Key findings and clinical implications from the Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study

Bradley E. Chipps, Robert S. Zeiger, Larry Borish, Sally E. Wenzel, Ashley Yegin, Mary Lou Hayden, Dave P. Miller, Eugene R. Bleecker, F. Estelle R. Simons, Stanley J. Szefler, Scott T. Weiss, Tmirah Haselkorn

Research output: Contribution to journalArticlepeer-review

147 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)332-342.e10
JournalJournal of Allergy and Clinical Immunology
Volume130
Issue number2
DOIs
StatePublished - Aug 2012
Externally publishedYes

Keywords

  • IgE
  • TENOR
  • allergy
  • asthma control
  • asthma exacerbations
  • burden
  • medication
  • quality of life
  • severe or difficult-to-treat asthma

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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