clinical to molecular approaches. Nat Med 2012; 18:716–725.
  • 2 Amelink M et al. Severe adult-onset asthma: a distinct phenotype. J Allergy Clin Immunol 2013; 132: 336–341.
  • 3 Zeiger RS et al. High Blood Eosinophil Count Is a Risk Factor for Future Asthma Exacerbations in Adult Persistent Asthma. J Allergy Clin Immunol Pract. 2014 Nov-Dec;2(6):741-50.
  • 4 Ten Brinke A et al. Factors associated with persistent airflow limitation in severe asthma. Am J Respir Crit Care Med 2001; 164: 744–748.
  • 5 Bumbacea D et al. Parameters associated with persistent airflow obstruction in chronic severe asthma. Eur Respir J 2004; 24: 122–128.
  • 6 de Groot JC et al. Management of the patient with eosinophilic asthma: a new era begins. ERJ Open Research 2015 1: 00024-2015.
  • 7 Bel EH et al. Oral glucocorticoid-sparing effect of mepolizumab in eosinophilic asthma. N Engl J Med 2014; 371: 1189–1197.
  • 8 Newby C et al. Lung function decline and variable airway inflammatory pattern: longitudinal analysis of severe asthma. J Allergy Clin Immunol 2014; 134: 287–294.
  • 9 Castro M et al. Reslizumab for inadequately controlled asthma with elevated blood eosinophil counts: results from two multicentre, parallel, double-blind, randomised, placebo-controlled, phase 3 trials. Lancet Respir Med 2015; 3: 355–366.
  • 10 Jarvis D et al. Asthma in adults and its association with chronic rhinosinusitis: the GA2LEN survey in Europe. Allergy 2012; 67: 91–98.

Références

L’asthme sévère a un retentissement majeur sur la qualité de vie

  • 1 Dockrell M et al. The limitations of severe asthma: the results of a European survey. Allergy 2007;62:134-41.
  • 2 Données EGB Phase 2.
  • 3 Bourdin A et al. Impact de l’asthme sévère en France : une étude à partir de l’échantillon généraliste de bénéficiaires. Revue des Maladies Respiratoires 2018;35S:A3-A29.

Augmentation du risque d’exacerbations

  • 1 European Network for Understand- ing Mechanisms of Severe Asthma. The ENFUMOSA cross-sectional European mul- ticentre study of the clinical phenotype of chronic severe asthma. Eur Respir J 2003; 22:470-7.
  • 2 Kupczyk M et al. Frequent exacerbators - a distinct phenotype of severe asthma. Clin Exp Allergy. 2014 Feb;44(2):212-21.

Augmentation des hospitalisations

  • 1 Pretolani M et al. Clinical and biological characteristics of the French COBRA cohort of adult subjects with asthma. Eur Respir J. 2017 Aug 24;50(2).
  • 2 Luskin AT et al. Impact of Asthma Exacerbations and Asthma Triggers on Asthma-related Quality of Life in Patients with Severe or Difficult-to-Treat Asthma. J Allergy Clin Immunol Pract. 2014;2:544-552.

Risques de morbidité liés aux CSO

  • Ref Price DB et al. Adverse outcomes from initiation of systemic corticosteroids for asthma: long-term observational study. J Asthma Allergy 2018;11:193-204.
  • 1 Barry LE et al. The cost of systemic corticosteroid-induced morbidity in severe asthma : a health economic analysis. Respir Res 2017;18:129.
  • 2 O’Neil S et al. The cost of treating severe refractory asthma in the UK : an economic analysis from the British Thoracic Society Difficult Asthma Registry. Thorax 2015;70-376-78.
Ressources

Risques de morbidité liés aux CSO

Augmentation du risque de mortalité

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