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1. S1-Leitlinie Long-/Post-COVID

Author

A. R. Koczulla, T. Ankermann, U. Behrends, P. Berlit, R. Berner, S. Böing, F. Brinkmann, U. Frank, C. Franke, R. Glöckl, C. Gogoll, W. Häuser, B. Hohberger, G. Huber, T. Hummel, V. Köllner, S. Krause, J. Kronsbein, T. Maibaum, A. Otto-Thöne, U. Pecks, E. M. J. Peters, S. Peters, M. Pfeifer, T. Platz, M. Pletz, F. Powitz, K. F. Rabe, C. Scheibenbogen, D. Schneider, A. Stallmach, M. Stegbauer, T. Tenenbaum, N. Töpfner, F. von Versen-Höynck, H. O. Wagner, C. Waller, C. N. Widmann, C. Winterholler, H. Wirtz, and R. Zwick

Subjects
Pulmonary and Respiratory Medicine
Abstract

ZusammenfassungDie Deutsche Gesellschaft für Pneumologie hat 2021 die AWMF S1-Leitlinie Long-/Post-COVID initiiert. In einem breiten interdisziplinären Ansatz wurde diese S1-Leitlinie basierend auf dem aktuellen Wissensstand gestaltet.Die klinische Empfehlung beschreibt die aktuellen Long- bzw. Post-COVID-Symptome, diagnostische Ansätze und Therapien.Neben der allgemeinen und konsentierten Einführung wurde ein fachspezifischer Zugang gewählt, der den aktuellen Wissensstand zusammenfasst.Die Leitlinie hat einen explizit praktischen Anspruch und wird basierend auf dem aktuellen Wissenszugewinn vom Autorenteam weiterentwickelt und adaptiert.

Published
2022
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2. [German S1 Guideline Long-/Post-COVID]

Author

A R, Koczulla, T, Ankermann, U, Behrends, P, Berlit, R, Berner, S, Böing, F, Brinkmann, U, Frank, C, Franke, R, Glöckl, C, Gogoll, W, Häuser, B, Hohberger, G, Huber, T, Hummel, V, Köllner, S, Krause, J, Kronsbein, T, Maibaum, A, Otto-Thöne, U, Pecks, E M J, Peters, S, Peters, M, Pfeifer, T, Platz, M, Pletz, F, Powitz, K F, Rabe, C, Scheibenbogen, D, Schneider, A, Stallmach, M, Stegbauer, T, Tenenbaum, N, Töpfner, F, von Versen-Höynck, H O, Wagner, C, Waller, C N, Widmann, C, Winterholler, H, Wirtz, and R, Zwick

Subjects
Post-Acute COVID-19 Syndrome, Humans, COVID-19
Abstract

The German Society of Pneumology initiated 2021 the AWMF S1 guideline Long COVID/Post-COVID. In a broad interdisciplinary approach, this S1 guideline was designed based on the current state of knowledge.The clinical recommendations describe current Long COVID/Post-COVID symptoms, diagnostic approaches, and therapies.In addition to the general and consensus introduction, a subject-specific approach was taken to summarize the current state of knowledge.The guideline has an explicit practical claim and will be developed and adapted by the author team based on the current increase in knowledge.Die Deutsche Gesellschaft für Pneumologie hat 2021 die AWMF S1-Leitlinie Long-/Post-COVID initiiert. In einem breiten interdisziplinären Ansatz wurde diese S1-Leitlinie basierend auf dem aktuellen Wissensstand gestaltet.Die klinische Empfehlung beschreibt die aktuellen Long- bzw. Post-COVID-Symptome, diagnostische Ansätze und Therapien.Neben der allgemeinen und konsentierten Einführung wurde ein fachspezifischer Zugang gewählt, der den aktuellen Wissensstand zusammenfasst.Die Leitlinie hat einen explizit praktischen Anspruch und wird basierend auf dem aktuellen Wissenszugewinn vom Autorenteam weiterentwickelt und adaptiert.

Published
2022

6. Multi-ancestral meta-analysis yields novel genetic loci for asthma exacerbations

Author

E Herrera Luis, V E Ortega, E J Ampleford, Y Y Sio, R Granell, E De Roos, N Terzikhan, E Elorduy Vergara, N Hernandez-Pacheco, J Perez-Garcia, E Martin-Gonzalez, F Lorenzo-Diaz, S Hashimoto, P Brinkman, A L Jorgensen, Q Yan, E Forno, S J Vijverberg, R Lethem, A Espuela-Ortiz, M Gorenjak, C Eng, R González-Pérez, J M Hernández-Pérez, P Poza-Guedes, O Sardón, P Corcuera, G A Hawkins, A Marsico, T Bahmer, K F Rabe, G Hansen, M V Kopp, R Rios, M J Cruz, F González-Barcala, J M Olaguibel, V Plaza, S Quirce, G Canino, M Cloutier, V Del Pozo, J R Rodriguez-Santana, J Korta-Murua, J Villar, U Potočnik, C Figueiredo, M Kabesch, S Mukhopadhyay, M Pirmohamed, D B Hawcutt, E Melén, C N Palmer, S Turner, A H Maitland-Van Der Zee, E Von Mutius, J C Celedón, G Brusselle, F T Chew, E Bleecker, D Meyers, E G Burchard, and M Pino-Yanes

Published
2022
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18. Severity score-based study of predictors and clinical correlates of Post-COVID Syndrome (PCS) in Germany

Author

T Bahmer, C Borzikowsky, W Lieb, A Horn, L Krist, J Fricke, C Scheibenbogen, K F Rabe, W Maetzler, C Maetzler, M Laudien, D Frank, S Ballhausen, A Viebke, A Hermes, O Muljukov, K G Haeusler, N E El Mokhtari, M Witzenrath, T Zoller, J J Vehreschild, S Hopff, G Anton, D Krefting, L Reinke, G Hein, F A Montellano, M Kohls, C Morbach, S Störk, J Reese, T Keil, P Heuschmann, M Krawczak, and S Schreiber

Published
2022
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26. Allergen-Immuntherapie in der aktuellen COVID-19-Pandemie – ein Positionspapier von ARIA, EAACI, AeDA, GPA und DGAKI (Kurzversion) – Positionspapier der deutschen ARIA-GruppeA in Kooperation mit der österreichischen ARIA-GruppeB, der schweizerischen ARIA-GruppeC, dem Ärzteverband Deutscher Allergologen (AeDA)D, der Deutschen Gesellschaft für Allergologie und Klinische Immunologie (DGAKI)E und der Gesellschaft für Pädiatrische Allergologie (GPA)F in Kooperation mit der AG Klinische Immunologie, Allergologie und Umweltmedizin der DGHNO-KHCG und der Europäischen Akademie für Allergologie und Klinische Immunologie (EAACI)H

Author

J. Ring, Thilo Jakob, Wolfgang Czech, Jörg Kleine-Tebbe, Thomas Werfel, P. Stute, Stefan Wöhrl, Jean Bousquet, Cezmi A. Akdis, Regina Roller-Wirnsberger, Ralph Mösges, Peter Valentin Tomazic, Michael Gerstlauer, Susanne Lau, Adam Chaker, Wolfgang Pohl, Friedrich Horak, Hans F. Merk, Martin Wagenmann, Margitta Worm, Werner Aberer, Wolfgang Schlenter, Jeroen Buters, Rudolf Valenta, Petra Staubach, Otto Spranger, Peter Schmid-Grendelmeier, Thomas Keil, Katja Nemat, Wolfgang Wehrmann, E. Hamelmann, R. Brehler, Nikolai Khaltaev, Marcus Maurer, A. H. Fink-Wagner, Tilo Biedermann, Karl Christian Bergmann, O. Pfaar, K. F. Rabe, Isabella Pali-Schöll, Norbert Mülleneisen, T. Zuberbier, Laurent P. Nicod, Mübeccel Akdis, Sven Becker, Verena Niederberger-Leppin, Marek Jutel, Jean-Pierre Michel, Thomas Fuchs, Christian Vogelberg, Roland Buhl, Joachim Saloga, Thomas Bieber, François Spertini, Uta Rabe, Holger Wrede, Christian Taube, Claus Vogelmeier, Ulf Darsow, Kirsten Jung, Karin Hoffmann-Sommergruber, Paolo Maria Matricardi, and Ludger Klimek

Subjects
Allergen immunotherapy, Coronavirus disease 2019 (COVID-19), business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Otorhinolaryngology, Dermatology clinic, Pandemic, Immunology, Position paper, Medicine, business, Coronavirus Infections
Published
2020
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27. Cost of scheduled and unscheduled asthma management in seven European Union countries

Author

A. E. Williams, A. C. Lloyd, L. Watson, and K. F. Rabe

Subjects
Asthma, Europe, healthcare costs, Diseases of the respiratory system, RC705-779
Abstract

Frequent need for emergency healthcare indicates poor asthma control and consumes resources that might be better spent on improved management. This study estimated the cost of scheduled and unscheduled healthcare for asthma in seven European Union (EU) countries. The occurrence of asthma-related healthcare resource use and asthma symptom severity were identified from a telephone sample of people with asthma in France, Germany, Italy, the Netherlands, Spain, Sweden and the UK. Healthcare resource use was multiplied by country-specific unit costs to estimate per patient annual expenditure. Patients were divided into four groups according to asthma symptom severity: mild intermittent symptoms, mild persistent symptoms, moderate persistent symptoms and severe persistent symptoms. Cost was divided between scheduled and unscheduled care. Drug cost was not evaluable. The study included 2,803 patients, of whom 1,695 (60%) reported mild symptoms and 2,050 (73%) were aged 16 yrs. The average annual per patient cost was 789 for patients aged 0–4 yrs, 463 for patients aged 5–15 yrs and 566 for adults. Unscheduled care accounted for 47% of total cost in infants, 45% in children and 56% in adults. Around half of expenditure on asthma management was found to be due to unscheduled care regardless of the severity of patient symptoms.

Published
2006

28. [S2k Guideline - Recommendations for Inpatient Therapy of Patients with COVID-19]

Author

S, Kluge, U, Janssens, T, Welte, S, Weber-Carstens, G, Schälte, C D, Spinner, J J, Malin, P, Gastmeier, F, Langer, M, Wepler, M, Westhoff, M, Pfeifer, K F, Rabe, F, Hoffmann, B W, Böttiger, J, Weinmann-Menke, A, Kersten, P, Berlit, R, Haase, G, Marx, and C, Karagiannidis

Subjects
Inpatients, Respiratory Distress Syndrome, SARS-CoV-2, Practice Guidelines as Topic, COVID-19, Humans, Pandemics
Abstract

