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1. Pharmacological treatment of asthma in a cohort of adults during a 20-year period: results from the European Community Respiratory Health Survey I, II and III

Author

Christer Janson, Simone Accordini, Lucia Cazzoletti, Isa Cerveri, Sebastien Chanoine, Angelo Corsico, Diogenes Seraphim Ferreira, Judith Garcia-Aymerich, David Gislason, Rune Nielsen, Ane Johannessen, Rain Jogi, Andrei Malinovschi, Jesús Martinez-Moratalla Rovira, Alessandro Marcon, Isabelle Pin, Jennifer Quint, Valerie Siroux, Enrique Almar, Valeria Bellisario, Karl A. Franklin, José A. Gullón, Mathias Holm, Joachim Heinrich, Dennis Nowak, José Luis Sánchez-Ramos, Joost J. Weyler, Deborah Jarvis, The members of the ECRHS I scientific team., P. Burney, S. Chinn, C. Luczynska, D. Jarvis, E. Lai, P. Vermeire, H. Kesteloot, J. Bousquet, D. Nowak, J. Prichard, R. de Marco, B. Rijcken, J.M. Anto, J. Sunyer, J. Alves, G. Boman, N. Nielsen, P. Paoletti, M. Abramson, J. Kutin, F. van Bastelaer, R. Jõgi, A. Taytard, I. Pin, C. Pison, F. Neukirch, R. Liard, J. Knani, H-E. Wichmann, J. Heinrich, H. Magnussen, T. Gislason, D. Gislason, A. Marinoni, I. Cerveri, M. Bugiani, C. Bucca, C. Romano, L. Cascio, C. Campello, J. Droste, M. Kerkhof, A. Gulsvik, E. Omenaas, J. Martinez-Moratalla, E. Almar, A. Mateos, M. Arévalo, A. Sánchez, M. Vizcaya, X. Aguilar, A. Teixidó, J.M. Antó, M. Kogevinas, F. Burgos, J. Castellsagué, J. Roca, JB. Soriano, A. Tobías, N. Muiñozguren, J. Ramos González, A. Capelastegui, J. Maldonado Pérez, A. Pereira, J. Sánchez, J. Quiros, I. Huerta, F. Payo, N. Lindholm, P. Plaschke, C. Janson, E. Björnsson, L. Rosenhall, E. Norrman, B. Lundbäck, U. Ackermann-Liebrich, N. Küenzli, A. Perruchoud, M. Burr, J. Layzell, R. Hall, B. Harrison, The members of the ECRHS II scientific team., J. Knox, M. Wjst, N. Kuenzli, E.H. Walters, J. Raven, J. Weyler, M. van Sprundel, V. Nelen, A. Soon, C. Raherison, J. Ferran-Quentin, B. Leynaert, M. Zureik, P.J. Bousquet, C. Frye, I. Meyer, E. Bjornsson, K.B. Jörundsdóttir, S. Villani, M. Ponzio, F. Frigerio, M. Comelli, M. Grassi, A. Corsico, R. Bono, P. Piccioni, E. Caria, A. Carosso, E. Migliore, G. Castiglioni, G. Verlato, E. Zanolin, S. Accordini, A. Poli, V. Lo Cascio, M. Ferrari, I. Cazzoletti, C. Svanes, B. Laerum, J. Martinez-Moratalla Rovira, C. Boix, G. González, J.M. Ignacio García, J. Solera, J. Damián, J.P. Zock, X. Basagaña, A. Jaen, C. Acosta, N. Muñozguren, J. Ramos, I. Urrutia, U. Aguirre, J. Maldonado, J.L. Sanchez, A. de la Vega, L. Palenciano, J. Azofra, A. Cañada, K. Toren, L. Lillienberg, A.C. Olin, B. Balder, A. Pfeifer-Nilsson, R. Sundberg, D. Norback, G. Wieslander, M. Gunnbjornsdottir, M. Soderberg, K.A. Franklin, B. Lundback, B. Forsberg, L. Nystrom, B. Dibbert, M. Hazenkamp, M. Brutsche, D. Seaton, The members of the ECRHS III scientific team., M. Tumilty, J. Potts, T. Gislasson, T. Rochat, B. Leyneart, G. Benke, S. Dharmage, B. Thompson, S. Kaushik, M. Matheson, H. Bentouhami, H. Orru, P.O. Girodet, V. Siroux, J. Ferran, J.L. Cracowski, P. Demoly, A. Bourdin, I. Vachier, D. Soussan, D. Courbon, C. Neukirch, L. Alavoine, X. Duval, I. Poirier, E. Becker, G. Woelke, O. Manuwald, A-M. Kirsten, B. Benediktsdottir, E.S. Arnardottir, M. Clausen, G. Gudmundsson, L. Gudmundsdottir, H. Palsdottir, K. Olafsdottir, S. Sigmundsdottir, K. Bara-Jörundsdottir, A. Grosso, F. Albicini, E. Gini, E.M. Di Vincenzo, V. Ronzoni, F. Campanella, M. Gnesi, F. Manzoni, L. Rossi, O. Ferraro, R. Tassinari, V. Bellisario, G. Trucco, L. Calciano, L. Cazzoletti, A.M. Fratta Pasini, F. Locatelli, P. Marchetti, A. Marcon, E. Montoli, G. Nguyen, M. Olivieri, C. Papadopoulou, C. Posenato, G. Pesce, P. Vallerio, H.M. Boezen, A. Johannessen, T. Skorge, F. Gomez Real, S. García, A. Núñez, P. López, R. Sánchez, E. Mancebo, J-M. Antó, J. Garcia-Aymerich, A.E. Carsin, C. Sanjuas, S. Guerra, B. Jacquemin, P. Davdand Galdakao, S. Pascual, J. Antonio Maldonado, J.L. Sánchez, L. Palacios, N. Sánchez, M. Fernández, B. Robles, K. Torén, M. Holm, J-L. Kim, A-C. Olin, A. Dahlman-Höglund, L. Braback, L. Modig, B. Järvholm, K.A. Bertilsson, H. Franklin, C. Wahlgreen, B. Andersson, U. Spetz Nystrom, G.M. Bodinaa Lund, K. Nisser, N.M. Probst-Hensch, N. Künzli, D. Stolz, C. Schindler, J.M. Gaspoz, E. Zemp Stutz, M. Adam, C. Autenrieth, I. Curjuric, J. Dratva, A. Di Pasquale, R. Ducret-Stich, E. Fischer, L. Grize, A. Hensel, D. Keidel, A. Kumar, M. Imboden, N. Maire, A. Mehta, H. Phuleria, M. Ragettli, M. Ritter, E. Schaffner, G.A. Thun, A. Ineichen, T. Schikowski, M. Tarantino, M. Tsai, S. Kapur, R. Newson, N. Innes, and A. Wilson

