1. More than a decade follow-up in patients with severe or difficult-to-treat asthma: The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) II.
- Author
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Chipps BE, Haselkorn T, Paknis B, Ortiz B, Bleecker ER, Kianifard F, Foreman AJ, Szefler SJ, and Zeiger RS
- Subjects
- Adrenal Cortex Hormones immunology, Adult, Asthma immunology, Clinical Protocols, Cohort Studies, Cross-Sectional Studies, Disease Progression, Female, Follow-Up Studies, Humans, Immunoglobulin E immunology, Lung drug effects, Lung immunology, Male, Middle Aged, Quality of Life, Severity of Illness Index, Anti-Asthmatic Agents therapeutic use, Asthma drug therapy, Asthma epidemiology
- Abstract
Background: The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR I) study demonstrated high morbidity in patients with severe or difficult-to-treat asthma despite standard-of-care treatment., Objective: We sought to determine the long-term natural history of disease and outcomes in patients in TENOR I after more than a decade., Methods: TENOR I was a multicenter observational study (2001-2004) of 4756 patients with severe or difficult-to-treat asthma. TENOR II was a follow-up study of TENOR I patients using a single cross-sectional visit in 2013/2014. Overall, the sites participating in TENOR II originally enrolled 1230 patients in TENOR I. Clinical and patient-reported outcomes were assessed, including very poorly controlled asthma based on National Heart, Lung, and Blood Institute guidelines., Results: A total of 341 (27.7%) patients were enrolled in TENOR II and were representative of the TENOR I cohort. The most frequent comorbidities were rhinitis (84.0%), sinusitis (47.8%), and gastroesophageal reflux disease (46.3%). Mean percent predicted prebronchodilator and postbronchodilator FEV
1 were 72.7% (SD, 21.4%) and 78.2% (SD, 20.7%), respectively. A total of 231 (72.9%) of 317 patients had positive test responses to 1 or more allergen-specific IgEs. The mean blood eosinophil count was 200/μL (SD, 144/μL). Eighty-eight (25.8%) patients experienced an asthma exacerbation in the prior 3 months requiring hospital attention, oral corticosteroids, or both. More than half (197/339 [58.1%]) had very poorly controlled asthma. Medication use suggested undertreatment., Conclusion: TENOR II provides longitudinal data to characterize disease progression, heterogeneity, and severity in patients with severe or difficult-to-treat asthma. Findings show continued morbidity, including a high degree of comorbid conditions, allergic sensitization, exacerbations, and very poorly controlled asthma, including reduced lung function., (Copyright © 2017. Published by Elsevier Inc.)- Published
- 2018
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