The Journal of Allergy and Clinical Immunology
Volume 122, Issue 4 , Pages 662-668 , October 2008

Epidemiology of asthma exacerbations

  • Malcolm R. Sears, MB, FRACP, FRCPC, FAAAAI

      Affiliations

    • Corresponding Author InformationReprint requests: Malcolm R. Sears, MB, FRACP, FRCPC, FAAAAI, Professor of Medicine, McMaster University, Research Director, Firestone Institute for Respiratory Health, St Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, Ontario L8N 4A6, Canada.

Received 10 July 2008 ,Revised 31 July 2008 ,Accepted 1 August 2008.

References 

  1. Pauwels RA, Lofdahl C-G, Postma DS, Tattersfield AE, O'Byrne P, Barnes PJ, et al. Effect of inhaled formoterol and budesonide on exacerbations of asthma. N Engl J Med. 1997;337:1405–1411
  2. Reddel H, Ware S, Marks G, Salome C, Jenkins C, Woolcock A. Differences between asthma exacerbations and poor asthma control. Lancet. 1999;353:364–369
  3. Taylor DR, Bateman ED, Boulet L-P, Boushey. HA, Busse WW, Casale TB, et al. A new perspective on concepts of asthma severity and control. Eur Respir J. 2008;In press
  4. MacFaul R. Trends in asthma hospitalisation: is this related to prevention inhaler usage?. Arch Dis Child. 2004;89:1158–1160
  5. Chen Y, Stewart P, Johansen H, McRae L, Taylor G. Sex difference in hospitalization due to asthma in relation to age. J Clin Epidemiol. 2003;56:180–187
  6. Schatz M, Clark S, Camargo CA. Sex differences in the presentation and course of asthma hospitalizations. Chest. 2006;129:50–55
  7. Trawick DR, Holm C, Writh J. Influence of gender on rates of hospitalization, hospital course, and hypercapnea in high-risk patients admitted for asthma. Chest. 2001;119:115–119
  8. Troisi RJ, Speizer FE, Willett WC, Trichopoulos D, Rosner B. Menopause, postmenopausal estrogen preparations and the risk of adult-onset asthma: a prospective cohort study. Am J Respir Crit Care Med. 1995;152:1183–1188
  9. Barr RD, Wentowski CC, Grodstein F, Somers SC, Stampfler JM, Schwartz J, et al. Prospective study of postmenopausal hormone use and newly diagnosed asthma and chronic obstructive pulmonary disease. Arch Intern Med. 2004;164:379–386
  10. Tan KS, McFarlane LC, Lipworth BJ. Modulation of airway reactivity and peak flow variability in asthmatics receiving the oral contraceptive pill. Am J Respir Crit Care Med. 1997;155:1273–1277
  11. Johnston NW, Sears MR. Asthma exacerbations, I: epidemiology. Thorax. 2006;61:722–728
  12. Sears MR, Johnston NW. Understanding the September asthma epidemic. J Allergy Clin Immunol. 2007;120:526–529
  13. Johnston N. The similarities and differences of epidemic cycles of chronic obstructive pulmonary disease and asthma exacerbations. Proc Am Thorac Soc. 2007;4:591–596
  14. Silverman RA, Ito K, Stevenson L, Hastings HM. The relationship of fall school opening and emergency department asthma visits in a large metropolitan area. Arch Pediatr Adolesc Med. 2005;159:818–823
  15. Fleming DM, Cross KW, Sunderland R, Ross AM. Comparison of the seasonal patterns of asthma identified in general practitioner episodes, hospital admissions, and deaths. Thorax. 2000;55:662–665
  16. Garty BZ, Kosman E, Ganor E, Berger V, Garty L, Weitzen T, et al. Emergency room visits of asthmatic children, relation to air pollution, weather, and airborne allergens. Ann Allergy Asthma Immunol. 1998;81:563–570