Subjects
Medicine
Abstract

Asthma often remains uncontrolled, despite the fact that the pharmacological treatment has undergone large changes. We studied changes in the treatment of asthma over a 20-year period and identified factors associated with the regular use of inhaled corticosteroid (ICS) treatment. Changes in the use of medication were determined in 4617 randomly selected subjects, while changes in adults with persistent asthma were analysed in 369 participants. The study compares data from three surveys in 24 centres in 11 countries. The use of ICSs increased from 1.7% to 5.9% in the general population and the regular use of ICSs increased from 19% to 34% among persistent asthmatic subjects. The proportion of asthmatic subjects reporting asthma attacks in the last 12 months decreased, while the proportion that had seen a doctor in the last 12 months remained unchanged (42%). Subjects with asthma who had experienced attacks or had seen a doctor were more likely to use ICSs on a regular basis. Although ICS use has increased, only one-third of subjects with persistent asthma take ICSs on a regular basis. Less than half had seen a doctor during the last year. This indicates that underuse of ICSs and lack of regular healthcare contacts remains a problem in the management of asthma.

Published
2019
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2. Risk of asthma in the general Spanish population attributable to specific immunoresponse. Spanish Group of the European Community Respiratory Health Survey

Author

Josep M. Antó, Nerea Muniozguren, Manolis Kogevinas, J L Sánchez, L Palenciano, Aurelio Tobias, Joan B. Soriano, Enrique Almar, Jordi Sunyer, and Peter Burney

Subjects
Adult, Hypersensitivity, Immediate, Male, Spirometry, medicine.medical_specialty, Allergy, Epidemiology, Population, medicine.disease_cause, Bronchial Provocation Tests, Bronchoconstrictor Agents, Diagnosis, Differential, Atopy, Surveys and Questionnaires, Internal medicine, Prevalence, Humans, Medicine, media_common.cataloged_instance, European union, education, Methacholine Chloride, Skin Tests, media_common, Asthma, education.field_of_study, medicine.diagnostic_test, business.industry, Smoking, Aeroallergen, General Medicine, Allergens, Immunoglobulin E, medicine.disease, respiratory tract diseases, Cross-Sectional Studies, Spain, Attributable risk, Immunology, Female, Bronchial Hyperreactivity, business, Immunocompetence
Abstract

