Alyami Sami M, Alshahwan Mosaad I, Alshammari Hamad S, Abugamza Faisal M, Alotaibi Sultan N, Abuoliat Omar A
Medicine, King Abdul Aziz Medical City, Riyadh, SAU.
Pulmonary Medicine, King Saud Bin Abdul Aziz University for Health Sciences College of Medicine, Riyadh, SAU.
Cureus. 2023 Mar 17;15(3):e36288. doi: 10.7759/cureus.36288. eCollection 2023 Mar.
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.
哮喘是一种常见的慢性气道炎症性疾病。在难治性哮喘中，控制不佳可能与多种因素有关，如存在未控制的合并症（如胃食管反流和过敏性鼻炎），以及吸入器使用技术不佳和依从性差。在本研究中，我们想评估已经接受生物治疗的重度哮喘患者是否存在这些因素。方法：一项基于问卷的研究，由研究者通过直接访谈患者来填写。我们纳入了沙特阿拉伯利雅得阿卜杜勒·阿齐兹国王医疗城所有接受生物治疗的哮喘患者。研究于2020年10月开始，2020年12月结束。问卷包括人口统计学部分以及哮喘症状、依从性、吸入器技术和合并症部分。
38例重度哮喘患者的病例系列显示，大多数患者的哮喘处于部分控制或未控制状态（66%）。根据常用筛查工具“STOPBANG”评分，约42%的患者有阻塞性睡眠呼吸暂停（OSA）的中/高风险。约47%的患者有未控制的胃食管反流病（GERD），大多数（80%）有未控制的过敏性鼻炎。只有一半的患者展示了正确的吸入器使用技术。在访谈时，未发现他们中有任何人接触哮喘触发因素。
大量严重未控制的哮喘患者被证明与至少一种可能干扰患者哮喘症状改善的合并症有关。通过对这些合并症采取适当的管理和控制措施，并对患者进行吸入器使用技术教育，可能会使哮喘患者的病情有显著改善。