Since December 2019, the novel coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome - Corona Virus-2) has been spreading rapidly in the sense of a global pandemic. This poses significant challenges for clinicians and hospitals and is placing unprecedented strain on the healthcare systems of many countries. The majority of patients with Coronavirus Disease 2019 (COVID-19) present with only mild symptoms such as cough and fever. However, about 6 % require hospitalization. Early clarification of whether inpatient and, if necessary, intensive care treatment is medically appropriate and desired by the patient is of particular importance in the pandemic. Acute hypoxemic respiratory insufficiency with dyspnea and high respiratory rate ( 30/min) usually leads to admission to the intensive care unit. Often, bilateral pulmonary infiltrates/consolidations or even pulmonary emboli are already found on imaging. As the disease progresses, some of these patients develop acute respiratory distress syndrome (ARDS). Mortality reduction of available drug therapy in severe COVID-19 disease has only been demonstrated for dexamethasone in randomized controlled trials. The main goal of supportive therapy is to ensure adequate oxygenation. In this regard, invasive ventilation and repeated prone positioning are important elements in the treatment of severely hypoxemic COVID-19 patients. Strict adherence to basic hygiene, including hand hygiene, and the correct wearing of adequate personal protective equipment are essential when handling patients. Medically necessary actions on patients that could result in aerosol formation should be performed with extreme care and preparation.Seit Dezember 2019 verbreitet sich das neuartige Coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome – Corona Virus-2) rasch im Sinne einer weltweiten Pandemie. Dies stellt Kliniker und Krankenhäuser vor große Herausforderungen und belastet die Gesundheitssysteme vieler Länder in einem nie dagewesenen Ausmaß. Die Mehrheit der Patienten mit Coronavirus Disease 2019 (COVID-19) zeigt lediglich milde Symptome wie Husten und Fieber. Allerdings benötigen etwa 8 % eine stationäre Behandlung. Der frühzeitigen Klärung, ob eine stationäre und ggfs. intensivmedizinische Behandlung medizinisch sinnvoll und vom Patienten gewollt ist, kommt in der Pandemie eine besondere Bedeutung zu. Die akute hypoxämische respiratorische Insuffizienz mit Dyspnoe und hoher Atemfrequenz ( 30/min) führt i. d. R. zur Aufnahme auf die Intensivstation. Oft finden sich dann bereits bilaterale pulmonale Infiltrate/Konsolidierungen oder auch Lungenembolien in der Bildgebung. Im weiteren Verlauf entwickeln einige dieser Patienten ein akutes Lungenversagen (Acute Respiratory Distress Syndrome; ARDS). Eine Sterblichkeitsreduktion einer verfügbaren medikamentösen Therapie bei schwerer COVID-19-Erkrankung ist bisher lediglich für Dexamethason in randomisiert, kontrollierten Studien nachgewiesen. Das Hauptziel der supportiven Therapie besteht in der Sicherstellung einer ausreichenden Oxygenierung. Die invasive Beatmung und wiederholte Bauchlagerung sind dabei wichtige Elemente in der Behandlung von schwer hypoxämischen COVID-19-Patienten. Die strikte Einhaltung der Basishygiene, einschließlich der Händehygiene, sowie das korrekte Tragen von adäquater persönlicher Schutzausrüstung sind im Umgang mit den Patienten unabdingbar. Medizinisch notwendige Handlungen am Patienten, die zur Aerosolbildung führen könnten, sollten mit äußerster Sorgfalt und Vorbereitung durchgeführt werden.

Published
2021

29. Benefits of Tiotropium/Olodaterol Over Tiotropium Alone in Delaying Clinically Significant Deterioration in Patients with COPD

Author

Wenqiong Xue, Gary T. Ferguson, Dave Singh, Janwillem W. H. Kocks, K. F. Rabe, A. de la Hoz, Jadwiga A. Wedzicha, James D. Chalmers, Ioanna Tsiligianni, and Marc Miravitlles

Subjects
medicine.medical_specialty, COPD, business.industry, Internal medicine, Tiotropium-olodaterol, medicine, In patient, business, medicine.disease
Published
2020
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30. Airway pathology in severe asthma is related to airflow obstruction but not symptom control

Author

Diogenes S. Ferreira, Rafael Stelmach, Monique Buttignol, Alberto Cukier, H. S. Del Frari, Regina Maria Carvalho-Pinto, K. F. Rabe, B. L. Oliveira, Aila Mirtes Teles, Raquel Annoni, Marisa Dolhnikoff, Bianca Bergamo de Araujo-Paulino, Edgard H. Katayama, Marcelo Gervilla Gregório, and Thais Mauad

Subjects
Adult, Male, 0301 basic medicine, Budesonide, medicine.medical_specialty, Immunology, INFLAMAÇÃO, Bronchi, Inflammation, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Maintenance therapy, Prednisone, Internal medicine, Submucosa, medicine, Budesonide, Formoterol Fumarate Drug Combination, Humans, Immunology and Allergy, Anti-Asthmatic Agents, Asthma, business.industry, Middle Aged, respiratory system, medicine.disease, respiratory tract diseases, Airway Obstruction, 030104 developmental biology, medicine.anatomical_structure, 030228 respiratory system, Airway Remodeling, Female, Formoterol, medicine.symptom, Airway, business, medicine.drug
Abstract

Background Patients with asthma present structural and inflammatory alterations that are believed to play a role in disease severity. However, airway remodeling and inflammation have not been extensively investigated in relation to both symptom control and airflow obstruction in severe asthmatics. We aimed to investigate several inflammatory and structural pathological features in bronchial biopsies of severe asthmatics that could be related to symptom control and airflow obstruction after standardized treatment. Methods Fifty severe asthmatics received prednisone 40 mg/d for 2 weeks and maintenance therapy with budesonide/formoterol 400/12 μg twice daily + budesonide/formoterol 200/6 μg as needed for 12 weeks. Endobronchial biopsies were performed at the end of 12 weeks. We performed extensive immunopathological analyses of airway tissue inflammation and remodeling features in patients stratified by asthma symptom control and by airflow obstruction. Results Airway tissue inflammation and remodeling were not associated with symptom control. Asthmatics with persistent airflow obstruction had greater airway smooth muscle (Asm) area with decreased periostin and transforming growth factor beta-positive cells within Asm bundles, in addition to lower numbers of chymase-positive mast cells in the submucosa compared to patients with nonpersistent obstruction. Conclusions Symptom control in severe asthmatics was not associated with airway tissue inflammation and remodeling, although persistent airflow obstruction in these patients was associated with bronchial inflammation and airway structural changes.

Published
2017
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31. Cytokine levels in children and adults with wheezing and asthma show specific patterns of variability over time

Author

M, Weckmann, D, Thiele, L, Liboschik, T, Bahmer, M, Pech, A-M, Dittrich, O, Fuchs, C, Happle, B, Schaub, I, Ricklefs, K F, Rabe, E, von Mutius, G, Hansen, I R, König, M V, Kopp, and P, Zabel

Subjects
Adult, Male, 0301 basic medicine, Time Factors, Adolescent, medicine.medical_treatment, Immunology, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Wheeze, Humans, Immunology and Allergy, Medicine, 610 Medicine & health, Child, Macrophage inflammatory protein, Respiratory Sounds, Asthma, Adults, Cytokines, Season, Variability, Children, business.industry, Interleukin, Original Articles, Models, Theoretical, medicine.disease, 030104 developmental biology, Cytokine, Child, Preschool, Cohort, Bronchitis, Female, Seasons, medicine.symptom, business, Body mass index, Algorithms, 030215 immunology
Abstract

Levels of cytokines are used for in-depth characterization of patients with asthma; however, the variability over time might be a critical confounder. To analyze the course of serum cytokines in children, adolescents and adults with asthma and in healthy controls and to propose statistical methods to control for seasonal effects. Of 532 screened subjects, 514 (91 center dot 5%) were included in the All Age Asthma Cohort (ALLIANCE). The cohort included 279 children with either recurrent wheezing bronchitis (more than two episodes) or doctor-diagnosed asthma, 75 healthy controls, 150 adult asthmatics and 31 adult healthy controls. Blood samples were collected and 25 mu l serum was used for analysis with the Bio-Plex Pr human cytokine 27-Plex assay. Mean age, body mass index and gender in the three groups of wheezers, asthmatic children and adult asthmatics were comparable to healthy controls. Wheezers (34 center dot 5%), asthmatic children (78 center dot 7%) and adult asthmatics (62 center dot 8%) were significantly more often sensitized compared to controls (4 center dot 5, 22 and 22 center dot 6%, respectively). Considering the entire cohort, interleukin (IL)-1ra, IL-4, IL-9, IL-17, macrophage inflammatory protein (MIP)-1-alpha and tumor necrosis factor (TNF)-alpha showed seasonal variability, whereas IL-1 beta, IL-7, IL-8, IL-13, eotaxin, granulocyte colony-stimulating factor (G-CSF), interferon gamma-induced protein (IP)-10, MIP-1 beta and platelet-derived growth factor (PDGF)-BB did not. Significant differences between wheezers/asthmatics and healthy controls were observed for IL-17 and PDGF-BB, which remained stable after adjustment for the seasonality of IL-17. Seasonality has a significant impact on serum cytokine levels in patients with asthma. Because endotyping has achieved clinical importance to guide individualized patient-tailored therapy, it is important to account for seasonal effects.

Published
2020
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32. S102 Eosinophil counts as a predictor of future COPD exacerbations in the DYNAGITO trial

Author

Christine Jenkins, Antonio Anzueto, Florian Voß, A. de la Hoz, Pma Calverley, K. F. Rabe, and Jadwiga A. Wedzicha

Subjects
medicine.medical_specialty, education.field_of_study, COPD, Exacerbation, business.industry, Population, Severe exacerbation, Total population, respiratory system, Eosinophil, medicine.disease, medicine.anatomical_structure, Internal medicine, Post-hoc analysis, medicine, In patient, education, business
Abstract

Background There is conflicting evidence from previous studies as to whether eosinophil counts predict the risk of future exacerbations in COPD. Aims In this post hoc analysis, we investigated the link between baseline eosinophil count and moderate/severe exacerbation rates during the DYNAGITO trial. Methods DYNAGITO was a 52-week, double-blind, randomised trial in patients with COPD with FEV1 Results At baseline, 81% of patients had an eosinophil count ≤300 cells/µL and 49% had an eosinophil count ≤150 cells/µL. 65–76% of patients were receiving ICS across eosinophil subgroups. Similar rates of moderate/severe exacerbations were observed across eosinophil subgroups (figure). Rates were similar across eosinophil counts in patient subgroups with low or high exacerbation history. Conclusions Relatively few patients had an eosinophil count >300 cells/µL, and there was no increase in exacerbation rates with increasing baseline eosinophil count in the total population, or in patients with low or high exacerbation history. In this population, many of whom were receiving ICS, exacerbation history, but not blood eosinophil count, was an important determinant of exacerbation risk.

Published
2019
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33. S29 The impact of GOLD stage on the effectiveness of tiotropium/olodaterol in preventing COPD exacerbations in the DYNAGITO trial

Author

Antonio Anzueto, A. de la Hoz, Christine Jenkins, Pma Calverley, K. F. Rabe, Jadwiga A. Wedzicha, and Florian Voß

Subjects
COPD, medicine.medical_specialty, biology, Exacerbation, business.industry, Olodaterol, Muscarinic antagonist, Lama, medicine.disease, biology.organism_classification, Rate ratio, Gastroenterology, Confidence interval, chemistry.chemical_compound, chemistry, Internal medicine, Bronchodilation, medicine, business, medicine.drug
Abstract

Rationale The DYNAGITO trial investigated the effect of bronchodilation on exacerbation rate in patients with COPD. The observed rates were 0.90 per patient-year with tiotropium/olodaterol (T/O) and 0.97 per patient-year with tiotropium alone (Tio) (rate ratio 0.93; 99% confidence interval 0.85–1.02; P=0.0498). We investigated whether the effect on exacerbation rate was the same across patients with varying degrees of baseline airflow limitation. Methods DYNAGITO was a 52-week, double-blind trial in which patients with COPD were randomized (1:1) to receive T/O 5/5µg or Tio 5µg once daily, delivered via Respimat® (NCT02296138). Patients continued to take inhaled corticosteroids (ICS) if receiving them at baseline. Inclusion criteria included post-bronchodilator FEV1 Results Overall, there were 2,784 patients classed as GOLD 2, 4,039 GOLD 3 and 992 GOLD 4. Baseline COPD treatment differed by GOLD stage. More patients were receiving a long-acting muscarinic antagonist (LAMA) only or LAMA/long-acting β2-agonist (LABA) in GOLD 2 (12.6% and 13.4%) than GOLD 3 (7.5% and 12.0%) or 4 (5.6% and 8.4%), while fewer patients were receiving LAMA/LABA/ICS in GOLD 2 (32.6%) than in GOLD 3 (42.8%) or 4 (47.7%). T/O reduced the exacerbation rate compared with Tio in GOLD 2 and 3 patients, but not in GOLD 4 patients (figure 1). Conclusion The results demonstrate that improving bronchodilation with T/O reduced the exacerbation rate compared with Tio in patients with GOLD 2 and 3 COPD. The lack of effect of bronchodilators in the most severely limited patients has been reported previously (Wedzicha et al. N Engl J Med 2016;374:2222–34) and may reflect the complex contributors to airflow obstruction in very severe COPD.

