Publications by authors named "Luis Perez de Llano"
Erratum to 'Cough severity visual analog scale scores and quality of life in patients with refractory or unexplained chronic cough' [Respir Investig 62(6) (2024), 987-994].
Respir Investig
December 2024
Article Synopsis
- This study investigates how the severity of chronic cough affects the quality of life (QoL) and other outcomes for Spanish patients with refractory chronic cough (RCC) or unexplained chronic cough (UCC).
- Patients self-reported cough severity using various tools, and their results were categorized into three groups based on cough severity scores, revealing a direct link between higher severity and worse QoL.
- The findings suggest that patients with more severe coughs reported greater negative impacts on their daily lives, indicating they may need more targeted treatment interventions.
Background: Biologic asthma therapies reduce exacerbations and long-term oral corticosteroids (LTOCS) use in randomized controlled trials (RCTs); however, there are limited data on outcomes among patients ineligible for RCTs. Hence, we investigated responsiveness to biologics in a real-world population of adults with severe asthma.
Methods: Adults in the International Severe Asthma Registry (ISAR) with ≥24 weeks of follow-up were grouped into those who did, or did not, initiate biologics (anti-IgE, anti-IL5/IL5R, anti-IL4/13).
Improved phenotyping in pneumonia is necessary to strengthen risk assessment. Via a feasible and multidimensional approach with basic parameters, we aimed to evaluate the effect of host response at admission on severity stratification in COVID-19 and community-acquired pneumonia (CAP). Three COVID-19 and one CAP multicenter cohorts including hospitalized patients were recruited.
View Article and Find Full Text PDFExploring Definitions and Predictors of Response to Biologics for Severe Asthma.
J Allergy Clin Immunol Pract
September 2024
Article Synopsis
Article Synopsis
- The study investigates how pre-biologic biomarker levels, specifically immunoglobulin E (IgE), blood eosinophil count (BEC), and fractional exhaled nitric oxide (FeNO), influence asthma treatment outcomes when patients start biologic therapy.
- Conducted across 23 countries with over 3750 patients, the research focused on changes in exacerbation rates, symptom control, and lung function about a year after starting treatment.
- Results showed that higher levels of BEC and FeNO were linked to significant improvements in lung function for specific biologic therapies, while IgE was not a strong predictor of treatment effectiveness.
Article Synopsis
- There is currently no agreed-upon definition for asthma remission in real life, and the factors that help patients achieve it after starting biologics are not well understood.
- A study analyzed data from 23 countries to see how many adults with severe asthma reached multidomain-defined remission after beginning biologic treatment, using specific criteria for remission.
- Results showed that less than a quarter of participants achieved full remission, with higher chances for those with fewer exacerbations, lower corticosteroid use, and better control and lung function before treatment, suggesting that early intervention is crucial for better outcomes.
Background: Exacerbation frequency strongly influences treatment choices in patients with severe asthma.
Research Question: What is the extent of the variability of exacerbation rate across countries and its implications in disease management?
Study Design And Methods: We retrieved data from the International Severe Asthma Registry, an international observational cohort of patients with a clinical diagnosis of severe asthma. We identified patients aged ≥ 18 years who did not initiate any biologics prior to baseline visit.
Background: There is little agreement on clinically useful criteria for identifying real-world responders to biologic treatments for asthma.
Objective: To investigate the impact of pre-biologic impairment on meeting domain-specific biologic responder definitions in adults with severe asthma.
Methods: This was a longitudinal, cohort study across 22 countries participating in the International Severe Asthma Registry (https://isaregistries.
Article Synopsis
- Previous studies on how comorbidities affect the effectiveness of biologic agents in asthma were limited in size and duration, lacking comparisons between different biologic classes.
- This cohort study analyzed data from the International Severe Asthma Registry across 21 countries to assess changes in asthma outcomes after starting biologic therapy in patients with type 2-related comorbidities.
- Results showed that patients with chronic rhinosinusitis (CRS) and nasal polyps (NPs) experienced significantly better outcomes, including fewer exacerbations and improved asthma control, while allergic rhinitis and atopic dermatitis did not influence therapy effectiveness.
Definitions and measures of asthma control used in clinical trials and practice often vary, as highlighted in the manuscript, "Is asthma control more than just an absence of symptoms? An expert consensus statement". Furthermore, the authors discussed differences between patients and healthcare professionals (HCPs) in terms of understanding and managing asthma. Given these disparities, there is a need for consensus regarding what constitutes well-controlled asthma and, especially, how best it can be measured and recorded.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to evaluate the prevalence and impact of comorbidities in adults with severe asthma, as their presence can complicate asthma management practices.* -
- Data was analyzed from the International Severe Asthma Registry, identifying 30 comorbidities linked to asthma, with findings indicating a significant percentage of patients experience multiple comorbidities that affect their asthma outcomes.* -
- Results showed that patients with specific comorbidities like allergic rhinitis and nasal polyposis had higher rates of asthma exacerbations and were more likely to require long-term oral corticosteroids, highlighting the need for effective management strategies.*
Background: Effectiveness of biologics has neither been established in patients with high oral corticosteroid exposure (HOCS) nor been compared with effectiveness of continuing with HOCS alone.
Objective: To examine the effectiveness of initiating biologics in a large, real-world cohort of adult patients with severe asthma and HOCS.
Methods: This was a propensity score-matched, prospective cohort study using data from the International Severe Asthma Registry.
Article Synopsis
- The SHARP study aimed to gather real-world evidence on severe asthma treatment by linking data from 10 different national registries across Europe, focusing on patients treated with mepolizumab.
- The analysis, which included 912 patients, found that mepolizumab significantly reduced the frequency of asthma exacerbations and the use of maintenance oral glucocorticoids before and during the COVID-19 pandemic.
- The study highlighted considerable variation in patient characteristics and treatment practices between the different registries, emphasizing the diverse nature of severe asthma management in Europe.
Background: Patients with severe asthma may present with characteristics representing overlapping phenotypes, making them eligible for more than one class of biologic. Our aim was to describe the profile of adult patients with severe asthma eligible for both anti-IgE and anti-IL5/5R and to compare the effectiveness of both classes of treatment in real life.
Methods: This was a prospective cohort study that included adult patients with severe asthma from 22 countries enrolled into the International Severe Asthma registry (ISAR) who were eligible for both anti-IgE and anti-IL5/5R.
Background: Severe uncontrolled asthma (SUA) is frequently treated with biologic therapy if a T2 phenotype is found. Bronchoscopy is not routinely recommended in these patients unless a specific indication to rule out comorbidities is present.
Research Question: Is routine bronchoscopy safe and useful in phenotyping and endotyping patients with SUA before the indication of a biologic therapy?
Study Design And Methods: Prospective study of consecutive patients with SUA who were referred to a specialized asthma clinic to assess the indication of a biologic therapy.