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《重症哮喘的临床问题:迈向精准医学的共识与争议》。

Clinical Issues in Severe Asthma: Consensus and Controversies on the Road to Precision Medicine.

机构信息

Division of Genetics, Genomics, and Precision Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, AZ; Division of Pharmacogenomics, Center for Applied Genetics and Genomics Medicine, University of Arizona College of Medicine, Tucson, AZ.

Robert Wood Johnson Medical School, University of Pennsylvania, Philadelphia, PA; Clinical & Translational Science, Rutgers Institute for Translational Medicine & Science, University of Pennsylvania, Philadelphia, PA.

出版信息

Chest. 2018 Oct;154(4):982-983. doi: 10.1016/j.chest.2018.08.1022.

Abstract

As seen in this CME online activity (available at http://courses.elseviercme.com/708e), the various forms of asthma affect > 300 million people globally and > 25 million people in the United States. Asthma-related symptoms and exacerbations result in nearly 2 million ED visits annually, and many of these visits lead to inpatient hospital stays. There is an urgent need to improve the care of the estimated 5% to 15% of patients who have severe asthma. Importantly, studies have shown that severe asthma accounts for an outsized proportion of the disease-related morbidity, mortality, and health-care costs. Examining cohorts from several large patient networks that were created to better understand clinical presentations, biopsychosocial consequences, and long-term outcomes of severe asthma revealed substantial disease burden, significant gaps in longitudinal care, and a clear need for additional treatment options. This CME-accredited Clinical Issues program is intended for allergists/clinical immunologists, pulmonologists, and other health-care providers involved in the management of patients with severe asthma. During the activity, a panel of expert faculty will discuss and debate a series of topics related to the evaluation and long-term treatment of various severe asthma phenotypes. Activity topics include education regarding (1) The classification of severe asthma to differentially diagnose patients with disease that is uncontrolled despite relatively intensive therapy; (2) potential phenotypes and available biomarkers, including strengths, limitations, and how to translate results into the selection of therapies; and (3) the different mechanisms of action, efficacy, and safety of biologic therapies that target the pathophysiology of severe asthma. The goal is to provide clinician learners with the latest evidence and a fresh perspective on evolving management paradigms for severe asthma.

摘要

在这个 CME 在线活动(可在 http://courses.elseviercme.com/708e 上获得)中,可以看到,各种形式的哮喘影响着全球超过 3 亿人,以及美国超过 2500 万人。哮喘相关的症状和恶化导致每年近 200 万次 ED 就诊,其中许多就诊导致住院治疗。迫切需要改善估计有 5%至 15%的重度哮喘患者的护理。重要的是,研究表明,重度哮喘占与疾病相关的发病率、死亡率和医疗保健费用不成比例的比例。从几个旨在更好地了解严重哮喘的临床表现、心理社会后果和长期结局的大型患者网络中检查队列,揭示了大量的疾病负担、纵向护理方面的显著差距,以及明显需要更多的治疗选择。这个获得 CME 认证的临床问题项目面向参与管理重度哮喘患者的过敏症专家/临床免疫学家、肺科医生和其他医疗保健提供者。在活动期间,一组专家教员将讨论和辩论一系列与各种重度哮喘表型的评估和长期治疗相关的主题。活动主题包括:(1) 严重哮喘的分类,以对尽管接受了相对强化治疗但仍未控制的疾病进行差异化诊断;(2) 潜在表型和可用的生物标志物,包括优势、局限性以及如何将结果转化为治疗选择;以及(3) 靶向重度哮喘病理生理学的生物疗法的不同作用机制、疗效和安全性。目标是为临床学习者提供最新的证据和对重度哮喘不断发展的管理模式的新视角。

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