Published
2019
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34. Comparison of PD-L1 expression between paired cytologic and histologic specimens from non-small cell lung cancer patients

Author

Christiane Kuempers, D. Heigener, M. Reck, L.I.S. van der Linde, K F Rabe, Sven Perner, Wenzel Vogel, Florian Stellmacher, Jutta Kirfel, L Welker, and Markus Reischl

Subjects
0301 basic medicine, Adult, Male, Lung Neoplasms, Concordance, Standard deviation, B7-H1 Antigen, Pathology and Forensic Medicine, 03 medical and health sciences, 0302 clinical medicine, Paired samples, Cytology, Carcinoma, Non-Small-Cell Lung, Biomarkers, Tumor, Medicine, Humans, Lung cancer, Molecular Biology, Predictive biomarker, Aged, Aged, 80 and over, Observer Variation, business.industry, Cell Biology, General Medicine, Middle Aged, medicine.disease, Immunohistochemistry, 030104 developmental biology, 030220 oncology & carcinogenesis, Pd l1 expression, Female, Non small cell, business, Nuclear medicine
Abstract

Expression of programmed death ligand 1 assessed on histologic samples is a confirmed predictive biomarker for anti-PD-1 immunotherapy, but its evaluation is not approved for immunocytochemistry. We investigated if PD-L1 expression shows comparable results on paired cytologic and histologic tumor specimens and interobserver variability. Percentage of PD-L1-positive tumor cells of 247 paired samples of non-small cell lung cancer was evaluated by three independent investigators. Samples were compared on the basis of the continuous values and also categorized with the tumor proportion score (TPS). Concordance was defined if continuous values were both within a deviation of 10% and if categorized values were identically grouped. Interobserver variability was assessed by the standard deviation of the mean. Based on continuous values between paired samples, perfect concordance rate was approximately 53%. With categorization of PD-L1 expression based on TPS, category was identical in 74.1%. However, defining the continuous values of PD-L1 expression between paired samples within a deviation of 10% as concordant, concordance rate was 82%. Interobserver variability was significantly higher in evaluation of cytologic specimens. Evaluation of PD-L1 expression in paired histologic and cytologic tumor specimens shows comparable results if a deviation of 10% between the values is tolerated. Interobserver variability demonstrates a much more challenging interpretation of PD-L1 expression for cytologic samples.

Published
2019

39. Webinar zu Empfehlungen zur stationären Therapie von Patienten mit COVID-19 – Living Guideline

Author

T. Welte, F. Hoffmann, M. Stegemann, M. Krawczyk, B. W. Bottiger, Florian Länger, Christoph D. Spinner, Peter Berlit, K. F. Rabe, Stefan Kluge, Michael Westhoff, W. Nehls, Steffen Weber-Carstens, J. Weinmann-Menke, U. Janssens, S. Laudi, R. Haase, Michael Pfeifer, C. K. F. Fichtner, G. Schalte, M. Wepler, Petra Gastmeier, Gernot Marx, A. Kersten, Jakob J Malin, M. Nothacker, and N. Skoetz

Subjects
2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Anzeige: Webinare zu Leitlinien in der Chirurgie, Emergency medicine, Medicine, Surgery, business
Published
2021

40. Asthma bronchiale – Aktuelle Diagnostik und Therapie

Author

K. F. Rabe and T. Bahmer

Subjects
Pulmonary and Respiratory Medicine, Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, 030228 respiratory system, business.industry, medicine, 030212 general & internal medicine, business
Abstract

Asthma bronchiale ist eine heterogene Erkrankung, die durch eine chronische Atemwegsentzundung charakterisiert ist. Die Unterscheidung unterschiedlicher Phanotypen nach Art der zugrundeliegenden Entzundungsreaktion (TH2 vs. Non-TH2) ist insbesondere bei Patienten mit schwerem, therapierefraktarem Asthma von Bedeutung, da sich neue Therapiestrategien gezielt gegen einzelne TH2-assoziierte Interleukine richten. Fur eine erfolgreiche Asthmabehandlung ist neben der reinen Symptomkontrolle auch die Vermeidung von Exazerbationen und fixierter Atemwegsobstruktion sowie die Kontrolle medikamentoser Nebeneffekte von Bedeutung. Hierfur empfiehlt sich der fruhzeitige Einsatz einer niedrigdosierten inhalativen Kortikosteroidtherapie (ICS), ggf. in Kombination mit einem langwirksamen β‑2-Agonisten (LABA; ICS/LABA-Kombination). Vor etwaigen ICS-Dosissteigerungen sollten verschiedene Faktoren, wie die Inhaliertechnik, uberpruft werden. Nach einer Dosissteigerung durfen kontrollierte ICS-Dosisreduzierungsversuche nicht vergessen werden, um medikamentose Nebenwirkungen zu begrenzen.

Published
2016
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41. [Guideline for the Diagnosis and Treatment of COPD Patients - Issued by the German Respiratory Society and the German Atemwegsliga in Cooperation with the Austrian Society of Pneumology]

Author

C, Vogelmeier, R, Buhl, O, Burghuber, C-P, Criée, S, Ewig, J, Godnic-Cvar, S, Hartl, F, Herth, P, Kardos, K, Kenn, D, Nowak, K F, Rabe, M, Studnicka, H, Watz, T, Welte, W, Windisch, and H, Worth

Subjects
Pulmonary Disease, Chronic Obstructive, Evidence-Based Medicine, Austria, Germany, Pulmonary Medicine, Humans, Societies, Medical
Abstract

This document is a revision of the guideline for diagnosis and treatment of COPD that replaces the version from 2007. A multitude of recent reports regarding risk factors, diagnosis, assessment, prevention and pharmacological as well as non-pharmacological treatment options made a major revision mandatory. The new guideline is based on the GOLD document taking into account specifics in Germany and Austria.Das vorliegende Dokument ist eine Neufassung und Aktualisierung der Leitlinie zur Diagnostik und Therapie von Patienten mit COPD, die die bisherige Version aus dem Jahr 2007 ablöst. Die Fülle an neuen Erkenntnissen zu Risikofaktoren, Diagnostik, Schweregradeinschätzung, Prävention und medikamentösen sowie nicht medikamentösen Therapiemaßnahmen machten eine umfassende Überarbeitung erforderlich. Die neue Leitlinie baut auf das GOLD-Dokument unter Berücksichtigung von Besonderheiten in Deutschland und Österreich auf.

Published
2018

42. The Aging Lung: Clinical and Imaging Findings and the Fringe of Physiological State

Author

C. Weber, K. F. Rabe, B. Storbeck, and T. H. Schröder

Subjects
Lung Diseases, In vivo magnetic resonance spectroscopy, Geriatrics, Aging, medicine.medical_specialty, Pathology, Lung, business.industry, Interstitial fibrosis, Models, Biological, Physiological Aging, medicine.anatomical_structure, Patient age, Ageing, medicine, Humans, Radiology, Nuclear Medicine and imaging, Thickening, Tomography, X-Ray Computed, Intensive care medicine, business
Abstract

Since aspects of demographic transition have become an essential part of socioeconomic, medical and health-care research in the last decades, it is vital for the radiologist to discriminate between normal ageing related effects and abnormal imaging findings in the elderly. This article reviews functional and structural aspects of the ageing lung and focuses on typical ageing related radiological patterns. Key points: • The physiological aging process of the thoracic organs shows typical structural and functional aspects. • Mild interstitial fibrosis and focal parenchymal abnormalities like septal thickening can be diagnosed frequently – whereas a clinical correlate is often lacking. • With increasing patient age, the influence by various intrinsic and extrinsic factors (including comorbidities of the patient, and drug inhalation toxicants) also increases. • A growing spectrum of imaging techniques (including functional cardiopulmonary MRI, MRI spectroscopy, hybrid-techniques) is confronted by rare empiric data in the very old people (aging 80 years and older). Citation Format: • Schroder TH, Storbeck B, Rabe KF. et al. The Aging Lung: Clinical and Imaging Findings and the Fringe of Physiological State. Fortschr Rontgenstr 2015; 187: 430 – 439

Published
2015
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43. [Guideline for the Diagnosis and Treatment of Asthma - Guideline of the German Respiratory Society and the German Atemwegsliga in Cooperation with the Paediatric Respiratory Society and the Austrian Society of Pneumology]

Author

R, Buhl, R, Bals, X, Baur, D, Berdel, C-P, Criée, M, Gappa, A, Gillissen, T, Greulich, P, Haidl, E, Hamelmann, P, Kardos, K, Kenn, L, Klimek, S, Korn, M, Lommatzsch, H, Magnussen, T, Nicolai, D, Nowak, O, Pfaar, K F, Rabe, J, Riedler, T, Ritz, K, Schultz, A, Schuster, T, Spindler, C, Taube, K, Taube, C, Vogelmeier, A, von Leupoldt, F, Wantke, S, Weise, J, Wildhaber, H, Worth, and A, Zacharasiewicz

Subjects
Risk Factors, Austria, Germany, Humans, Prognosis, Asthma, Societies, Medical
Abstract

The present guideline is a new version and an update of the guideline for the diagnosis and treatment of asthma, which replaces the previous version for german speaking countries from the year 2006. The wealth of new data on the pathophysiology and the phenotypes of asthma, and the expanded spectrum of diagnostic and therapeutic options necessitated a new version and an update. This guideline presents the current, evidence-based recommendations for the diagnosis and treatment of asthma, for children and adolescents as well as for adults with asthma.Die vorliegende Leitlinie ist eine Neufassung und Aktualisierung der Leitlinie zur Diagnostik und Therapie von Patienten mit Asthma, welche die bisher für den deutschen Sprachraum gültige Version aus dem Jahr 2006 ablöst. Die Fülle an neuen Erkenntnissen zur Pathophysiologie und zu den Phänotypen von Asthma und das erweiterte Spektrum an diagnostischen und therapeutischen Möglichkeiten bei dieser Erkrankung machte eine Neufassung und Aktualisierung notwendig. Es werden sowohl für Kinder und Jugendliche als auch für Erwachsene mit Asthma die aktuellen, Evidenz-basierten diagnostischen und therapeutischen Empfehlungen dargelegt.

