European Clinical Respiratory Journal最新文献

{"title":"The complexities of elexacaftor/tezacaftor/ivacaftor therapeutic drug monitoring in a person with cystic fibrosis and <i>Mycobacterium abscessus</i> pulmonary disease.","authors":"Claire Y Mou, Daniel J Henderson, Angela G Matson, Karen M Herd, David W Reid, Timothy Riddles, Ellie Johnson, Brett McWhinney, Rebecca Swenson, Andrew Burke, Ieuan E S Evans","doi":"10.1080/20018525.2025.2458341","DOIUrl":"10.1080/20018525.2025.2458341","url":null,"abstract":"<p><p>Therapeutic drug monitoring (TDM) of elexacaftor/tezacaftor/ivacaftor (ETI) remains challenging due to a lack of clarity around the parameters that govern ETI plasma concentrations, whilst the use of concomitant CYP3A inducers rifabutin and rifampicin is not recommended. We present the complexities of TDM for ETI performed in a person with cystic fibrosis and refractory <i>Mycobacterium abscessus</i> pulmonary disease. Utilising National Association of Testing Authorities (NATA) accredited assays and target considerations published by the Therapeutic Goods Administration (TGA), Australia, ETI plasma concentration variability was monitored over the course of an acute admission with added complexity from an antibiotic regimen including rifabutin, a moderate cytochrome P450 3A (CYP3A) inducer, and clofazimine, a mild CYP3A inhibitor. This case highlights the challenges surrounding ETI TDM in the context of acute severe illness, malnutrition, chronic infection, and drug-to-drug interactions. The marked clinical improvement seen, alongside sustained ETI plasma concentrations and suppressed sweat chloride levels on serial testing, provided reassurance of the use of ETI and rifabutin concomitantly in this case, and highlights the potential utility of TDM in helping guide clinical practice. Though a current barrier to the application of TDM includes ETI only being available as a fixed dose combination.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"12 1","pages":"2458341"},"PeriodicalIF":1.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Idiopathic subglottic stenosis in a 32-year-old pregnant woman.","authors":"Bo Toennesen, Thomas Kjærgaard, Johannes Martin Schmid","doi":"10.1080/20018525.2025.2456312","DOIUrl":"10.1080/20018525.2025.2456312","url":null,"abstract":"<p><p>Diagnosis of subglottic stenosis remains greatly a challenge for physicians due to case rarity and presentation of symptoms imitating several other more prevalent medical disorders. Idiopathic subglottic stenosis most often occurs in previously healthy perimenopausal Caucasian women. Several cases have reported symptom progression and increased stenosis, during or in between pregnancies in younger women. The following case of a 32-year-old woman provides an example of significantly long duration from initial symptom onset to diagnosis of idiopathic subglottic stenosis. Additionally, the case illustrates how pregnancy complicates diagnosis and due to the potential risk of stenosis progression and complications during labour, the patient had to undergo surgery with balloon-dilation at week 17 of pregnancy.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"12 1","pages":"2456312"},"PeriodicalIF":1.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications during chest tube drainage for iatrogenic pneumothorax.","authors":"Birgitte Siem Joensen, Uffe Bodtger, Christian B Laursen, Rob J Hallifax, Beenish Iqbal, Søren Helbo Skaarup","doi":"10.1080/20018525.2025.2453255","DOIUrl":"10.1080/20018525.2025.2453255","url":null,"abstract":"<p><strong>Background: </strong>Iatrogenic pneumothorax is a common complication of diagnostic and therapeutic pulmonary procedures. New guidelines on primary spontaneous pneumothorax suggest ambulatory approaches may be suitable. However, guidance on iatrogenic pneumothorax occurring in patients with impaired lung function, increased age, comorbidity and frailty is lacking, and the safety profile of ambulatory management is not known. The objective was to study the safety of iatrogenic pneumothorax treated with chest tubes and to identify the risks of life-threatening events.</p><p><strong>Methods: </strong>In a retrospective cohort of patients admitted and treated with an adhesive valve-integrated chest tube system, we recorded the incidence of complications. The primary outcome was the incidence of life-threatening events that required urgent medical action. Incidences of serious adverse events, adverse events, serious device-related events and whether outpatient ambulatory treatment would be safe were recorded based on the review of the medical charts.