Reassessment of the Need for Asthmatic Patients for Biologic Treatment in a Tertiary Care Hospital

Reassessment of the Need for Asthmatic Patients for Biologic Treatment in a Tertiary Care Hospital

 Asthma is a common chronic inflammatory airway condition. In difficult-to-treat asthma, poor control can be linked to multiple factors like the presence of uncontrolled comorbidities (e.g. gastroesophageal reflux and allergic rhinitis), as well as to poor inhaler use techniques and adherence. In th...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) Vol. 15; no. 3; p. e36288
Main Authors: Alyami, Sami M, Alshahwan, Mosaad I, Alshammari, Hamad S, Abugamza, Faisal M, Alotaibi, Sultan N, Abuoliat, Omar A
Format: Journal Article
Language:English
Published: United States Cureus Inc 17-03-2023
Cureus
Subjects:
Allergy/Immunology
Asthma
Biological products
Family/General Practice
Females
Gastroesophageal reflux
Hay fever
Inhalers
Obesity
Overweight
Patients
Pulmonology
Questionnaires
Rhinitis
Sinusitis
Sleep apnea
Smoking
Social sciences
Saudi Arabia
Riyadh Saudi Arabia
obstructive sleep apnea
asthma
biologics
rhinosinusitis
gastroesophageal reflux
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Summary: Asthma is a common chronic inflammatory airway condition. In difficult-to-treat asthma, poor control can be linked to multiple factors like the presence of uncontrolled comorbidities (e.g. gastroesophageal reflux and allergic rhinitis), as well as to poor inhaler use techniques and adherence. In this study we wanted to evaluate our severe asthma patients already on a biologic treatment with regard to presence of any of these factors.  Method: A questionnaire-based study, filled by investigators through direct interview with patients. We included all asthma patients on biologic treatment at King Abdul Aziz Medical City, Riyadh, KSA. Started in October 2020 and ended in December 2020. The questionnaire had a demographic section and sections for asthma symptoms, compliance, inhaler techniques, and comorbidities.  Case series of N=38 severe asthma patients showed that majority had partially controlled or uncontrolled asthma (66%). Some 42% had intermediate/high risk for obstructive sleep apnea (OSA) based on the common screening tool "STOPBANG" score. Some 47% of our patients had uncontrolled gastro-esophageal reflux disease (GERD), and majority (80%) had uncontrolled allergic rhinitis. Only half of them demonstrated appropriate inhaler technique. And none of them was found exposed to asthma triggers at the time of interview. Significant number of severe uncontrolled asthmatic patients were shown to be associated with at least one comorbid condition that might be interfering with patients' improvement in asthmatic symptoms. By taking appropriate measures toward management and controlling of those comorbid conditions and also educating patients about technique to use inhalers might show notable improvement in asthmatic patients' condition.
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ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.36288