Published
2018

44. Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018): Change management in allergic rhinitis and asthma multimorbidity using mobile technology

Author

Karin C. Lødrup Carlsen, L. Cecchi, F. Portejoie, T. Vontetsianos, Olivier Vandenplas, M. van Hague, D. Mora Bogado, M. Illario, Dana Wallace, L. Namazova-Baranova, E. Asayag, I. Ribeirinho, E. Costa, Shona Pedersen, Inger Kull, Davor Plavec, M. Morais-Almeida, Mickael Bewick, N.H. Chavannes, I. J. Ansotegui, G. De Carlo, K. S. Bennoor, Faradiba Sarquis Serpa, S. Arnavielle, F. Corti, Moises A. Calderon, Martín Bedolla-Barajas, Mette Sørensen, Isabella Annesi-Maesano, Elaine Colgan, Przemyslaw Kardas, M. van Eerd, Jorge Maspero, Valérie Siroux, Isabelle Momas, Ralph Mösges, Yves Dauvilliers, T. Keil, T. Bieber, Marit Westman, Rachel Nadif, O. Pfaar, A.C. Carvalho Coehlo, R. M. Cortés-Grimaldo, I. Skrindo, Piotr Kuna, Nicola Scichilone, Antonella Muraro, Kimihiro Okubo, Paulo Augusto Moreira Camargos, C. Cartier, Oliver Pfaar, K. Ohta, Barbara P. Yawn, Igor Kaidashev, Michel Thibaudon, X. Basagana, I. Kaidashev, Bilun Gemicioglu, S. Genova, Hae-Sim Park, J.J. Matta Campos, Simon Walker, Ulf Darsow, Fulvio Braido, J. Salimäki, T. Zuberbier, Raphaël Chiron, Mohammad Reza Masjedi, G.D. Marshall, Branislava Milenkovic, W. J. Fokkens, Eric D. Bateman, Robert M. Naclerio, Steve Montefort, M. de Fátima Emerson, T. Werfel, Cemal Cingi, A. Szylling, Martin Wagenmann, I. Baiardini, L. T. T. Le, N. Khaltaev, Ki-Suck Jung, Agnieszka Lipiec, Panayiotis K. Yiallouros, A Valero, R. Gerth van Wijk, L. Hernández, Marek L. Kowalski, C. Zubrinich, Sinthia Bosnic-Anticevich, Miguel A. Sierra, Erik Melén, T. Haahtela, Rute Almeida, Violeta Kvedariene, R. Pawankar, T.A. Popov, Flore Amat, Sanna Toppila-Salmi, M. Gotua, A. Sheikh, A. Bedbrook, Torsten Zuberbier, B. De Martino, Gérard Dray, Francesca Avolio, E. Mandajieva, B. Samolinski, Petr Panzner, P. Kuna, Philippe-Jean Bousquet, T. D. Nyembue, Luo Zhang, Leyla Namazova-Baranova, Ana Maria Carriazo, João Fonseca, E. Van Ganse, Roland Buhl, M. Bochenska Marciniak, Cristiana Stellato, J. da Silva, J. E. Gereda, Han-Jung Park, M.C. Costa-Dominguez, W. Carr, Dirceu Solé, S. Forti, Nanshan Zhong, Jordi Sunyer, Alain Didier, Y. Z. Chen, Thomas B. Casale, Jim Phillips, Isabelle Bosse, Manuel Teixeira Veríssimo, D. Y. Wang, U. Trama, Cristina Bárbara, David Somekh, T. Camuzat, R. N. Naclerio, Enrico Novellino, Leszek Klimek, M. Rodriguez Gonzalez, Holger J. Schünemann, Mario Barbagallo, D. Larenas-Linnemann, Mario Sánchez-Borges, Massimo Triggiani, Y. Okamoto, E. Mathieu-Dupas, N. Di Carluccio, S. Toppila-Salmi, Omer Kalayci, Rudolf Valenta, J. Coll, F. de Blay, Wienczyslawa Czarlewski, W. Pohl, Piotr Wroczyński, Kian Fan Chung, Nikolaos G. Papadopoulos, Pascal Demoly, Hubert Blain, M. Crescenzo, O. Kalayci, Leocadio Rodríguez-Mañas, G. Moda, L. Cox, Z. Gutter, A. Mair, Andrew Bush, Maria-Dolores Mogica-Martinez, Giorgio Walter Canonica, Antonio Valero, Daniel Laune, A. Zurkuhlen, Paul C. Potter, D. Wallace, Gabrielle L. Onorato, Mihaela Zidarn, E.P. Prokopakis, Anne Lise Courbis, Sergio Bonini, Ruta Dubakiene, A. Papi, Y. El-Gamal, Jacques Mercier, Wytske Fokkens, Rodolphe Bourret, S. Palkonen, A. Yorgancioglu, G. Vezzani, J. A. Rizzo, D. Plavec, D. Caillot, G. De Feo, E. Menditto, Caterina Bucca, A. C. Pozzi, Hironori Sagara, I. Grisle, I. Pin, Christopher E. Brightling, Ludger Klimek, F.F. Morato-Castro, Désirée Larenas-Linnemann, Alessandro Vatrella, A. A. Cruz, Guy Joos, E.D. Bateman, Erendira Rodriguez-Zagal, H. Douagui, T. To, Edgardo Jares, C. Bindslev-Jensen, G. Levato, J. O. B. Hourihane, R. Rajabian-Soderlund, C. Odzhakova, J. Bousquet, M. T. Ventura, Arzu Yorgancioglu, Osman M. Yusuf, H. J. Zar, Giovanni Rolla, Sebastian L. Johnston, M.S. Dykewicz, Esben Eller, A. Gamkrelidze, Filip Raciborski, Renzo Angles, Rafael Stelmach, M. Nogues, David Price, Mário Morais-Almeida, Tari Haahtela, Teresa To, D. Conforti, Stephen R. Durham, S. Gonzalez Diaz, V. Cardona, Werner Aberer, B. Milenkovic, Luigi Napoli, K. C. Bergmann, P W Hellings, M. Lessa, P. Panzner, Alfonso M. Cepeda Sarabia, M. Guidacci, A.L. Matos, Todor A. Popov, C. Suppli Ulrik, Diana Deleanu, N. de Paula Motta Rubini, Carsten Bindslev-Jensen, I. Majer, Ioana Agache, B. A. Barreto, R. Picard, Erkka Valovirta, A. Fink-Wagner, L. Colas, João O. Malva, Thomas Keil, M. T. Burguete Cabañas, Bolesław Samoliński, M.H. Garcia-Cruz, L.P. Boulet, K. Nekam, Edyta Krzych-Fałta, P. Devillier, J. Ferreira de Mello, Jussi Karjalainen, I. Bogus-Buczynska, Susan Waserman, Marcus Maurer, Tomas Chivato, Elena Bacci, M. Przemecka, Olga Lourenço, José Miguel Fuentes-Pérez, M. Zidarn, Talant Sooronbaev, J.M. Anto, W. Czarlewski, R. Murray, Luís Nogueira-Silva, G. Passalacqua, E. Chkhartishvili, Oscar Mayora, Victoria Cardona, M. Sondermann, Piotr Lacwik, S. Ouedraogo, I. Baroni, Artur Z. Białoszewski, G Scadding, J. Strozek, R. Emuzyte, Neven Miculinic, Ruby Pawankar, Ken Ohta, I. Agache, J.L. Gálvez-Romero, Nikos G. Papadopoulos, E. O. Meltzer, I. Annesi-Maesano, E. De Manuel Keenoy, Jorge A. Luna-Pech, Ana Margarida Pereira, Paul Potter, M. Ortega Cisneros, J. Li, K. F. Rabe, M. Rottem, Mikael Benson, Ali Fuat Kalyoncu, Dermot Ryan, Dieter Maier, C.Y. García-Cobas, S. Bialek, G. Du Toit, S. Shamai, S. Mavale-Manuel, Rojin Rajabian-Soderlund, Maddalena Illario, Philippe Devillier, F. Rodenas, Emmanuel P. Prokopakis, De Yun Wang, Niels H. Chavannes, E.H.D. Bel, Bianca Beghe, Sietze Reitsma, John Wright, O. Lourenço, L.T.T. Le, Josep M. Antó, T. Casale, Paul K. Keith, K. C. Lødrup Carlsen, P. Demoly, Mikael Kuitunen, Marc Humbert, A. M. Cepeda Sarabia, Ignacio J. Ansotegui, M.C. Rizzo, Davide Caimmi, Milan Sova, Nick A. Guldemond, P. Yakovliev, Judah A. Denburg, Jaime Correia de Sousa, Elisabete Melo-Gomes, Aziz Sheikh, I. Bosse, M. M. Ciaravolo, S. Di Capua Ercolano, Alpana Mair, P. Lieberman, Isabella Pali-Schöll, Leif Bjermer, G. De Vries, M. Roman Rodriguez, Johanna Salimäki, Carmen Panaitescu, F. Mihaltan, Giulia De Feo, F. E. R. Simons, A. Blua, B. Mahboub, D. Ryan, M. Bewick, Anabela Mota-Pinto, J.A. Fonseca, Neil Wilson, Marek Jutel, Dennis M. Williams, M. Akdis, Menachem Rottem, Marcello Persico, J. C. Ivancevich, Nelson Rosario, A. Farsi, Alvaro A. Cruz, Liguo Zhang, Anna Bedbrook, L. Bertorello, Magnus Wickman, Marilyn Urrutia-Pereira, O. Spranger, René Maximiliano Gómez, C. Bachert, Renaud Louis, Musa Khaitov, C. Stellato, Constantinos Pitsios, Roland Buonaiuto, A. Romano, Sîan A Williams, R. Puy, Daniela Rivero-Yeverino, Y. Mohammad, J. Farrell, Jan Brozek, Ricardo Pio Monti, E. Paulino, J. Correia de Sousa, Miguel Alejandro Medina-Ávalos, Jocelyne Just, Peter Valentin Tomazic, Jean-François Ferrero, Antoine Magnan, S. Waserman, J Rosado-Pinto, Maciek Kupczyk, C.S. Bosnic-Anticevich, T. Dedeu, Tommi Vasankari, R. Mösges, Robin O'Hehir, Ema Paulino, Peter Hellings, A. Neou, M. Wickman, D. Lauri, Jean Bousquet, A. Ciceran, Jacques Bouchard, Yehia El-Gamal, M.G. Dominguez-Silva, M.R. Alberti, Jean-Louis Pépin, Kimi Okubo, Juan Carlos Ivancevich, Patrik Eklund, Benoit Pugin, C. Dario, Mussa Khaitov, Luisa Brussino, A.G. Chuchalin, Elísio Costa, Susanna Palkonen, Lars Münter, Pedro Carreiro-Martins, R.E. Pulido Ross, Ettore Novellino, Kai-Håkon Carlsen, María Antonieta Guzmán, G.W. Canonica, Gabriel Onorato, Giuseppe De Carlo, R.E. Roller-Wirnsberger, Brian J. Lipworth, M. A. Guzman, J.N. Tebyriçá, Adnan Custovic, Yoshitaka Okamoto, Rimantas Stukas, P. Manning, J. Sastre-Dominguez, Caroline L.S. George, Robyn E O'Hehir, K. Maciej, Bassam Mahboub, J. F. Fontaine, Arũnas Valiulis, Xavier Rodó, D. Vicheva, G. Canfora, Vitalis Briedis, S. Rodrigues Valle, Mark S. Dykewicz, Joanne Rimmer, G. Castellano, B. Pigearias, A. L. Boner, Yunuen Rocío Huerta-Villalobos, Christine Rolland, H. Neffen, H. Arshad, Javier Gómez-Vera, P. Moura Santo, Frederic Viart, F. Blasi, J. Garcia-Aymerich, Lorenzo Cecchi, V. Niedeberger, Giorgio Ciprandi, F. Caballero-Fonseca, Jean-François Fontaine, J Mullol, Maurizio Romano, M. Viegi, Mario E. Zernotti, Arunas Valiulis, Anna Asarnoj, Antonio Nieto, J. Lavrut, D. Dokic, V. Kvedariene, Ewa Jassem, Cezmi A. Akdis, Ruth Murray, Claus Bachert, Peter Schmid-Grendelmeier, Emilie Burte, Joaquim Mullol, Guido Iaccarino, J. Kleine-Tebbe, P. V. Tomazic, E. Eller, Alessandro Fiocchi, H.J. Schunemann, M. Sorlini, C. Robalo-Cordeiro, Ana-Maria Todo-Bom, J. Brozek, Marco Nalin, Matteo Bonini, J. C. Sisul, S.E. Dahlen, F. Amat, Juan Carlos Sisul, Jawad Hajjam, Ana Todo-Bom, Enrica Menditto, Bousquet J., Hellings P.W., Agache I., Amat F., Annesi-Maesano I., Ansotegui I.J., Anto J.M., Bachert C., Bateman E.D., Bedbrook A., Bennoor K., Bewick M., Bindslev-Jensen C., Bosnic-Anticevich S., Bosse I., Brozek J., Brussino L., Canonica G.W., Cardona V., Casale T., Cepeda Sarabia A.M., Chavannes N.H., Cecchi L., Correia de Sousa J., Costa E., Cruz A.A., Czarlewski W., De Carlo G., De Feo G., Demoly P., Devillier P., Dykewicz M.S., El-Gamal Y., Eller E.E., Fonseca J.A., Fontaine J.-F., Fokkens W.J., Guzman M.-A., Haahtela T., Illario M., Ivancevich J.-C., Just J., Kaidashev I., Khaitov M., Kalayci O., Keil T., Klimek L., Kowalski M.L., Kuna P., Kvedariene V., Larenas-Linnemann D., Laune D., Le L.T.T., Carlsen K.L., Lourenco O., Mahboub B., Mair A., Menditto E., Milenkovic B., Morais-Almeida M., Mosges R., Mullol J., Murray R., Naclerio R., Namazova-Baranova L., Novellino E., O'Hehir R.E., Ohta K., Okamoto Y., Okubo K., Onorato G.L., Palkonen S., Panzner P., Papadopoulos N.G., Park H.-S., Paulino E., Pawankar R., Pfaar O., Plavec D., Popov T.A., Potter P., Prokopakis E.P., Rottem M., Ryan D., Salimaki J., Samolinski B., Sanchez-Borges M., Schunemann H.J., Sheikh A., Sisul J.-C., Rajabian-Soderlund R., Sooronbaev T., Stellato C., To T., Todo-Bom A.-M., Tomazic P.-V., Toppila-Salmi S., Valero A., Valiulis A., Valovirta E., Ventura M.-T., Wagenmann M., Wang D.Y., Wallace D., Waserman S., Wickman M., Yorgancioglu A., Zhang L., Zhong N., Zidarn M., Zuberbier T., Aberer W., Akdis C.A., Akdis M., Alberti M.R., Almeida R., Angles R., Arnavielle S., Asayag E., Asarnoj A., Arshad H., Avolio F., Bacci E., Baiardini I., Barbara C., Barbagallo M., Baroni I., Barreto B.A., Basagana X., Bedolla-Barajas M., Beghe B., Bel E.H., Bergmann K.C., Benson M., Bertorello L., Bialoszewski A.Z., Bieber T., Bialek S., Bjermer L., Blain H., Blasi F., Blua A., Bochenska Marciniak M., Bogus-Buczynska I., Boner A.L., Bonini M., Bonini S., Bouchard J., Boulet L.P., Bourret R., Braido F., Briedis V., Brightling C.E., Bucca C., Buhl R., Buonaiuto R., Panaitescu C., Burguete Cabanas M.T., Burte E., Bush A., Caballero-Fonseca F., Caillot D., Caimmi D., Calderon M.A., Camargos P.A.M., Camuzat T., Canfora G., Carreiro-Martins P., Carriazo A.M., Carr W., Cartier C., Castellano G., Chen Y., Chiron R., Chivato T., Chkhartishvili E., Chuchalin A.G., Chung K.F., Ciaravolo M.M., Ciceran A., Cingi C., Ciprandi G., Carvalho Coehlo A.C., Colas L., Colgan E., Coll J., Conforti D., Cortes-Grimaldo R.M., Corti F., Costa-Dominguez M.C., Courbis A.L., Cox L., Crescenzo M., Custovic A., Dahlen S.E., Dario C., da Silva J., Dauvilliers Y., Darsow U., De Blay F., Dedeu T., de Fatima Emerson M., De Vries G., De Martino B., de Paula Motta Rubini N., Deleanu D., Denburg J.A., Di Capua Ercolano S., Di Carluccio N., Didier A., Dokic D., Dominguez-Silva M.G., Douagui H., Dray G., Dubakiene R., Durham S.R., Du Toit G., Eklund P., Emuzyte R., Farrell J., Farsi A., Ferreira de Mello J., Ferrero J., Fink-Wagner A., Fiocchi A., Forti S., Fuentes-Perez J.M., Galvez-Romero J.L., Gamkrelidze A., Garcia-Aymerich J., Garcia-Cobas C.Y., Garcia-Cruz M.H., Gemicioglu B., Genova S., George C., Gereda J.E., Gerth van Wijk R., Gomez R.M., Gomez-Vera J., Gonzalez Diaz S., Gotua M., Grisle I., Guidacci M., Guldemond N.A., Gutter Z., Hajjam J., Hernandez L., Hourihane J.O., Huerta-Villalobos Y.R., Humbert M., Iaccarino G., Jares E.J., Jassem E., Johnston S.L., Joos G., Jung K.S., Jutel M., Kalyoncu A.F., Karjalainen J., Kardas P., Keith P.K., Khaltaev N., Kleine-Tebbe J., Kuitunen M., Kull I., Kupczyk M., Krzych-Falta E., Lacwik P., Lauri D., Lavrut J., Lessa M., Levato G., Li J., Lieberman P., Lipiec A., Lipworth B., Lodrup Carlsen K.C., Louis R., Luna-Pech J.A., Maciej K., Magnan A., Maier D., Majer I., Malva J., Mandajieva E., Manning P., De Manuel Keenoy E., Marshall G.D., Masjedi M.R., Maspero J.F., Mathieu-Dupas E., Matta Campos J.J., Matos A.L., Maurer M., Mavale-Manuel S., Mayora O., Medina-Avalos M.A., Melen E., Melo-Gomes E., Meltzer E.O., Mercier J., Miculinic N., Mihaltan F., Moda G., Mogica-Martinez M.D., Mohammad Y., Momas I., Montefort S., Monti R., Mora Bogado D., Morato-Castro F.F., Mota-Pinto A., Moura Santo P., Munter L., Muraro A., Nadif R., Nalin M., Napoli L., Neffen