</p><p><strong>Results: </strong>In 97 patients, 6 (6%) life-threatening events occurred, including episodes of respiratory failure and an urgent need for new chest tube insertion. The event incidence was 21% in patients with pre-biopsy saturation below 95% and 1% in patients with saturation above 95%, <i>p</i> = 0.003, and greater if the lung had not expanded on the first radiograph, 25%, after insertion of the chest tube, than if the lung had fully expanded, 4%, or partially expanded, 2%, <i>p</i> = 0.009.</p><p><strong>Conclusions: </strong>The incidence of life-threatening events during chest tube-treated iatrogenic pneumothorax is significant, but acceptable in patients without impaired lung function prior to the procedure and early response to treatment.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"12 1","pages":"2453255"},"PeriodicalIF":1.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detecting respiratory impairment in newly diagnosed rheumatoid arthritis by MRC dyspnoea scale and microfibrillar-associated protein 4.","authors":"Bjørk K Sofiudottir, Sören Möller, Robin Christensen, Stefan Harders, Grith L Sørensen, Jesper Blegvad, Mette Herly, Dzenan Masic, Grazina Urbonaviciene, Frank Andersen, Christin Isaksen, Brian Bridal Løgstrup, Charlotte Hyldgaard, Torkell Ellingsen","doi":"10.1080/20018525.2024.2449270","DOIUrl":"10.1080/20018525.2024.2449270","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the Medical Research Council (MRC) dyspnoea scale and serum Microfibrillar-associated protein 4 (MFAP4) levels for the detection of respiratory impairment in newly diagnosed rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>Patients underwent blood tests, pulmonary function tests (PFT) and dyspnoea assessment using the MRC scale. Respiratory impairment was defined as a diffusion capacity of the lungs for carbon monoxide (DLCO) <80% predicted or FEV1/FVC <70%. The primary outcomes were the MRC and MFAP4's sensitivity, specificity, and diagnostic odds ratio (DOR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>One hundred and thirty-one patients had available baseline tests. Mean age was 57.7 years (SD: 10.9), 61% were female, and 45% had respiratory impairment. For MRC score ≥ 2, the sensitivity was 39.0% (95% CI 26.5; 52.6), specificity 76.4% (95% CI 64.9; 85.6), and DOR 2.07 (95% CI 0.97; 4.40). For MFAP4 > 29.0 U/mL, the sensitivity was 62.7% (95% CI 49.1; 75.0), specificity 56.9% (95% CI 44.7; 68.6), and DOR 2.22 (95% CI 1.10; 4.50). The DOR was 3.01 (95% CI 1.27; 7.16) for MFAP4 detecting respiratory impairment when adjusted for age, sex and smoking status.</p><p><strong>Conclusion: </strong>The MRC dyspnoea score and unadjusted MFAP4 levels were poor predictors of respiratory impairment in patients with early treatment-naïve rheumatoid arthritis.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"12 1","pages":"2449270"},"PeriodicalIF":1.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in pulmonary function in patients with Birt-Hogg-Dubé syndrome: a retrospective cohort study.","authors":"Marie Moldt Holmager, Sarah Wordenskjold Stougaard, Ole Graumann, Marianne Præstegaard, Lilian Bomme Ousager, Lars Lund, Annette Schuster, Casper Falster, Jesper Rømhild Davidsen","doi":"10.1080/20018525.2024.2449271","DOIUrl":"10.1080/20018525.2024.2449271","url":null,"abstract":"<p><strong>Background: </strong>Birt-Hogg-Dubé syndrome (BHD), a rare genetic disease characterized by multiple pulmonary cysts, can lead to spontaneous pneumothorax, cutaneous hamartomas, renal cysts, and renal cell cancer. The overall aim of this study was to assess clinical characteristics of patients with BHD-emphasizing on trends in pulmonary function patterns.</p><p><strong>Methods: </strong>By use of data from electronic patient journals, we conducted a retrospective cohort study on clinical characteristics and pulmonary function tests (PFT) from patients with BHD, who were clinically followed-up in a Danish tertiary referral center for rare and interstitial lung diseases.