  17. Lincoln D, Morgan G, Sheppeard V, Jalaludin B, Corbett S, Beard J. Childhood asthma and return to school in Sydney, Australia. Public Health. 2006;120:854–862
  18. Lister S, Sheppeard V, Morgan G, Corbett Kaldor J, Henry R. February asthma outbreaks in NSW: a case control study. Aust N Z J Public Health. 2001;25:514–519
  19. Vrieze A, Postma DS, Kerstjens HAM. Perimenstrual asthma: a syndrome without known cause or cure. J Allergy Clin Immunol. 2003;112:271–282
  20. Singh AM, Busse WW. Asthma exacerbations, 2: aetiology. Thorax. 2006;61:809–816
  21. Gibson PG, Simpson JL, Saltos N. Heterogeneity of airway inflammation in persistent asthma: evidence of neutrophilic inflammation and increased sputum interleukin-8. Chest. 2001;119:1329–1336
  22. D'silva L, Cook RJ, Allen CJ, Hargreave FE, Parameswaran K. Changing pattern of sputum cell counts during successive exacerbations of airway disease. Respir Med. 2007;101:2217–2220
  23. Johnston SL, Pattemore PK, Sanderson G, Smith S, Lampe F, Josephs L, et al. Community study of role of viral infections in exacerbations of asthma in 9-11 year old children. BMJ. 1995;310:1225–1228
  24. Nicholson KG, Kent J, Ireland DC. Respiratory viruses and exacerbations of asthma in adults. BMJ. 1993;307:982–986
  25. Friedlander SL, Busse WW. The role in rhinovirus in asthma exacerbations. J Allergy Clin Immunol. 2005;116:267–273
  26. Khetsuriani N, Kazerouni NN, Erdman DD, Lu X, Redd SC, Anderson LJ, et al. Prevalence of viral respiratory tract infections in children with asthma. J Allergy Clin Immunol. 2007;119:314–321
  27. Johnston NW, Johnston SL, Duncan JM, Greene JM, Kabadze T, Keith PK, et al. The September epidemic of asthma exacerbations in children: a search for etiology. J Allergy Clin Immunol. 2005;115:132–138
  28. Murray CS, Poletti G, Kebadze T, Morris J, Woodcock A, Johnston SC, et al. Study of modifiable risk factors for asthma exacerbations: virus infection and allergen exposure increase the risk of asthma hospital admissions in children. Thorax. 2006;61:376–382
  29. Kling S, Donninger H, Williams Z, Vermeulen J, Weinberg F, Latiff K, et al. Persistence of rhinovirus RNA after asthma exacerbation in children. Clin Exp Allergy. 2005;35:672–678
  30. Williams JV, Crowe JE, Enriquez R, Minton P, Peebles RS, Hamilton RG, et al. Human metapneumovirus infection plays an etiologic role in acute asthma exacerbations requiring hospitalization in adults. J Infect Dis. 2005;192:1149–1153
  31. Contoli M, Caramore G, Mallia P, Johnston S, Papi A. Mechanisms of respiratory virus-induced asthma exacerbations. Clin Exp Allergy. 2005;35:137–145
  32. Murray CS, Simpson A, Custovic A. Allergens, viruses, and asthma exacerbations. Proc Am Thorac Soc. 2004;1:99–104
  33. Green RM, Custovic A, Sanderson G, Hunter J, Johnston SL, Woodcock A. Synergism between allergens and viruses and risk of hospital admission with asthma: case-control study. BMJ. 2002;324:1–5
  34. Ko FWS, Tam W, Won TW, Lai CKW, Wong GWK, Leung T-F, et al. Effects of air pollution on asthma hospitalization rates in different age groups in Hong Kong. Clin Exp Allergy. 2007;37:1312–1319
  35. Marks GB, Colquhoun JR, Girgis ST, Koshi MH, Treloar ABA, Hansen P, et al. Thunderstorm outflows preceding epidemics of asthma during spring and summer. Thorax. 2001;56:468–471