H., Niedeberger V., Nekam K., Neou A., Nieto A., Nogueira-Silva L., Nogues M., Nyembue T.D., Odzhakova C., Ortega Cisneros M., Ouedraogo S., Pali-Scholl I., Papi A., Passalacqua G., Pedersen S., Pepin J.L., Pereira A.M., Persico M., Phillips J., Picard R., Pigearias B., Pin I., Pitsios C., Pohl W., Portejoie F., Pozzi A.C., Price D., Puy R., Pugin B., Pulido Ross R.E., Przemecka M., Rabe K.F., Raciborski F., Reitsma S., Ribeirinho I., Rimmer J., Rivero-Yeverino D., Rizzo J.A., Rizzo M.C., Robalo-Cordeiro C., Rodenas F., Rodo X., Rodriguez Gonzalez M., Rodriguez-Manas L., Rolland C., Rodrigues Valle S., Roman Rodriguez M., Romano A., Rodriguez-Zagal E., Rolla G., Roller-Wirnsberger R.E., Romano M., Rosado-Pinto J., Rosario N., Sagara H., Sastre-Dominguez J., Scadding G.K., Scichilone N., Schmid-Grendelmeier P., Serpa F.S., Shamai S., Sierra M., Simons F.E.R., Siroux V., Skrindo I., Sole D., Somekh D., Sondermann M., Sova M., Sorensen M., Sorlini M., Spranger O., Stelmach R., Stukas R., Sunyer J., Strozek J., Szylling A., Tebyrica J.N., Thibaudon M., Trama U., Triggiani M., Suppli Ulrik C., Urrutia-Pereira M., Valenta R., van Eerd M., van Ganse E., van Hague M., Vandenplas O., Vezzani G., Vasankari T., Vatrella A., Verissimo M.T., Viart F., Viegi M., Vicheva D., Vontetsianos T., Walker S., Werfel T., Westman M., Williams D.M., Williams S., Wilson N., Wright J., Wroczynski P., Yakovliev P., Yawn B.P., Yiallouros P.K., Yusuf O.M., Zar H.J., Zernotti M.E., Zubrinich C., Zurkuhlen A., Bousquet, Jean, Hellings, Peter W., Agache, Ioana, Amat, Flore, Annesi-Maesano, Isabella, Ansotegui, Ignacio J., Anto, Josep M., Bachert, Clau, Bateman, Eric D., Bedbrook, Anna, Bennoor, Kazi, Bewick, Mickael, Bindslev-Jensen, Carsten, Bosnic-Anticevich, Sinthia, Bosse, Isabelle, Brozek, Jan, Brussino, Luisa, Canonica, Giorgio W., Cardona, Victoria, Casale, Thoma, Cepeda Sarabia, Alfonso M., Chavannes, Niels H., Cecchi, Lorenzo, Correia de Sousa, Jaime, Costa, Elisio, Cruz, Alvaro A., Czarlewski, Wienczyslawa, De Carlo, Giuseppe, De Feo, Giulia, Demoly, Pascal, Devillier, Philippe, Dykewicz, Mark S., El-Gamal, Yehia, Eller, Esben E., Fonseca, Joao A., Fontaine, Jean-Françoi, Fokkens, Wytske J., Guzmán, Maria-Antonieta, Haahtela, Tari, Illario, Maddalena, Ivancevich, Juan-Carlo, Just, Jocelyne, Kaidashev, Igor, Khaitov, Musa, Kalayci, Omer, Keil, Thoma, Klimek, Ludger, Kowalski, Marek L., Kuna, Piotr, Kvedariene, Violeta, Larenas-Linnemann, Desiree, Laune, Daniel, Le, Lan T. T., Carlsen, Karin Lodrup, Lourenço, Olga, Mahboub, Bassam, Mair, Alpana, Menditto, Enrica, Milenkovic, Branislava, Morais-Almeida, Mario, Mösges, Ralph, Mullol, Joaquim, Murray, Ruth, Naclerio, Robert, Namazova-Baranova, Leyla, Novellino, Ettore, O'Hehir, Robyn E., Ohta, Ken, Okamoto, Yoshitaka, Okubo, Kimi, Onorato, Gabrielle L., Palkonen, Susanna, Panzner, Petr, Papadopoulos, Nikos G., Park, Hae-Sim, Paulino, Ema, Pawankar, Ruby, Pfaar, Oliver, Plavec, Davor, Popov, Ted A., Potter, Paul, Prokopakis, Emmanuel P., Rottem, Menachem, Ryan, Dermot, Salimäki, Johanna, Samolinski, Boleslaw, Sanchez-Borges, Mario, Schunemann, Holger J., Sheikh, Aziz, Sisul, Juan-Carlo, Rajabian-Söderlund, Rojin, Sooronbaev, Talant, Stellato, Cristiana, To, Teresa, Todo-Bom, Ana-Maria, Tomazic, Peter-Valentin, Toppila-Salmi, Sanna, Valero, Antonio, Valiulis, Aruna, Valovirta, Erkka, Ventura, Maria-Teresa, Wagenmann, Martin, Wang, De Yun, Wallace, Dana, Waserman, Susan, Wickman, Magnu, Yorgancioglu, Arzu, Zhang, Luo, Zhong, Nanshan, Zidarn, Mihaela, Zuberbier, Torsten, Bousquet, J., Hellings, P. W., Aberer, W., Agache, I., Akdis, C. A., Akdis, M., Alberti, M. R., Almeida, R., Amat, F., Angles, R., Annesi-Maesano, I., Ansotegui, I. J., Anto, J. M., Arnavielle, S., Asayag, E., Asarnoj, A., Arshad, H., Avolio, F., Bacci, E., Bachert, C., Baiardini, I., Barbara, C., Barbagallo, M., Baroni, I., Barreto, B. A., Basagana, X., Bateman, E. D., Bedolla-Barajas, M., Bedbrook, A., Bewick, M., Beghé, B., Bel, E. H., Bergmann, K. C., Bennoor, K. S., Benson, M., Bertorello, L., Białoszewski, A. Z., Bieber, T., Bialek, S., Bindslev-Jensen, C., Bjermer, L., Blain, H., Blasi, F., Blua, A., Bochenska Marciniak, M., Bogus-Buczynska, I., Boner, A. L., Bonini, M., Bonini, S., Bosnic-Anticevich, C. S., Bosse, I., Bouchard, J., Boulet, L. P., Bourret, R., Bousquet, P. J., Braido, F., Briedis, V., Brightling, C. E., Brozek, J., Bucca, C., Buhl, R., Buonaiuto, R., Panaitescu, C., Burguete Cabañas, M. T., Burte, E., Bush, A., Caballero-Fonseca, F., Caillot, D., Caimmi, D., Calderon, M. A., Camargos, P. A. M., Camuzat, T., Canfora, G., Canonica, G. W., Cardona, V., Carlsen, K. H., Carreiro-Martins, P., Carriazo, A. M., Carr, W., Cartier, C., Casale, T., Castellano, G., Cecchi, L., Cepeda Sarabia, A. M., Chavannes, N. H., Chen, Y., Chiron, R., Chivato, T., Chkhartishvili, E., Chuchalin, A. G., Chung, K. F., Ciaravolo, M. M., Ciceran, A., Cingi, C., Ciprandi, G., Carvalho Coehlo, A. C., Colas, L., Colgan, E., Coll, J., Conforti, D., Correia de Sousa, J., Cortés-Grimaldo, R. M., Corti, F., Costa, E., Costa-Dominguez, M. C., Courbis, A. L., Cox, L., Crescenzo, M., Cruz, A. A., Custovic, A., Czarlewski, W., Dahlen, S. E., Dario, C., da Silva, J., Dauvilliers, Y., Darsow, U., De Blay, F., De Carlo, G., Dedeu, T., de Fátima Emerson, M., De Feo, G., De Vries, G., De Martino, B., de Paula Motta Rubini, N., Deleanu, D., Demoly, P., Denburg, J. A., Devillier, P., Di Capua Ercolano, S., Di Carluccio, N., Didier, A., Dokic, D., Dominguez-Silva, M. G., Douagui, H., Dray, G., Dubakiene, R., Durham, S. R., Du Toit, G., Dykewicz, M. S., El-Gamal, Y., Eklund, P., Eller, E., Emuzyte, R., Farrell, J., Farsi, A., Ferreira de Mello, J., Ferrero, J., Fink-Wagner, A., Fiocchi, A., Fokkens, W. J., Fonseca, J. A., Fontaine, J. F., Forti, S., Fuentes-Perez, J. M., Gálvez-Romero, J. L., Gamkrelidze, A., Garcia-Aymerich, J., García-Cobas, C. Y., Garcia-Cruz, M. H., Gemicioğlu, B., Genova, S., George, C., Gereda, J. E., Gerth van Wijk, R., Gomez, R. M., Gómez-Vera, J., González Diaz, S., Gotua, M., Grisle, I., Guidacci, M., Guldemond, N. A., Gutter, Z., Guzmán, M. A., Haahtela, T., Hajjam, J., Hernández, L., Hourihane, J. O. 'B., Huerta-Villalobos, Y. R., Humbert, M., Iaccarino, G., Illario, M., Ivancevich, J. C., Jares, E. J., Jassem, E., Johnston, S. L., Joos, G., Jung, K. S., Jutel, M., Kaidashev, I., Kalayci, O., Kalyoncu, A. F., Karjalainen, J., Kardas, P., Keil, T., Keith, P. K., Khaitov, M., Khaltaev, N., Kleine-Tebbe, J., Klimek, L., Kowalski, M. L., Kuitunen, M., Kull, I., Kuna, P., Kupczyk, M., Kvedariene, V., Krzych-Fałta, E., Lacwik, P., Larenas-Linnemann, D., Laune, D., Lauri, D., Lavrut, J., Le, L. T. T., Lessa, M., Levato, G., Li, J., Lieberman, P., Lipiec, A., Lipworth, B., Lodrup Carlsen, K. C., Louis, R., Lourenço, O., Luna-Pech, J. A., Maciej, K., Magnan, A., Mahboub, B., Maier, D., Mair, A., Majer, I., Malva, J., Mandajieva, E., Manning, P., De Manuel Keenoy, E., Marshall, G. D., Masjedi, M. R., Maspero, J. F., Mathieu-Dupas, E., Matta Campos, J. J., Matos, A. L., Maurer, M., Mavale-Manuel, S., Mayora, O., Medina-Avalos, M. A., Melén, E., Melo-Gomes, E., Meltzer, E. O., Menditto, E., Mercier, J., Miculinic, N., Mihaltan, F., Milenkovic, B., Moda, G., Mogica-Martinez, M. D., Mohammad, Y., Momas, I., Montefort, S., Monti, R., Mora Bogado, D., Morais-Almeida, M., Morato-Castro, F. F., Mösges, R., Mota-Pinto, A., Moura Santo, P., Mullol, J., Münter, L., Muraro, A., Murray, R., Naclerio, R., Nadif, R., Nalin, M., Napoli, L., Namazova-Baranova, L., Neffen, H., Niedeberger, V., Nekam, K., Neou, A., Nieto, A., Nogueira-Silva, L., Nogues, M., Novellino, E., Nyembue, T. D., O'Hehir, R. E., Odzhakova, C., Ohta, K., Okamoto, Y., Okubo, K., Onorato, G. L., Ortega Cisneros, M., Ouedraogo, S., Pali-Schöll, I., Palkonen, S., Panzner, P., Papadopoulos, N. G., Park, H. S., Papi, A., Passalacqua, G., Paulino, E., Pawankar, R., Pedersen, S., Pépin, J. L., Pereira, A. M., Persico, M., Pfaar, O., Phillips, J., Picard, R., Pigearias, B., Pin, I., Pitsios, C., Plavec, D., Pohl, W., Popov, T. A., Portejoie, F., Potter, P., Pozzi, A. C., Price, D., Prokopakis, E. P., Puy, R., Pugin, B., Pulido Ross, R. E., Przemecka, M., Rabe, K. F., Raciborski, F., Rajabian-Soderlund, R., Reitsma, S., Ribeirinho, I., Rimmer, J., Rivero-Yeverino, D., Rizzo, J. A., Rizzo, M. C., Robalo-Cordeiro, C., Rodenas, F., Rodo, X., Rodriguez Gonzalez, M., Rodriguez-Mañas, L., Rolland, C., Rodrigues Valle, S., Roman Rodriguez, M., Romano, A., Rodriguez-Zagal, E., Rolla, G., Roller-Wirnsberger, R. E., Romano, M., Rosado-Pinto, J., Rosario, N., Rottem, M., Ryan, D., Sagara, H., Salimäki, J., Samolinski, B., Sanchez-Borges, M., Sastre-Dominguez, J., Scadding, G. K., Schunemann, H. J., Scichilone, N., Schmid-Grendelmeier, P., Serpa, F. S., Shamai, S., Sheikh, A., Sierra, M., Simons, F. E. R., Siroux, V., Sisul, J. C., Skrindo, I., Solé, D., Somekh, D., Sondermann, M., Sooronbaev, T., Sova, M., Sorensen, M., Sorlini, M., Spranger, O., Stellato, C., Stelmach, R., Stukas, R., Sunyer, J., Strozek, J., Szylling, A., Tebyriçá, J. N., Thibaudon, M., To, T., Todo-Bom, A., Tomazic, P. V., Toppila-Salmi, S., Trama, U., Triggiani, M., Suppli Ulrik, C., Urrutia-Pereira, M., Valenta, R., Valero, A., Valiulis, A., Valovirta, E., van Eerd, M., van Ganse, E., van Hague, M., Vandenplas, O., Ventura, M. T., Vezzani, G., Vasankari, T., Vatrella, A., Verissimo, M. T., Viart, F., Viegi, M., Vicheva, D., Vontetsianos, T., Wagenmann, M., Walker, S., Wallace, D., Wang, D. Y., Waserman, S., Werfel, T., Westman, M., Wickman, M., Williams, D. M., Williams, S., Wilson, N., Wright, J., Wroczynski, P., Yakovliev, P., Yawn, B. P., Yiallouros, P. K., Yorgancioglu, A., Yusuf, O. M., Zar, H. J., Zhang, L., Zhong, N., Zernotti, M. E., Zidarn, M., Zuberbier, T., Zubrinich, C., Zurkuhlen, A., CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Laboratory of clinical immunology, Department of Allergy and Clinical Immunology, Transylvania University of Brasov, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Epidémiologie, Systèmes d'Information, Modélisation, Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Epidemiology of Allergic and Respiratory Diseases Department [iPlesp] (EPAR), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Department of Allergy and Immunology, Hospital Quirónsalud Bizkaia [Bilbao], Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hacettepe University = Hacettepe Üniversitesi, Mechanobiology Institute [Singapore] (MBI), National University of Singapore (NUS), Department of Clinical Epidemiology and Biostatistics and Medicine, McMaster University [Hamilton, Ontario], Department of Dermatology [Graz, Austria], Medical University Graz, Swiss Institute of Allergy and Asthma Research (SIAF), Universität Zürich [Zürich] = University of Zurich (UZH), Department Engineering Quimica (ICEMS), Ghent University Hospital, Istituto Nazionale di Fisica Nucleare, sezione di Bari (INFN, sezione di Bari), Istituto Nazionale di Fisica Nucleare (INFN), IMIM-Hospital del Mar, Generalitat de Catalunya, University of Cape Town, Divisions of Human Genetics Infection, Inflammation and Repair, University of Southampton-School of Medicine, Centre de gérontologie, Department of Pathophysiology and Transplantation, Università degli Studi di Milano = University of Milan (UNIMI), Istituto di Geoscienze e Georisorse, Pavia, Institute of Neurobiology and Molecular Medicine, CNR, Rome, Italy and Department of Medicine-University of Naples Federico II = Università degli studi di Napoli Federico II, Woolcock Institute of Medical Research [Sydney], The University of Sydney, Université Laval [Québec] (ULaval), Departments of Clinical Epidemiology and Biostatistics and Medicine [Ontario], Service greffe de moelle osseuse, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Royal Brompton Hospital, Région Languedoc-Roussillon-Midi-Pyrénées, Vall d'Hebron University Hospital [Barcelona], University of South Florida [Tampa] (USF), Università degli Studi di Firenze = University of Florence (UniFI), University of Michigan, Department of Atmospheric, Centres de Ressources et de Compétences de la Mucoviscidose [Montpellier] (CRCM [Montpellier]), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Service des Maladies Respiratoires, Russian State Medical University, Universidade do Porto, Instituto de Biologia Molecular e Celular (IBMC), UCB Pharma, Colombes, Hôpital Gui de Chauliac [CHU Montpellier], CHU Strasbourg, European Federation of Allergy (EFA), Airways Diseases Patients' Associations, Università degli Studi di Salerno = University of Salerno (UNISA), Laboratoire de recherche sur les mécanismes moléculaires et pharmacologiques de l’obstruction bronchique (LOBIP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Laboratoire de Génie Informatique et Ingénierie de Production (LGI2P), IMT - MINES ALES (IMT - MINES ALES), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Linköping University (LIU), Department of Dermatology and Allergy Centre, Odense University Hospital, Vilnius University [Vilnius], Center of Research in Health Technologies and Information Systems (CINTESIS), Universidade do Porto = University of Porto, Institut d'Electronique du Solide et des Systèmes (InESS), Centre National de la Recherche Scientifique (CNRS), Son Pisa Primary Care Centre, IB-Salut Balearic Health Service, Center for Allergy and Immunology Research [Tbilisi], Department of Dermatology, Helsinki University Hospital-Skin and Allergy Hospital, Swedish Meteorological and Hydrological Institute (SMHI), CORYSS-TESS, Ukrainina Medical Stomatological Academy [Poltava, Ukraine], Institute of Social Medicine, Epidemiology and Health Economics-Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Biologie des organismes marins et écosystèmes (BOME), Muséum national d'Histoire naturelle (MNHN)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), NRC Institute of immunology FMBA, Moscow Russian federation, Allergy and Asthma Center Westend, German Society for Otorhinolaryngology HNS, Rheinische Friedrich-Wilhelms-Universität Bonn, The Institute of Environmental Medicine [Stockholm] (IMM), Karolinska Institutet [Stockholm], Medical University of Łódź (MUL), Hospital Medica Sur, Institut de Recherche en Infectiologie de Montpellier (IRIM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Applied Physical Chemistry Laboratory (APCLab), Institute of Geophysics and Planetary Physics [Los Angeles] (IGPP), University of California [Los Angeles] (UCLA), University of California (UC)-University of California (UC), Équipe de Recherche en Textes, Informatique, Multilinguisme (ERTIM), Institut National des Langues et Civilisations Orientales (Inalco), Institute of Oceanology [China], University of Beira Interior [Portugal] (UBI), Unité de recherche de l'institut du thorax (ITX-lab), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Pulmonary and allergy unit, American University of Sharjah-Rashid Hospital-Dubai Health Authority (DHA), Astrophysique Interprétation Modélisation (AIM (UMR7158 / UMR_E_9005 / UM_112)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Sysdiag-Modélisation et Ingénierie des Systèmes Complexes Biologiques pour le Diagnostic (SysDiag ), BIO-RAD-Centre National de la Recherche Scientifique (CNRS), 'Federico II' University of Naples Medical School, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Pneumology Department, Marius Nasta Institute of Pneumology, Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw - Poland-Faculté de Pharmacie de Paris, Allergy and Clinical Immunology Department, Hospital CUF Descobertas, Universität zu Köln = University of Cologne, Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Section of Otolaryngology-Head & Neck Surgery (OHNS), University of Chicago, Department of Pharmacy Naples, Université de Naples, Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital-Monash University Building, AMREP, Dept. of Electronic Engineering, Chubu University, Department of Otorhinolaryngology, Chiba University Hospital, Department of Allergology and Clinical Immunology, Charles University [Prague] (CU)-Medical Faculty in Pilsen, Department of Earth and Planetary Sciences [Cambridge, USA] (EPS), Harvard University, Allergy and Respiratory Diseases, Università degli studi di Genova = University of Genoa (UniGe), Department of Pediatrics, Nippon Medical School, Centre Hospitalier Universitaire [Grenoble] (CHU), Department of Otorhinolaryngology, Head and Neck Surgery [Mannheim, Germany], University Hospital Mannheim, Laboratoire de physique et chimie des nano-objets (LPCNO), Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Institut National des Sciences Appliquées (INSA)-Université de Toulouse (UT)-Institut National des Sciences Appliquées (INSA)-Université de Toulouse (UT)-Institut de Chimie de Toulouse (ICT), Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Institut de Recherche sur les Systèmes Atomiques et Moléculaires Complexes (IRSAMC), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), CHU Grenoble, Children’s Hospital Srebrnjak [Zagreb, Croatia], Department of Physics [UMIST Manchester], University of Manchester Institute of Science and Technology (UMIST), Laboratori Nazionali del Sud (LNS), Getafe University Hospital, Madrid, Karl-Franzens-Universität Graz, Ecologie comportementale (EC), École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Recherche Agronomique (INRA)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université de Rennes (UR)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université de Bourgogne (UB)-Centre National de la Recherche Scientifique (CNRS), Allergy Asthma and Immunology [Haifa, Israel], Ha'Emek Medical Center, Afula-Rappaport Faculty of Medicine, University of Edinburgh, Medical University of Warsaw - Poland, Department of Allergy and Clinical Immunology [Caracas, Venezuela], Centro Médico Docente La Trinidad, Department of Computer Science [Haifa], University of Haifa [Haifa], Allergy and Respiratory Research Group, Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), National Centre of Cardiology and Internal Medicine, Ministry of Health Kyrgyz Republic, Réseau National de Surveillance Aérobiologique (RNSA), Berkeley Seismological Laboratory, Division of Clinical Immunology and Allergy, University of Naples Federico II = Università degli studi di Napoli Federico II, CIRCE, Ctr Res Energy Resources & Consumpt, Zaragoza 50018, Spain, Vilnius University Clinic of Children's Diseases, Suomen Terveystalo Allergy Clinic, Health Service and Performance Research (HESPER), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Centre d'EPistémologie et d'ERgologie Comparatives (CEPERC), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Institute for Climate and Atmospheric Science [Leeds] (ICAS), School of Earth and Environment [Leeds] (SEE), University of Leeds-University of Leeds, Nova Southeastern University (NSU), Department of Otolaryngology, National University of Singapore (NUS)-Yong Loo Lin School of Medicine, Sachs' Children's Hospital, IAES, Department of Pulmonology, Manisa Celal Bayar University, Center for Evolutionary and Theoretical Immunology [Albuquerque, New Mexico] (CETI), The University of New Mexico [Albuquerque], National Key State Laboratory for ThermoStructural Composites (TSCM), Northwestern Polytechnical University [Xi'an] (NPU), Respiratory and Allergic Diseases, University Clinic of Respiratory and Allergic Diseases Golnik, University Hospital of Cologne [Cologne], Supported by the European Innovation Partnership on Active and Healthy Ageing and POLLAR (EIT Health, European Union)., European Project: 643803,H2020,H2020-HCO-2014,PROEIPAHA(2015), UCL - (MGD) Service de pneumologie, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidemiology of Allergic and Respiratory Diseases Department [Paris] (EPAR), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospital Quiròn Bizkaia Erandio, Université Pierre et Marie Curie - Paris 6 (UPMC), University of Milan, University of Naples Federico II-CNR, Rome, Italy and Department of Medicine, Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Università degli Studi di Firenze = University of Florence [Firenze] (UNIFI), Hôpital Gui de Chauliac, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Università degli Studi di Salerno (UNISA), Institut de Physique du Globe de Paris (IPGP), Centre National de la Recherche Scientifique (CNRS)-Université de La Réunion (UR)-Université Paris Diderot - Paris 7 (UPD7)-IPG PARIS-Institut national des sciences de l'Univers (INSU - CNRS), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin]-Epidemiology and Health Economics, Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Muséum national d'Histoire naturelle (MNHN), University of California-University of California, unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Astrophysique Interprétation Modélisation (AIM (UMR_7158 / UMR_E_9005 / UM_112)), Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris Diderot - Paris 7 (UPD7), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hospital CUF-Descobertas, Universität zu Köln, Medical Faculty in Pilsen-Charles University in Prague - the First Faculty of Medicine, Harvard University [Cambridge], University of Genoa (UNIGE), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut de Chimie de Toulouse (ICT-FR 2599), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Institut de Recherche sur les Systèmes Atomiques et Moléculaires Complexes (IRSAMC), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS), University of Graz, École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Recherche Agronomique (INRA)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université Claude Bernard Lyon 1 (UCBL), Centro Medico-Docente La Trinidad, Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), Università degli studi di Napoli Federico II, Center for Evolutionary and theoretical Immunology, Biology, National Institute for Health Research, CNR, Rome, Italy and Department of Medicine-University of Naples Federico II, Institut national des sciences de l'Univers (INSU - CNRS)-IPG PARIS-Université Paris Diderot - Paris 7 (UPD7)-Université de La Réunion (UR)-Centre National de la Recherche Scientifique (CNRS), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche sur les Systèmes Atomiques et Moléculaires Complexes (IRSAMC), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), Karl-Franzens-Universität [Graz, Autriche], Department of Dermatology, Allergology and Venereology, Clinicum, University of Helsinki, Children's Hospital, Faculty of Law, HUS Children and Adolescents, HUS Inflammation Center, University Hospitals Leuven [Leuven], Universitat Pompeu Fabra [Barcelona]-Catalunya ministerio de salud, University of Zürich [Zürich] (UZH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), University of South Florida (USF), Università degli Studi di Firenze = University of Florence [Firenze], Laboratoire Magmas et Volcans (LMV), Observatoire de Physique du Globe de Clermont-Ferrand (OPGC), Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS)-Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS)-Université Jean Monnet [Saint-Étienne] (UJM)-Centre National de la Recherche Scientifique (CNRS), Universidade do Porto [Porto], Charité - Universitätsmedizin Berlin / Charite - University Medicine Berlin -Epidemiology and Health Economics, Université Pierre et Marie Curie - Paris 6 (UPMC)-Muséum national d'Histoire naturelle (MNHN)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre de Biologie pour la Gestion des Populations (UMR CBGP), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut National de la Recherche Agronomique (INRA)-Centre international d'études supérieures en sciences agronomiques (Montpellier SupAgro)-Université de Montpellier (UM)-Institut de Recherche pour le Développement (IRD [France-Sud])-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Sondra, CentraleSupélec, Université Paris-Saclay (COmUE) (SONDRA), ONERA-CentraleSupélec-Université Paris Saclay (COmUE), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche sur les Systèmes Atomiques et Moléculaires Complexes (IRSAMC), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Toulouse III - Paul Sabatier (UT3), RNSA, Centre d'EPistémologie et d'ERgologie Comparatives - UMR 7304 (CEPERC), Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU), Ear, Nose and Throat, AII - Inflammatory diseases, Pulmonology, Institut de Recherche sur les Systèmes Atomiques et Moléculaires Complexes (IRSAMC), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie de Toulouse (ICT-FR 2599), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), National Institute for Nuclear Physics (INFN), Université Laval, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Università degli Studi di Firenze [Firenze], University of Salerno (UNISA), Centre National de la Recherche Scientifique (CNRS)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Observatoire de Physique du Globe de Clermont-Ferrand (OPGC), Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Centre National de la Recherche Scientifique (CNRS), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Sondra, CentraleSupélec, Université Paris-Saclay (SONDRA), ONERA-CentraleSupélec-Université Paris-Saclay, Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), École normale supérieure - Paris (ENS Paris)-Institut National de la Recherche Agronomique (INRA)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université de Rennes 1 (UR1), Universidade do Minho, İÜC, Cerrahpaşa Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, uBibliorum, and Internal Medicine