</p><p><strong>Results: </strong>A total of 101 patients (44 men (43.6%); mean age 48.4 years (SD ± 15.9 years)) with BHD were included. Chest HRCT scans revealed pulmonary cysts in 82.2% of whom 38.6% had experienced at least one pneumothorax (median 2; IQR1-4). Baseline PFT showed FEV1/FVC ratio and RV% within normal values of predicted. In 28.7% of the patients, a slight decrease in DLco below 80% of predicted was observed (mean 86.9% ± SD 15.8%). At two years follow-up, there were no significant declines in FEV1 and FVC, nor after accounting for age, gender, and smoking. At baseline cutaneous manifestations were found in 58.4% of the patients, 47.5% had benign renal cysts, and 11.9% had renal tumours.</p><p><strong>Conclusion: </strong>More than 80% of patients with BHD presented with pulmonary cysts, but consistent with other studies all had normal PFTs at two years follow-up. We conclude that routine monitoring of pulmonary function and pulmonary follow-up may not be necessary in patients with BHD.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"12 1","pages":"2449271"},"PeriodicalIF":1.8,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac troponin and increased mortality risk among individuals with restrictive spirometric pattern on lung function testing.","authors":"Sara Johansson, Petra Sandin, Lenita Lindgren, Nicholas L Mills, Linnea Hedman, Helena Backman, Ulf Nilsson","doi":"10.1080/20018525.2024.2436203","DOIUrl":"10.1080/20018525.2024.2436203","url":null,"abstract":"<p><strong>Background: </strong>Individuals with a restrictive spirometric pattern have a high burden of cardiovascular and metabolic morbidity.</p><p><strong>Objective: </strong>To assess prevalence of elevated cardiac biomarkers among individuals with a restrictive spirometric pattern compared to those with a normal lung function and to evaluate the association between cardiac biomarkers and mortality.</p><p><strong>Methods: </strong>In 2002-04, individuals with airway obstruction were identified from population-based cohorts, together with age- and sex-matched non-obstructive referents. The analysis population consisted of the non-obstructive referents stratified according to whether they had a restrictive spirometric pattern or normal lung function in whom cardiac biomarkers were measured. Deaths were recorded until 31 December 2010.</p><p><strong>Results: </strong>Participants with a restrictive spirometric pattern were older and more likely to be obese with a higher burden of cardiovascular risk factors than those with normal function. Elevated cardiac troponin but not natriuretic peptide levels were more common in those with a restrictive spirometric pattern independent of age, sex, BMI, or risk factors (adjusted OR 1.8, 95% CI 1.29-2.74). At 5 years, death occurred more frequently in participants with restrictive spirometric pattern compared to those with normal function (15.7% [31/197] versus 7.6% [57/751]), with highest mortality rate in those with restriction and elevated cardiac troponin (28.7% [27/94]). Cardiac troponin was independently associated with death among those with a restrictive spirometric pattern (HR 4.91, 95% CI 1.58-15.26) but not in those with normal lung function.</p><p><strong>Conclusion: </strong>Cardiac troponin was elevated more often in people with a restrictive spirometric pattern in whom it was a strong independent predictor of death.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"12 1","pages":"2436203"},"PeriodicalIF":1.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translation and cross-cultural adaptation of the self evaluation of breathing questionnaire (SEBQ) into Danish.","authors":"Karen Hjerrild Andreasson, Julie Sandell Jacobsen, Anja Leth Egsgaard, Kate Rauff Denby, Charlotte Hyldgaard, Uffe Bodtger, Charlotte Suppli Ulrik, Lone Schaadt, Rosalba Courtney, Anne Mette Schmidt","doi":"10.1080/20018525.2024.2413318","DOIUrl":"https://doi.org/10.1080/20018525.2024.2413318","url":null,"abstract":"<p><strong>Background and purpose: </strong>Dysfunctional breathing (DB) with or without an underlying medical condition is associated with impaired quality of life. DB-related symptoms can be measured with the 25-item Self Evaluation of Breathing Questionnaire (SEBQ). However, the SEBQ is not available in Danish.The aim of the present study was to translate and cross-culturally adapt the SEBQ into Danish and to assess the face validity of the Danish version of the questionnaire in individuals with DB-related symptoms.