Asthma diagnosis and treatmentPredicting episodes of poor asthma control in treated patients with asthma
Section snippets
Subjects and design
Over the period from September 15 to November 30, 2000, a total of 2032 patients with asthma were recruited by 19 centers of the American Lung Association Asthma Clinical Research Centers to evaluate the safety of influenza vaccine with respect to asthma exacerbations. The study was a randomized, double-masked, crossover trial of influenza vaccine and placebo administration (vaccine followed by placebo or placebo followed by vaccine) separated by 2 to 4 weeks (mean, 22 days). Patients were
Results
Of 2032 patients initially enrolled and assigned to vaccine administration, 2009 (98.9%) received both injections, 1952 (96.1%) received both injections and completed 14-day diaries after each postinjection period, and 1949 also completed baseline questionnaires. The group with complete diary data (28 days) and baseline questionnaires was included in our current analysis, combining postvaccine and postplacebo data. Peak flow was measured at the time of each injection in 1821 (93.3%) and FEV1
Discussion
In our study of patients with asthma recruited for a relatively short-term trial of influenza vaccine, we found factors suggestive of an increased risk of subsequent episodes of poor asthma control and exacerbation. We studied a large group of physician-diagnosed patients with asthma with wider ranges of age, demographics, and disease severity than are usually reported. Although we excluded individuals with current or recent exacerbations, and individuals under active therapy for an
References (25)
- et al.
Integrating patient preferences into health outcomes assessment: the multiattribute asthma symptom utility index
Chest
(1998) - et al.
Worldwide severity and control of asthma in children and adults: the Global Asthma Insights and Reality surveys
J Allergy Clin Immunol
(2004) - National Center for Health Statistics. Asthma prevalence, health care use and mortality, 2002. Hyattsville (Md):...
- et al.
Pediatric asthma deaths in Victoria: the mild are at risk
Pediatr Pulmonol
(1992) National Asthma Education Program Expert Panel Report: Guidelines for the Diagnosis and Management of Asthma
(1997)Global initiative for asthma: global strategy for asthma management and prevention: NHLBI/VVHO workshop report. National Heart, Lung and Blood Institute publication #95-3659
(1995)The safety of inactivated influenza vaccine in adults and children with asthma
N Engl J Med
(2001)- et al.
Spirometric reference values from a sample of the general U. S. population
Am J Respir Crit Care Med
(1999) - et al.
Comparison of regularly scheduled with as-needed a use of albuterol in mild asthma
N Engl J Med
(1996) - et al.
Additive effects of inhaled formoterol and budesonide on reducing asthma exacerbations: a one-year controlled study
N Engl J Med
(1997)
Long-acting beta2-agonist monotherapy vs continued therapy with inhaled corticosteroids in patients with persistent asthma: a randomized controlled trial
JAMA
Comparison of addition of salmeterol to inhaled steroids with doubling of the dose of inhaled steroids
Am J Respir Crit Care Med
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Supported by the American Lung Association.
Disclosure of potential conflict of interest: K. McCoy has received grant support from Chiron and Inspire Pharmaceuticals. C. G. Irvin has consulting arrangements with Biogen, MethaPharm, Merck, and Sepracor; has received grant support from GlaxoSmithKline; and is on the speakers' bureau for Merck. J. G. Mastronarde has received grant support from Pfizer and is on the speaker's bureau for GlaxoSmithKline. N. A. Hanania has received grant support from GlaxoSmithKline and Sepracor and is on the speakers' bureau for GlaxoSmithKline and Genentech. N. R. Anthonisen has served on advisory boards for GlaxoSmithKline and Altana and has received honoraria from GlaxoSmithKline. The rest of the authors have declared that they have no conflict of interest.
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Participating centers listed in Appendix B.