  36. Atkinson RW, Strachan DP, Anderson HR, Hajat S, Emberlin J. Temporal associations between daily counts of fungal spores and asthma exacerbations. Occup Environ Med. 2006;63:580–590
  37. Sandberg S, Jarvenpaa S, Penttinen A, Paton JY, McCann DC. Asthma exacerbations in children immediately following stressful life events: a Cox's hierarchical regression. Thorax. 2004;59:1046–1051
  38. Koga T, Oshita Y, Kamimura T, Koga H, Aizawa H. Characterisation of patients with frequent exacerbation of asthma. Respir Med. 2006;100:273–278
  39. Griswold SK, Nordstrom CR, Clark S, Gaeta TJ, Price ML, Camargo CA, et al. Asthma exacerbations in North American adults who are the “frequent fliers” in the emergency department?. Chest. 2005;127:1579–1586
  40. ten Brinke A, Sterk PJ, Masclee AAM, Spinhoven P, Schmidt JT, Zwinderwan AH, et al. Risk factors of frequent exacerbations in difficult-to-treat asthma. Eur Respir J. 2005;26:812–818
  41. Miller MK, Lee JH, Miller DP, Wenzel SE. Recent asthma exacerbations: a key predictor of future exacerbations. Respir Med. 2007;101:481–489
  42. Dusser D, Montani D, Chanez P, de Blic J, Delacourt C, Deschildre A, et al. Mild asthma: an expert review on epidemiology, clinical characteristics and treatment recommendations. Allergy. 2007;62:591–604
  43. Lemiere C, Ernst P, Olivenstein R, Yamauchi Y, Govindarajuk , Ludwig MS, et al. Airway inflammation assessed by invasive and noninvasive means in severe asthma: eosinophilic and noneosinophilic phenotypes. J Allergy Clin Immunol. 2006;118:1033–1039
  44. Bateman ED. Severity and control of severe asthma. J Allergy Clin Immunol. 2006;117:519–521
  45. Ito K, Chung KF, Adcock IM. Update on glucocorticoid action and resistance. J Allergy Clin Immunol. 2006;117:522–543
  46. Pendergraft TB, Stanford RH, Beasley R, Stempel DA, McLaughlin T. Seasonal variation in asthma-related hospital and intensive care unit admissions. J Asthma. 2005;42:265–271
  47. Alvarez GG, Schulzer M, Jung D, FitzGerald JM. A systematic review of risk factors associated with near-fatal and fatal asthma. Can Respir J. 2005;12:265–270
  48. Dhuper S, Maggiore D, Chung V, Shim C. Profile of near-fatal asthma in an inner-city hospital. Chest. 2003;124:1880–1884
  49. Federico MJ, Wamboldt FS, Carter R, Mansell A, Wamboldt MZ. History of serious asthma exacerbations should be included in guidelines of asthma severity. J Allergy Clin Immunol. 2007;119:50–56
  50. Williams LK, Joseph CL, Peterson EL, Wells K, Wang M, Chowdhury VK, et al. Patients with asthma who do not fill their inhaled corticosteroids: a study of primary nonadherence. J Allergy Clin Immunol. 2007;120:1153–1159
  51. O'Byrne P, Cuddy L, Taylor DW, Birch S, Morris J, Syrotuik J. Efficacy and cost benefit of inhaled corticosteroids in patients considered to have mild asthma in primary care practice. Can Respir J. 1996;3:169–175
  52. Guilbert TV, Morgan WJ, Zeiger M, Mauger DJ, Boehmer SJ, Szefler SJ, et al. Long-term inhaled corticosteroids in preschool children at high risk for asthma. N Engl J Med. 2006;354:1985–1997
  53. The Childhood Asthma Management Program Research Group. Long-term effects of budesonide or nedocromil in children with asthma. N Engl J Med. 2000;343:1054–1063
  54. FitzGerald JM, Boulet L-P, McIvor RA, Zimmerman S, Chapman KR. Asthma control in Canada remains suboptimal: The Reality of Asthma Control (TRAC) study. Can Respir J. 2006;13:253–259