</p><p><strong>Materials and methods: </strong>The SEBQ was translated and cross-culturally adapted into Danish using an internationally acknowledged six-step forward-backward translation guideline in an interactive process with an expert committee of clinicians, translators, methodologists and the SEBQ developer. Face validity was explored through semi-structured interviews with 24 adult individuals with DB-related symptoms (age 20-70 years, female <i>n</i> = 14).</p><p><strong>Results: </strong>The SEBQ was successfully translated and cross-culturally adapted into Danish. Three major modifications were made following the translation process and participant interviews. First, an introductory paragraph, including a recall period of the previous seven days, was added. Second, the administration of the questionnaire was changed from a paper to an electronic version. Finally, adaptations regarding semantic equivalence, especially concerning being 'breathless' and 'short of breath', were performed. The participants expressed that the final version of the SEBQ embraced their DB-related symptoms, was understandable, and easy to complete.</p><p><strong>Conclusion: </strong>The SEBQ is the first available Danish questionnaire to measure DB-related symptoms, following an internationally acknowledged cross-cultural adaptation and face validity evaluation approach. This promising validation should be followed by an assessment of measurement properties in individuals with DB-related symptoms to investigate the adequacy of the SEBQ in a Danish context.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"11 1","pages":"2413318"},"PeriodicalIF":1.8,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors behind favorable long-term lung cancer survival in Norway compared to Denmark: a retrospective cohort study.","authors":"Anja Gouliaev, Janna Berg, Azza A Khalil, Susanne O Dalton, Torben R Rasmussen, Niels L Christensen","doi":"10.1080/20018525.2024.2414485","DOIUrl":"10.1080/20018525.2024.2414485","url":null,"abstract":"<p><strong>Background: </strong>Long-term survival of patients with non-small cell lung cancer (NSCLC) is considerably higher in Norway compared to Denmark, even though diagnostic work-up, treatment, and follow-up are comparable. We aim to explore factors behind favorable long-term survival for lung cancer patients in Norway compared to Denmark.</p><p><strong>Method: </strong>A retrospective cohort study of patients with NSCLC diagnosed between 2014 and 2016. From the Danish Lung Cancer Registry, 1000 patients were randomly selected, and 974 patients were included. From the Norwegian Vestfold Hospital Trust, 220 patients were randomly selected, and 218 were included. Data from medical records were obtained for all patients. The Danish and Norwegian cohorts were compared using the Pearson chi squared test and multivariate logistic regression analysis.</p><p><strong>Results: </strong>The two cohorts were comparable in terms of age, sex, and smoking history. However, the Danish patients had a higher number of pack-years (43.5 vs 34.5 <i>p</i> < 0.001) and more comorbidities. The Norwegian patients had less advanced disease stage (<i>p</i> < 0.001), and a larger proportion was treated with curative intent (90 (41.3%) vs 343 (35.2%), <i>p</i> = 0.063). One-year survival was similar, but the 5-year survival was superior in the Norwegian cohort (58 (26.6%) vs 177 (18.2%), <i>p</i> = 0.005). In a multivariate logistic regression model, adjusted for sex, smoking history, performance status, TNM stage and comorbidity, the odds ratio of being a five-year survivor in Norway was 1.81 (95% CI: 1.11-2.94) compared to Denmark.</p><p><strong>Conclusions: </strong>We found a higher proportion of Norwegian patients diagnosed at potential curable stage and fewer heavy smokers compared to Danish patients. This could contribute to the superior long-term survival found in Norwegian NSCLC patients.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"11 1","pages":"2414485"},"PeriodicalIF":1.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic status and emergency department visits in adults with a history of severe childhood asthma: a register-based study.","authors":"Osman Savran, Klaus Bønnelykke, Charlotte Suppli Ulrik","doi":"10.1080/20018525.2024.2413199","DOIUrl":"https://doi.org/10.1080/20018525.2024.2413199","url":null,"abstract":"<p><strong>Background and objective: </strong>Our knowledge of socioeconomic status (SES) and emergency department (ED) visits in adults with a history of severe childhood asthma is limited. Our aim was, therefore, to investigate these variables in individuals with a history of severe childhood asthma compared to a control population.