Research Findings on Allergic Asthma Unveiled

Investigators are presenting more than 380 abstracts on preliminary findings in the diagnosis and treatment of allergic diseases at the ACAAI Annual Meeting in Philadelphia, Nov. 9-15. Following are highlights of some key investigations on allergic asthma.

?Global Asthma Physician & Patient (GAPP) Survey: Lack of Communication Between Patients & Physicians in U.S. May Influence Compliance.? (Abstract #4: Nov. 12 at 1:45 p.m.) ? Carlos E. Baena-Cagnani, M.D., Cordoba, Argentina, et al ? Authors identify the GAPP Survey as the first-ever global quantitative survey designed to uncover asthma attitudes and treatment practices among physicians and patients, with the goal of identifying barriers to optimal management. 5,482 interviews were conducted globally of patients and physicians, and parents of children with asthma. They found that 40 percent of patients with asthma don?t believe or aren?t sure asthma attacks can be fatal in people with mild asthma. Patients report that their physicians do not discuss plans for treating asthma (47 percent) or correct inhaler technique (37 percent) as frequently as physicians say that they do (87 percent, 95 percent respectively). Investigators conclude that these discrepancies may contribute to the lack of education, understanding and compliance with asthma treatment.

?Longitudinal Patterns of Disease Activity in Patients Receiving Care in an Inner City Asthma Disease Management Program: The Breathmobile Program.? (Abstract #6: Nov. 12 at 2:15 p.m.) ? Lyne Scott, M.D., Van Nuys, Calif., et al ? In the Breathmobile program, NAEPP guideline criteria are used to evaluate asthma severity at the initial visit and at subsequent visits. In this analysis of 1,372 patients less than 18 years of age at the time of enrollment, investigators found asthma activity varies despite reassessment and adjustment of therapy based on careful tracking within a disease management program. They conclude that these results highlight the need for systematic monitoring of a highly variable and dynamic disease in order to optimize therapy.

?Workday Loss Correlate with Asthma Control.? (Abstract #7: Nov. 12 at 2:30 p.m.) ? Kaiser Lim, M.D., et al, Rochester, Minn. ? A cross-sectional survey of 5,958 subjects with physician-diagnosed asthma was conducted from May through July 2005. Asthma was reported as being completely controlled in 54.4 percent of patients. A total of 89.3 percent reported no workday loss, while 8.9 percent reported 1 to 9 days lost and 1.8 percent reported 10 or more days lost. Only 6.4 percent of well-controlled asthma patients reported work/school days lost compared to 29 percent for the not well-controlled patients. Authors conclude that a high degree of asthma control can be achieved in a population of asthma patients. Assessment of asthma control should be considered as another quality of asthma care performance measure.

?The Association of Body Mass Index (BMI) and Bronchial Asthma in Children at UST Hospital Outpatient Department.? (Abstract #14: Nov. 12 at 2:15 p.m.) ? K.ristine Marie F. Gutierrez, M.D., Quezon City, Philippines, and A.G. Andaya, Manila, Philippines. This study of 230 children age 2-18 years old examines possible age related differences in the relationship between obesity and bronchial asthma. In the children age 10 years and above, the risk of developing bronchial asthma was 25 times greater in obese children, however, in children less than 10 years, obese children were less likely to develop bronchial asthma than non-obese children.

?Maintaining Asthma Control Results in Reduced Asthma Exacerbations, Urgent Care and Hospitalization in Inner City Asthmatic Children.? (Abstract #P75: Nov. 11-12, Noon ? 1:00 p.m.) ? Kenny Y. Kwong, M.D., et al, Los Angeles ? In a retrospective analysis of 1,834 inner-city asthmatic children treated in an asthma disease management program (Breathmobile), investigators show that risk of asthma exacerbations, urgent care visits and hospitalizations are influenced by pattern of asthma control. Patients were stratified into groups depending on the number of visits during year 1 in which their asthma was rated as difficult to control (DTC), moderately controlled (MC) and well controlled (WC). Probability of an acute attack by each follow-up visit during year 2 was higher in patients with DTC and MC asthma compared to patients with WC asthma regardless of initial asthma severity. Probability of an urgent care visit and/or hospitalization by each follow-up visit in year 2 was significantly higher in patients with DTC asthma versus patients with WC asthma.

?Seasonal Variance and Aeroallergen Sensitivity for Status Asthmaticus Admissions to the Pediatric Intensive Care Unit.? (Abstract #P98: Nov. 11-12, Noon ? 1:00 p.m.) ? Pulin Patel, D.O., et al, Detroit ? Investigators noted that asthma exacerbation requiring Pediatric Intensive Care Unit (PICU) admissions is more prevalent during the months of August, September and October at Children?s Hospital in Detroit. The increased PICU rate, however, did not correlate with the aeroallergen sensitivity to the prevalent allergen during these months. Authors conclude that this may be attributed to other factors, such as viral upper respiratory infections, weather changes and medication non-compliance, in addition to aeroallergen sensitivity that predisposes severe asthma exacerbation during the late summer and early fall months.

?Asthma Screening in a School Setting.? (Abstract #P106: Nov. 11-12, Noon ? 1:00 p.m.) ? Ethan Lauf Goldstein, Cherry Hill, N.J., and Donald J. Dvorin, M.D., Philadelphia ? Authors report that approximately 6.3 million school aged children in the U.S. have asthma, with a large number having unidentified symptoms. The negative effects of pediatric asthma include impaired school performance, school absenteeism and impaired exercise tolerance. As part of the Nationwide Asthma Screening Program sponsored by the American College of Allergy, Asthma and Immunology (ACAAI), screening with spirometry, peak flow, SaO2 and validated questionnaires led to physician referrals of 70 percent of the 44 students with no prior history of asthma. History of allergies was a common premorbid condition in referred students.

?Physicians Call for FDA-Approved Nebulizer Medications, Not Manufactured Knockoffs. (Abstract #P242: Nov. 11-12, Noon ? 1:00 p.m.) ? Nancy Sander, Fairfax, Va., and Sandra Fusco-Walker, Lincoln Park, N.Y. ? Prescriptions for FDA-approved nebulizer medications are increasingly substituted with unlawfully manufactured products report the authors. Manufactured under the guise of extemporaneous compounding, these nebulizer products pose health risks for patients and liability risks for physicians. In a survey conducted by Allergy & Asthma Network Mothers of Asthmatics (AANMA) of 438 of its professional members and members of the American College of Allergy, Asthma and Immunology, 98 percent of respondents said it is ?important? or ?critically important? that the nebulizer medications they prescribe are FDA-approved for safety, efficacy and sterility.

About ACAAI

The American College of Allergy, Asthma and Immunology (ACAAI) is a professional medical organization headquartered in Arlington Heights, Ill., that promotes excellence in the practice of the subspecialty of allergy and immunology. The College, comprising more than 5,000 allergists-immunologists and related health care professionals, fosters a culture of collaboration and congeniality in which its members work together and with others toward the common goals of patient care, education, advocacy and research.


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