Predicting the benefits of type-2 targeted anti-inflammatory treatment with the prototype Oxford Asthma Attack Risk Scale (ORACLE)

Article Respiratory System

Derivation of a prototype asthma attack risk scale centred on blood eosinophils and exhaled nitric oxide

Simon Couillard et al.

Summary: A risk scale predicting asthma attacks based on blood eosinophil count and exhaled nitric oxide (FeNO) was proposed, showing potential to predict and prevent asthma attacks through anti-inflammatory treatment.

THORAX (2022)

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Article Critical Care Medicine

Efficacy and safety of once-daily single-inhaler triple therapy (FF/UMEC/VI) versus FF/VI in patients with inadequately controlled asthma (CAPTAIN): a double-blind, randomised, phase 3A trial

Laurie A. Lee et al.

Summary: In patients with uncontrolled moderate or severe asthma using ICS/LABA, adding UMEC improved lung function but did not significantly reduce moderate and/or severe exacerbations. Single-inhaler FF/UMEC/VI is an effective treatment option with a favorable risk-benefit profile. Higher dose FF primarily reduced exacerbations, especially in patients with elevated biomarkers of type 2 airway inflammation. Further studies are needed to confirm the effects of type 2 inflammatory biomarkers on treatment outcomes in asthma.

LANCET RESPIRATORY MEDICINE (2021)

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Letter Critical Care Medicine

Fractional Exhaled Nitric Oxide Nonsuppression Identifies Corticosteroid-Resistant Type 2 Signaling in Severe Asthma

Simon Couillard et al.

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2021)

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Article Respiratory System

Patient characteristics, biomarkers and exacerbation risk in severe, uncontrolled asthma

Monica Kraft et al.

Summary: This study identified clinical characteristics and biomarkers associated with elevated exacerbation risk in severe, uncontrolled asthma patients. Factors such as exacerbation history, maintenance corticosteroid use, nasal polyposis, Asian race, geographic region, and elevated blood eosinophil counts and F-ENO concentrations were found to be correlated with increased exacerbation risk when combined or persistently achieving type 2 inflammation criteria.

EUROPEAN RESPIRATORY JOURNAL (2021)

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Article Critical Care Medicine

Baseline FeNO as a prognostic biomarker for subsequent severe asthma exacerbations in patients with uncontrolled, moderate-to-severe asthma receiving placebo in the LIBERTY ASTHMA QUEST study: a post-hoc analysis

William W. Busse et al.

Summary: In this study, higher baseline FeNO levels were associated with greater risk of severe asthma exacerbations in patients with uncontrolled, moderate-to-severe asthma, especially when combined with elevated eosinophil count and prior exacerbations, supporting the added value of FeNO as a prognostic biomarker. Further research is needed to confirm FeNO as an independent predictor for asthma exacerbations.

LANCET RESPIRATORY MEDICINE (2021)

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Article Critical Care Medicine