</p><p><strong>Methods: </strong>The Kongsberg cohort comprises Danish individuals with a history of severe childhood asthma and a previous 4-month stay at an asthma care facility in Kongsberg, Norway, between 1950 and 1979. The cohort was compared 1:1 to sex and age matched controls with no previous diagnosis of or treatment for obstructive airway disease (OAD). Data from the national Danish health registries were used for comparing cases and controls.</p><p><strong>Results: </strong>A total of 1394 adults from the Kongsberg cohort were alive and residing in Denmark (mean age 63 years, 43% females) at the index date (June 2022). A Charlson comorbidity index score of ≥1 was higher in the study cohort compared to controls (7% versus 3%) (<i>p</i> < 0.01). Cases had a 1.5-fold increased likelihood of having a high educational level (<i>p</i> < 0.001) compared to controls. Compared to the controls, cases had a higher risk of all-cause ED visits, with individuals having lower educational levels showing the highest proportion of ED visits. Furthermore, 31.2% and 22.9%, respectively, of cases and controls with high educational levels had had ED visits. Compared to controls, logistic regression analysis revealed a 1.7-fold higher risk of all-cause ED visits in cases (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>In adults with a history of severe childhood asthma, educational level, comorbidity burden, and risk of ED visit were higher compared to matched controls with no history of obstructive airway disease.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"11 1","pages":"2413199"},"PeriodicalIF":1.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11459781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbid allergy and rhinitis and patient-related outcomes in asthma and COPD: a cross-sectional study.","authors":"Zainab Al-Hadrawi, Maaike Giezeman, Mikael Hasselgren, Christer Janson, Marta A Kisiel, Karin Lisspers, Scott Montgomery, Anna Nager, Hanna Sandelowsky, Björn Ställberg, Josefin Sundh","doi":"10.1080/20018525.2024.2397174","DOIUrl":"10.1080/20018525.2024.2397174","url":null,"abstract":"<p><strong>Introduction: </strong>The study aimed to compare prevalence of comorbid allergic manifestations and rhinitis, allergy testing and associations with patient-related outcomes in patients with asthma and COPD.</p><p><strong>Methods: </strong>Cross-sectional study of randomly selected Swedish patients with a doctor's diagnosis of asthma (<i>n</i> = 1291) or COPD (<i>n</i> = 1329). Self-completion questionnaires from 2014 provided data on demographics, rhinitis, allergic symptoms at exposure to pollen or furry pets, exacerbations, self-assessed severity of disease and scores from the Asthma Control Test (ACT) and the COPD Assessment Test (CAT), and records were reviewed for allergy tests.</p><p><strong>Results: </strong>Allergic manifestations were more common in asthma (75%) compared with COPD (38%). Rhinitis was reported in 70% of asthma and 58% of COPD patients. Allergy tests had been performed during the previous decade in 28% of patients with asthma and in 8% of patients with COPD.In patients with asthma; comorbid allergy and rhinitis were both independently associated with increased risk for poor asthma symptom control (ACT < 20) (OR [95% CI] 1.41 [1.05 to 1.87] and 2.13 [1.60 to 2.83]), exacerbations (1.58 [1.15 to 2.17] and 1.38 [1.02 to 1.86]), and self-assessed moderate/severe disease (1.64 [1.22 to 2.18] and 1.75 [1.33 to 2.30]). In patients with COPD, comorbid allergy and rhinitis were both independently associated with increased risk for low health status (CAT ≥ 10) (OR [95% CI] 1.46 [1.20 to 1.95] and 2.59 [1.97 to 3.41]) respectively, with exacerbations during the previous six months (1.91 [1.49 to 2.45] and 1.57 [1.23 to 2.01]), and with self-assessed moderate/severe disease (1.70 [1.31 to 2.22] and 2.13 [1.66 to 2.74]).</p><p><strong>Conclusion: </strong>Allergic manifestations and rhinitis are more common in asthma than COPD but associated with worse outcomes in both diseases. This highlights the importance of examining and treating comorbid allergy and rhinitis, not only in asthma but also in COPD.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"11 1","pages":"2397174"},"PeriodicalIF":1.8,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}