Background Individuals with asthma are more atopic than the general population, but few reports have quantified this association, i.e. the proportion of asthma in the community due to specific immunoresponse. We aimed to determine the population attributable risk of asthma in the community due to atopy, and the quantity and quality of specific immunoresponses to common aeroallergens involved. Methods We used data from a cross-sectional study in a random sample of the general Spanish population, 20-44 years old, from five areas. In all, 1816 participants were given a symptoms questionnaire, a methacholine challenge and were assessed for atopy. Bronchial responsiveness (BR) was defined as a > or =20% fall in forced expiratory volume in one second (FEV1) after methacholine. Asthma was defined as symptomatic bronchial responsiveness. Atopy was assessed by measuring serum specific IgE or skin tests for sensitivity to Alternaria, birch, cat, Cladosporium, Dermatophagoides pteronyssinus, olive, Parietaria, ragweed or timothy grass. Results Sensitivity to any of the individual allergens tested significantly increased the risk of being asthmatic, at least twofold compared to non-atopic individuals. The population attributable risk of atopy in explaining asthma is 41.97% (95% CI: 29.2-60.3) when adjusting for area of residence, age, sex, and smoking. In symptomatic individuals, atopy was an independent factor in producing an early measurable PD20 (methacholine dose producing 20% fall in FEV1), especially in those atopic to two or more aeroallergens, and irrespective of the particular aeroallergen. Conclusions Specific immunoresponse is strongly associated with asthma, but positivity to single allergens (quality) and the number of positive immunoresponses (quantity) do not change the per se risk of asthma in atopic individuals.

Published
1999
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3. Risk of asthma in the general Spanish population attributable to specific immunoresponse. Spanish Group of the European Community Respiratory Health Survey.

Author

Soriano JB, Antó JM, Sunyer J, Tobías A, Kogevinas M, Almar E, Muniozguren N, Sánchez JL, Palenciano L, and Burney P

Subjects
Adult, Allergens, Asthma diagnosis, Asthma immunology, Bronchial Hyperreactivity diagnosis, Bronchial Hyperreactivity epidemiology, Bronchial Hyperreactivity immunology, Bronchial Provocation Tests, Bronchoconstrictor Agents, Cross-Sectional Studies, Diagnosis, Differential, Female, Humans, Hypersensitivity, Immediate diagnosis, Hypersensitivity, Immediate epidemiology, Hypersensitivity, Immediate immunology, Male, Methacholine Chloride, Prevalence, Skin Tests, Smoking adverse effects, Spain epidemiology, Surveys and Questionnaires, Asthma epidemiology, Immunocompetence, Immunoglobulin E immunology
Abstract

Background: Individuals with asthma are more atopic than the general population, but few reports have quantified this association, i.e. the proportion of asthma in the community due to specific immunoresponse. We aimed to determine the population attributable risk of asthma in the community due to atopy, and the quantity and quality of specific immunoresponses to common aeroallergens involved., Methods: We used data from a cross-sectional study in a random sample of the general Spanish population, 20-44 years old, from five areas. In all, 1816 participants were given a symptoms questionnaire, a methacholine challenge and were assessed for atopy. Bronchial responsiveness (BR) was defined as a > or =20% fall in forced expiratory volume in one second (FEV1) after methacholine. Asthma was defined as symptomatic bronchial responsiveness. Atopy was assessed by measuring serum specific IgE or skin tests for sensitivity to Alternaria, birch, cat, Cladosporium, Dermatophagoides pteronyssinus, olive, Parietaria, ragweed or timothy grass., Results: Sensitivity to any of the individual allergens tested significantly increased the risk of being asthmatic, at least twofold compared to non-atopic individuals. The population attributable risk of atopy in explaining asthma is 41.97% (95% CI: 29.2-60.3) when adjusting for area of residence, age, sex, and smoking. In symptomatic individuals, atopy was an independent factor in producing an early measurable PD20 (methacholine dose producing 20% fall in FEV1), especially in those atopic to two or more aeroallergens, and irrespective of the particular aeroallergen., Conclusions: Specific immunoresponse is strongly associated with asthma, but positivity to single allergens (quality) and the number of positive immunoresponses (quantity) do not change the per se risk of asthma in atopic individuals.

Published
1999
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