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[Adult asthma exacerbations in questions]
D Montani1, A Cavailles, L Bertoletti
1Service de Pneumologie et de Réanimation Respiratoire, Hôpital Antoine-Béclère, Université Paris-Sud 11, AP-HP, 157 Rue de la Porte-de-Trivaux, 92140 Clamart, France. david.montani@abc.aphp.fr
Revue Des Maladies Respiratoires
|December 18, 2010
Summary
Asthma exacerbations are defined as a worsening of symptoms lasting over 24 hours, requiring treatment changes. Inhaled corticosteroids effectively reduce exacerbation frequency and asthma-related deaths, proving cost-effective.
Area of Science:
- Pulmonology
- Immunology
- Pharmacoeconomics
Context:
- Asthma exacerbations lack a universally consistent definition across international guidelines.
- Pathogenesis involves immune mechanisms and bronchial inflammation triggered by environmental factors.
- Mortality in 2010 was linked to exacerbation progression, often before medical intervention.
Purpose:
- To critically review and revise the definition, pathophysiology, treatment, and cost of adult asthma exacerbations.
- To establish a clear, actionable definition for asthma exacerbations.
- To evaluate the effectiveness and cost-effectiveness of asthma management strategies.
Summary:
- A revised definition of asthma exacerbation is proposed: a deterioration of clinical/functional parameters >24 hours, without baseline return, necessitating treatment change.
- Immune mechanisms and bronchial inflammation are key in exacerbation pathogenesis.
- Inhaled corticosteroids are proven to reduce exacerbation frequency and mortality, offering cost-effectiveness.
Impact:
- Provides a refined definition for consistent clinical application and research.
- Highlights the critical role of inhaled corticosteroids in managing asthma exacerbations and reducing mortality.
- Emphasizes the cost-effectiveness of inhaled corticosteroids in preventing exacerbations and associated healthcare costs.
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