TY - JOUR
T1 - Key findings and clinical implications from the Epidemiology and Natural History of Asthma
T2 - Outcomes and Treatment Regimens (TENOR) study
AU - Chipps, Bradley E.
AU - Zeiger, Robert S.
AU - Borish, Larry
AU - Wenzel, Sally E.
AU - Yegin, Ashley
AU - Hayden, Mary Lou
AU - Miller, Dave P.
AU - Bleecker, Eugene R.
AU - Simons, F. Estelle R.
AU - Szefler, Stanley J.
AU - Weiss, Scott T.
AU - Haselkorn, Tmirah
N1 - Funding Information:
Disclosure of potential conflict of interest: B. E. Chipps has consultant arrangements with Alcon, Genentech, AstraZeneca, GlaxoSmithKline, Meda, Novartis, Sunovion, Merck-Schering, ISTA, Quintiles, and Dey; is on the speakers' bureau for Alcon, Genentech, AstraZeneca, GlaxoSmithKline, Meda, Novartis, Sunovion, Merck-Schering, ISTA, and Dey; has received grants for clinical research from Genentech, AstraZeneca, GlaxoSmithKline, Novartis, Sunovion, and Merck-Schering; and has received grants for education activities from Alcon, Genentech, AstraZeneca, GlaxoSmithKline, and Novartis . R. S. Zeiger has consultant arrangements with AstraZeneca, Aerocrine, Genentech, GlaxoSmithKline, Novartis, Sunovion, Schering-Plough, and MedImmune and has received research support from Aerocrine, Genentech, GlaxoSmithKline, and Merck and Co . L. Borish has received honoraria from Merck; has consultant arrangements with Genentech, Endo Pharmaceuticals, Regeneron, Cephalon, Pfizer, and Hoffman-LaRoche; has received research support from Merck and Genentech ; is on committees for the American Academy of Allergy, Asthma & Immunology and the American College of Allergy, Asthma & Immunology; and is a volunteer for the Charlottesville Free Clinic. M. L. Hayden has received speaker's honoraria from TEVA, Merck and Co, and Dey Labs and has consultant arrangements with Sunovion. D. P. Miller's employer has Genentech as a client. E. R. Bleecker has consultant arrangements with Genentech and has received research support from Genentech . F. E. R. Simons has received research support from the Canadian Institutes of Health Research . S. J. Szefler has consultant arrangements with GlaxoSmithKline, Genentech, Merck, Boehringer-Ingelheim, Novartis, and Schering-Plough and has received research support from the National Institutes of Health/National Heart, Lung, and Blood Institute's Childhood Management Program (CAMP); the National Heart, Lung, and Blood Institute's Childhood Asthma Research and Education (CARE); the National Institutes of Health/National Heart, Lung, and Blood Institute's Asthma Clinical Research Network (ACRN); the National Institutes of Health/National Institutes of Allergy and Infectious Disease's Inner City Asthma Consortium (ICAC); GlaxoSmithKline; the National Institutes of Health/National Heart, Lung, and Blood Institute's Asthma Net; and a National Institute of Environmental Health Sciences/Environmental Protection Agency's Childhood Environmental Health Center grant . T. Haselkorn has been a paid consultant to Genentech, Inc since 2002. The rest of the authors declare that they have no relevant conflicts of interest.
PY - 2012/8
Y1 - 2012/8
N2 - Patients with severe or difficult-to-treat asthma are an understudied population but account for considerable asthma morbidity, mortality, and costs. The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study was a large, 3-year, multicenter, observational cohort study of 4756 patients (n = 3489 adults ≥18 years of age, n = 497 adolescents 13-17 years of age, and n = 770 children 6-12 years of age) with severe or difficult-to-treat asthma. TENOR's primary objective was to characterize the natural history of disease in this cohort. Data assessed semiannually and annually included demographics, medical history, comorbidities, asthma control, asthma-related health care use, medication use, lung function, IgE levels, self-reported asthma triggers, and asthma-related quality of life. We highlight the key findings and clinical implications from more than 25 peer-reviewed TENOR publications. Regardless of age, patients with severe or difficult-to-treat asthma demonstrated high rates of health care use and substantial asthma burden despite receiving multiple long-term controller medications. Recent exacerbation history was the strongest predictor of future asthma exacerbations. Uncontrolled asthma, as defined by the 2007 National Heart, Lung, and Blood Institute guidelines' impairment domain, was highly prevalent and predictive of future asthma exacerbations; this assessment can be used to identify high-risk patients. IgE and allergen sensitization played a role in the majority of severe or difficult-to-treat asthmatic patients.
AB - Patients with severe or difficult-to-treat asthma are an understudied population but account for considerable asthma morbidity, mortality, and costs. The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study was a large, 3-year, multicenter, observational cohort study of 4756 patients (n = 3489 adults ≥18 years of age, n = 497 adolescents 13-17 years of age, and n = 770 children 6-12 years of age) with severe or difficult-to-treat asthma. TENOR's primary objective was to characterize the natural history of disease in this cohort. Data assessed semiannually and annually included demographics, medical history, comorbidities, asthma control, asthma-related health care use, medication use, lung function, IgE levels, self-reported asthma triggers, and asthma-related quality of life. We highlight the key findings and clinical implications from more than 25 peer-reviewed TENOR publications. Regardless of age, patients with severe or difficult-to-treat asthma demonstrated high rates of health care use and substantial asthma burden despite receiving multiple long-term controller medications. Recent exacerbation history was the strongest predictor of future asthma exacerbations. Uncontrolled asthma, as defined by the 2007 National Heart, Lung, and Blood Institute guidelines' impairment domain, was highly prevalent and predictive of future asthma exacerbations; this assessment can be used to identify high-risk patients. IgE and allergen sensitization played a role in the majority of severe or difficult-to-treat asthmatic patients.
KW - IgE
KW - TENOR
KW - allergy
KW - asthma control
KW - asthma exacerbations
KW - burden
KW - medication
KW - quality of life
KW - severe or difficult-to-treat asthma
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UR - http://www.scopus.com/inward/citedby.url?scp=84864471456&partnerID=8YFLogxK
U2 - 10.1016/j.jaci.2012.04.014
DO - 10.1016/j.jaci.2012.04.014
M3 - Article
AN - SCOPUS:84864471456
VL - 130
SP - 332-342.e10
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
SN - 0091-6749
IS - 2
ER -