Expert Panel Report 3: Moving forward to improve asthma care

Advances in pediatric asthma in 2009: Gaining control of childhood asthma

The Emerging Role of Leukotriene Antagonists in Asthma Therapy

Implications of the asthma guidelines for the clinician

Is It Time for Aerobic Exercise to be Included in Asthma Treatment Guidelines?

A Paucity of Outcomes

In 1989, the National Asthma Education and Prevention Program (NAEPP) convened an expert panel to develop a report that would provide a general approach to the treatment of asthma. Expert Panel Report: Guidelines for the Diagnosis and Management of Asthma, or EPR-1, was published in 1991 and was subsequently updated with 2 other reports, EPR-2 in 1997 and the EPR update in 2002. Advances in science and a greater understanding of the pathophysiology of asthma prompted the NAEPP to convene a 3rd expert panel in 2004. After nearly 3 years of work, Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma-Full Report 2007, or EPR-3, was released on August 29, 2007. EPR-3 update from the NAEPP provides health care professionals with new information to improve the care of patients with asthma, including (1) more comprehensive discussion of asthma severity with expanded descriptions of impairment and risk, (2) increased focus on asthma control as a goal of therapy, and (3) expanded discussion of pharmacologic therapy for asthma with updated treatment algorithms. To (1) extract key educational messages from the EPR-3 update that effectively summarize the appropriate management of the patient with asthma and (2) provide supporting literature to substantiate the development of these educational messages. A consensus meeting of 9 asthma experts (4 pharmacists and 5 physicians) was held to discuss the EPR-3 update and condense its content into a usable format for the health care professional. Experts were selected on the basis of several criteria, including (1) affiliation with the NAEPP, (2) expertise in asthma management, and (3) familiarity with managed care processes. The author served as the 10th member and moderator of the meeting. Thorough review of the EPR-3 update resulted in the development of 7 key educational messages that can assist the health care professional in improving the management of the patient with asthma. Each educational message is presented with supporting literature to substantiate its distinction as a key point to be referenced when developing protocols for asthma management within managed care organizations. The complexity of asthma and its treatment has necessitated the development of several guidelines from the NAEPP, with the most recent EPR-3 update being released in late August 2007. One expert consensus has distilled the EPR-3 document into 7 key educational messages that can assist the health care professional in improving the care of the patient with asthma.

Abstract: BACKGROUND: Bronchial Asthma is one of the most common ailments prevalent in the Indian Population. Recent studies have suggested that Vitamin D3 may play a role in modulating immune responses and influencing asthma severity and control. However, the relationship between serum Vitamin D3 levels and asthma severity remains unclear, especially in the Indian population. OBJECTIVE: This study aimed to evaluate the serum Vitamin D3 levels in adults with bronchial asthma and assess its association with the severity of asthma and asthma control. MATERIALS AND METHODS: A cross-sectional study was conducted at the department of respiratory medicine of tertiary care center in western India. Serum Vitamin D3 levels were measured, and asthma severity was categorized using the National Asthma Education and Prevention Program (NAEPP) guidelines; asthma control was assessed using Global Initiative for Asthma (GINA) guidelines. The data were analyzed for correlations between serum Vitamin D3 levels, asthma severity, and asthma control. RESULTS: The study was conducted among eligible 45 patients with bronchial asthma. A significant inverse correlation was observed between serum Vitamin D3 levels and asthma severity (P < 0.05), with lower levels being associated with higher severity. In addition, lower Vitamin D3 levels were significantly correlated with poor asthma control (P < 0.05). CONCLUSION: Our findings suggest that lower serum Vitamin D3 levels are associated with greater asthma severity and poor asthma control in adults with bronchial asthma. Further longitudinal and interventional studies are needed to establish causality and the therapeutic benefits of Vitamin D3 in asthma management.

Update on immunogenicity in severe asthma: Experience with mepolizumab

Environmental and occupational allergies

SR Kochis, T Grant, W Phipatanakul. J Allergy Clin Immunol Pract . 2019;7(5):1516–1521.e1 This study assessed how a caregiver’s perception of their child’s asthma control might impact the child’s risk for having future urgent visits for asthma care. Two cohorts of low income, ethnic minority children in Baltimore or Boston from the Mouse Allergen and Asthma Cohort Study (MAACS) and the Mouse Allergen and Asthma Intervention Trial (MAAIT) with persistent asthma, aged 5 to 17 years were included. The MAACS study correlated mouse exposure with asthma features, while the MAAIT study evaluated …

A Little Bit of Knowledge Is a Dangerous Thing

Clothing–Potentially a Significant Source of Endotoxin Exposure

Pediatric Asthma: An Approach to Pharmacogenetics Analysis

Comparing Asthma Control Questionnaire (ACQ) and National Asthma Education and Prevention Program (NAEPP) asthma control criteria

Asthma Therapy: What's New and Is It Necessarily Better?