Subjects
Allergy, Medicina Básica [Ciências Médicas], asthma -- guideline, Allergic asthma, DECISION-MAKING, Allergic Rhinitis and Its Impact on Asthma, GUIDELINES, Medical and Health Sciences, Medical Records, 0302 clinical medicine, Health care, Immunology and Allergy, 030212 general & internal medicine, asthma, Change management, rhinitis, Immunology, MASK-RHINITIS, ComputingMilieux_MISCELLANEOUS, Rinitis, mobilne aplikacije, upravljanje sprememb, Medical record, GLOBAL STRATEGY, WORK PRODUCTIVITY, Telemedicine, mobile applications, 3. Good health, Asma alérgica, rhiniti, 1107 Immunology, Ciências Médicas::Medicina Básica, klinične poti, allergic -- guideline, Life Sciences & Biomedicine, Human, PATIENT PARTICIPATION, Allergic Rhinitis, medicine.medical_specialty, animal structures, multimorbidity, EUROPEAN INNOVATION PARTNERSHIP, Change Management, [object Object], Settore MED/10 - Malattie Dell'Apparato Respiratorio, Asthma/diagnosis, CHRONIC DISEASES, MACVIA-ARIA, 03 medical and health sciences, medicine, multimorbidnost, QUALITY, Humans, critical pathways, astma -- smernica, Patient participation, Asma, udc:616.2, Asthma, Science & Technology, ARIA, business.industry, Multimorbidity, Rhinitis, Allergic, Settore MED/09 - MEDICINA INTERNA, change management, Mobile Airways Sentinel Network (MASK) Study Group, Guideline, ta3121, medicine.disease, Rinite alérgica, Rhinitis, Allergic/diagnosis, Integrated care, alergijski rinitis -- smernica, Allergic Rhinitis and Its Impact on Asthma, asthma, Change management, rhinitis, Immunology and Allergy, Immunology, 030228 respiratory system, Family medicine, 3121 General medicine, internal medicine and other clinical medicine, Medical Record, Clinical Medicine, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Impact on Asthma
Abstract

Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second change management strategy is proposed by ARIA Phase 4 to increase self-medication and shared decision making in rhinitis and asthma multimorbidity. An innovation of ARIA has been the development and validation of information technology evidence-based tools (Mobile Airways Sentinel Network [MASK]) that can inform patient decisions on the basis of a self-care plan proposed by the health care professional., EAACI -European Academy of Allergy and Clinical Immunology(undefined), info:eu-repo/semantics/acceptedVersion

Published
2018
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45. Roflumilast with long-acting 2-agonists for COPD: influence of exacerbation history

Author

D. Bredenbröker, Leonardo M. Fabbri, Eric D. Bateman, P. M. Calverley, U. M. Goehring, M. Brose, and K. F. Rabe

Subjects
Cyclopropanes, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Exacerbation, Aminopyridines, Respiratory physiology, Rate ratio, Bronchodilators chronic obstructive pulmonary disease dyspnoea exacerbation lung function roflumilast, Placebos, Pulmonary Disease, Chronic Obstructive, Adrenal Cortex Hormones, Internal medicine, medicine, Humans, Adverse effect, Adrenergic beta-2 Receptor Agonists, Lung, Roflumilast, Aged, COPD, business.industry, Middle Aged, medicine.disease, Bronchodilator Agents, Clinical trial, Dyspnea, Anesthesia, Concomitant, Benzamides, Regression Analysis, Female, business, hormones, hormone substitutes, and hormone antagonists, medicine.drug
Abstract

The oral, selective phosphodiesterase type-4 inhibitor roflumilast reduces exacerbations and improves lung function in patients with severe-to-very severe chronic obstructive pulmonary disease (COPD). We investigated the efficacy and safety of roflumilast used concomitantly with long-acting β(2)-agonists (LABAs) to reduce exacerbations, and the influence of exacerbation history. Pooled data were analysed from two 12-month, placebo-controlled roflumilast (500 μg once daily) studies involving 3,091 patients with severe-to-very severe COPD. Approximately half of patients used concomitant LABAs; 39% used concomitant short-acting muscarinic antagonists (SAMAs); 27% were frequent exacerbators (two or more exacerbations per year). Roflumilast reduced the rate of moderate or severe exacerbations, with LABA (rate ratio (RR) 0.79, 95% CI 0.69-0.91; p=0.001) or without LABA (RR 0.85, 95% CI 0.74-0.99; p=0.039) and prolonged time both to first (p=0.035 with LABA, p=0.300 without LABA) and second (p=0.018 with LABA, p=0.049 without LABA) exacerbations. Frequent exacerbators experienced a reduction in moderate or severe exacerbations (RR 0.78, 95% CI 0.66-0.91; p=0.002). Similarly, roflumilast remained effective with concomitant SAMA. No differences arose in adverse events between these subgroups. Roflumilast may be used to reduce exacerbations and improve dyspnoea and lung function, without increasing adverse events in COPD patients receiving concomitant LABAs.

Published
2011
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46. Can anti-IgE therapy prevent airway remodeling in allergic asthma?

Author

William J. Calhoun, K. F. Rabe, N. Smith, and P. Jimenez

Subjects
Lamina reticularis, biology, business.industry, Immunology, Interleukin, Inflammation, Omalizumab, respiratory system, Granulocyte, Immunoglobulin E, respiratory tract diseases, medicine.anatomical_structure, medicine, biology.protein, Immunology and Allergy, Eosinophilia, medicine.symptom, Airway, business, medicine.drug
Abstract

Airway remodeling is a central feature of asthma. It is exemplified by thickening of the lamina reticularis and structural changes to the epithelium, submucosa, smooth muscle, and vasculature of the airway wall. Airway remodeling may result from persistent airway inflammation. Immunoglobulin E (IgE) is an important mediator of allergic reactions and has a central role in airway inflammation and asthma-related symptoms. Anti-IgE therapies (such as omalizumab) have the potential to block an early step in the allergic cascade and therefore have the potential to reduce airway remodeling. The reduction in free IgE levels following anti-IgE therapy leads to reductions in high-affinity IgE receptor (FceRI) expression on mast cells, basophils, and dendritic cells. This combined effect results in attenuation of several markers of inflammation, including peripheral and bronchial tissue eosinophilia and levels of granulocyte macrophage colony-stimulating factor, interleukin (IL)-2, IL-4, IL-5, and IL-13. Considering the previously demonstrated anti-inflammatory effects of anti-IgE therapy, along with results from a small study showing continued benefit after discontinuation of long-term treatment, a larger study to assess its effect on markers of airway remodeling is underway.

Published
2011
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47. The European Union conference on chronic respiratory disease: purpose and conclusions

Author

Marc Decramer, K. F. Rabe, Luke Clancy, A Turnbull, Yves Sibille, Benoit Nemery, Andrew Bush, K-H. Carlsen, Anita K. Simonds, and Thierry Troosters

Subjects
Pulmonary and Respiratory Medicine, Pediatrics, medicine.medical_specialty, COPD, Presidency, business.industry, Respiratory disease, medicine.disease, Pneumonia, Family medicine, Health care, Milestone (project management), medicine, media_common.cataloged_instance, European union, business, Cause of death, media_common
Abstract

On October 19, 2010, the European Respiratory Society (ERS) organised, at the request of the Belgian presidency of the Council of the European Union, the first ever pre-ministerial conference on “Chronic respiratory disease – exploring solutions in the EU”. On October 20, the conclusions of this conference were presented to the conference of the ministers of health and the top policy makers of the 27 EU countries, under the presidency of L. Onkelinkx, the Belgian Health Minister. Finally, several elements of these conclusions were incorporated in European Council conclusions on chronic disease 1. This pre-ministerial conference was the first ever high level conference on chronic respiratory disease and it was a worthwhile milestone in the “Year of the Lung” effort proclaimed by the Forum of International Respiratory Societies (www.yearofthelung.org). The main themes of the conference were prevention and care of respiratory disease, patient empowerment and innovative models of care. There was active participation of patients and patient organisations ( i.e. EFA, the European Federation of Allergy and Airway Disease Patients). Patient empowerment was defined as continuous education for patients, equal access to treatment and a meaningful involvement of patients in the decision making process. The importance of chronic respiratory disease cannot be overestimated. The big five respiratory disorders (chronic obstructive pulmonary disease, COPD, asthma, lung cancer, pneumonia and tuberculosis, are responsible for 20% of mortality worldwide 2, 3. The cost of treating these diseases in Europe is €100 billion annually. COPD affects 210 million people in the world, according to a recent estimation of the World Health Organization (WHO), and 44 million people in Europe 4. It is presently the fourth leading cause of death and it will become the third leading cause of death by 2030. It is currently the first leading cause of healthcare …

Published
2011
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48. Persistency of response to omalizumab therapy in severe allergic (IgE-mediated) asthma

Author

Marc Humbert, Robert Maykut, Clare Peckitt, Jo Leo, Jean Bousquet, Nicola Smith, Z. Siergiejko, Guy Peachey, K. F. Rabe, and E. Swiebocka

Subjects
medicine.medical_specialty, Allergy, Exacerbation, biology, business.industry, Immunology, Omalizumab, Immunoglobulin E, medicine.disease, Surgery, law.invention, Randomized controlled trial, Asthma Control Questionnaire, law, Internal medicine, Immunopathology, medicine, biology.protein, Immunology and Allergy, business, Asthma, medicine.drug
Abstract

P>Background: The physician's global evaluation of treatment effectiveness (GETE) at 16 weeks has been shown to be the most effective assessment of response to omalizumab (XOLAIR (R)). This randomized, open-label, parallel-group study evaluated the persistency of treatment responder classification in patients receiving omalizumab added to optimized asthma therapy (OAT). Methods: Patients (12-75 years, n = 400) with severe allergic asthma, uncontrolled despite Global Initiative for Asthma 2004 Step 4 therapy, received OAT and omalizumab (n = 272) or OAT (n = 128) for 32 weeks. Response or nonresponse was evaluated at Weeks 16 and 32. Response was defined as an investigator's (physician's) GETE rating of excellent or good; nonresponse was defined as a rating of moderate, poor or worsening. Results: Three hundred and forty-nine patients had GETE ratings available at Weeks 16 and 32 (omalizumab n = 258, OAT n = 91). Omalizumab responders of about 171/187 (91.4%)and 44/71 (62.0%) omalizumab nonresponders at Week 16 persisted as responders or nonresponders at Week 32. The investigator's GETE at Week 16 predicted persistency of response or nonresponse to omalizumab at Week 32 for 83.3% (215/258) of patients. OAT patients showed a lower persistency of response (18/28 [64.3%]) and a higher persistency of nonresponse (57/63 [90.5%]) than omalizumab patients. Excellent and good GETE ratings in omalizumab-treated patients were reflected by improvements in exacerbation rates (P

Published
2011
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49. Palliative Care Concepts in Respiratory Disease

Author

K F Rabe and D F Heigener

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Palliative care, business.industry, Palliative Care, Respiratory disease, Symptomatic treatment, MEDLINE, Pulmonary disease, medicine.disease, Respiration, Artificial, Health Services Accessibility, Walkers, Unmet needs, Pulmonary Disease, Chronic Obstructive, Dyspnea, medicine, Humans, Respiratory Insufficiency, Intensive care medicine, business, Lung cancer
Abstract

Many respiratory diseases besides lung cancer are still not curable. There is an unmet need for palliative care, especially in non-malignant conditions. In this article we focus on symptomatic treatment of typical symptoms in respiratory disease beyond causal treatment.

Published
2011
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50. High-affinity immunoglobulin E receptor expression is increased in large and small airways in fatal asthma

Author

Luiz Fernando Ferraz da Silva, Raquel Annoni, I den Otter, Ana Laura N. Carvalho, Thais Mauad, A. van Schadewijk, K. F. Rabe, Ingeborg M. Bajema, Peter J. Sterk, Marisa Dolhnikoff, Pieter S. Hiemstra, Ruy Camargo Pires-Neto, and Diogenes S. Ferreira

Subjects
Allergy, Lung, biology, business.industry, Immunology, Respiratory disease, Immunoglobulin E, medicine.disease, Mast cell, medicine.anatomical_structure, biology.protein, medicine, Immunology and Allergy, Respiratory system, Receptor, business, Respiratory tract
Abstract

Background IgE and its high-affinity receptor FcɛRI play an important role in allergy and asthma. The distribution of FcɛRI expression in the airways and within the airway wall, however, is largely unknown. Objective In this study, we aimed to map the distribution of FcɛRI in different layers of large airways (LA) and small airways (SA) in lung tissue from non-smoking and smoking patients who died of asthma [fatal asthma (FA)] and non-smoking controls (CTR). Methods Postmortem lung tissue from 24 cases of non-smoking FA, 13 smoking FA patients and from 19 subjects who died of non-pulmonary causes (CTR) was immunohistochemically stained for FcɛRI and AA1 (mast cell tryptase marker). The expression of these markers was analysed in inner, muscle, and outer layers of both LA and SA by image analysis. Results FcɛRI expression was higher in non-smoking and smoking FA compared with CTR in the inner and outer layer of SA. In the outer layer of LA, FcɛRI expression was higher in non-smoking FA compared with CTR. AA1 was higher in non-smoking FA compared with smoking FA and CTR in the outer layer of the SA, which was correlated with FcɛRI in this layer. Conclusion Our results show that the expression of FcɛRI is higher in both LA and SA in FA compared with CTR. These differences are predominantly found in the outer layer where they can be attributed in part to the increased mast cell numbers. These results indicate an increased capacity to mount IgE-mediated reactions in FA, both in LA and SA. Cite this as: I. den Otter, L. F. F. Silva, A. L. N. Carvalho, R. C. Pires-Neto, R. Annoni, D. S. Ferreira, I. Bajema, A. van Schadewijk, K. F. Rabe, M. Dolhnikoff, P. J. Sterk, P. S. Hiemstra and T. Mauad, Clinical & Experimental Allergy, 2010 (40) 1473-1481

Published
2010
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