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Getting a Grip on Asthma Control, Severity, & Exacerbations

A working group of experts from the European Respiratory Society (ERS) and the American Thoracic Society (ATS) recently published recommendations for the standardized definition and data collection for assessing asthma severity, asthma control, and asthma exacerbations in clinical trials and clinical practice (www.thoracic.org). “The FDA has traditionally required that increases in lung function (FEV1) be the primary outcome in clinical trials of new asthma therapy, but clinicians realize that the primary goals of patients are to minimize symptoms and prevent asthma attacks or exacerbations,” says Paul Enright, MD, a member of the working group. “Improved lung function is an easily available objective measure of pre-therapy asthma severity and the best test of bronchodilator therapy, but good, long-term asthma control on therapy is an even more important patient-oriented outcome.” Asthma Exacerbations According to Dr. Enright, emergency room visits for asthma indicate a failure of the healthcare system to help patients control their asthma. Asthma exacerbations occur across the spectrum of asthma severity, risk death, and cause considerable anxiety to patients and their families. They are also expensive and associated with significant loss of school days or work. Only in the past decade, however, have exacerbations been used as a primary outcome variable in research into the efficacy of drug treatment in asthma. Exacerbations should prompt changes in treatment, according to the ATS/ERS guidelines. Episodes vary considerably in speed of onset and in time to resolution, ranging from a few minutes to several weeks. They also vary in their absolute severity, both between and within individual patients. Clinical characteristics that cause acute distress and impairment in one patient may represent another...
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