  55. Bateman ED, Boushey HA, Bousquet J, Busse WW, Clark TJH, Pauwels RA, et al. Can guideline-defined asthma control be achieved? The Gaining Optional Asthma Control Study. Am J Respir Crit Care Med. 2004;170:836–844
  56. O'Byrne PM, Bisgaard H, Godard PP, Pistolesi M, Palmqvist M, Zhu Y, et al. Budesonide/formoterol combination therapy as both maintenance and reliever medication in asthma. Am J Respir Crit Care Med. 2005;171:129–136
  57. Rabe KF, Atienza T, Magyar P, Larsson P, Jorup C, Lalloo UG. Effect of budesonide in combination with formoterol for reliever therapy in asthma exacerbations: a randomised controlled, double-blind study. Lancet. 2006;368:744–753
  58. Kuna P, Peters MJ, Manjra AI, Jorup C, Naya IP, Martinez-Jimenez NE, et al. Effect of budesonide/formoterol maintenance and reliever therapy on asthma exacerbations. Int J Clin Pract. 2007;61:725–736
  59. Smith AD, Cowan JO, Brassett KP, Herbison GP, Taylor DR. Use of exhaled nitric oxide measurements to guide treatment in chronic asthma. N Engl J Med. 2005;352:2163–2173
  60. Sont JK, Willems LNA, Bel EH, van Krieken HJM, Vandenbroucke JP, Sterk PJ, et al. Clinical control and histopathologic outcome of asthma when using airway hyperresponsiveness as an additional guide to long-term treatment. Am J Respir Crit Care Med. 1999;159:1043–1051
  61. Green RH, Brightling CE, McKenna S, Hargadon B, Parker D, Bradding P, et al. Asthma exacerbations and sputum eosinophil counts: a randomised controlled trial. Lancet. 2002;360:1715–1721
  62. Jayaram L, Pizzichini MM, Cook RJ, Boulet L-P, Lemiere C, Pizzichini E, et al. Determining asthma treatment by monitoring sputum cell counts: effect on exacerbations. Eur Respir J. 2006;27:483–494
  63. Reddel HK, Barnes DJ. Pharmacological strategies for self-management of asthma exacerbations. Eur Respir J. 2006;28:182–199
  64. Harrison TV, Oborne J, Newton S, Tattersfield AE. Doubling the dose of inhaled corticosteroid to prevent asthma exacerbations: randomised controlled trial. Lancet. 2004;363:271–275
  65. FitzGerald JM, Becker A, Sears MR, Mink S, Chung K, Lee J, et al. Doubling the dose of budesonide versus maintenance treatment in asthma exacerbations. Thorax. 2004;59:550–556
  66. FitzGerald JM, Gibson PG. Asthma exacerbations, 4: prevention. Thorax. 2006;61:992–999
  67. Bisgaard H, Zielen S, Garcia-Garcia ML, Johnston ML, Gilles L, Menten J, et al. Montelukast reduces asthma exacerbations in 2- to 5- year-old children with intermittent asthma. Am J Respir Crit Care Med. 2005;171:315–322
  68. Robertson CF, Price D, Henry R, Mellis C, Glasgow N, Fitzgerald D, et al. Short-course montelukast for intermittent asthma in children: a randomized controlled trial. Am J Respir Crit Care Med. 2007;175:323–329
  69. Johnston NW, Mandhane PJ, Dai J, Duncan JM, Greene JM, Lambert K, et al. Attenuation of the September epidemic of asthma exacerbations in children: a randomized, controlled trial of montelukast added to usual therapy. Pediatrics. 2007;120:e702–e712
  70. Pauwels RA, Pedersen S, Busse WW, Tan WC, Chien YZ, Ohlsson SV, et al. Early intervention with budesonide in mild persistent asthma: a randomised, double-blind trial. Lancet. 2003;361:1071–1076
  71. Schokker S, Kooi EMW, de Vries TW, Brand PLP, Mulder PGH, Duiverman EJ, et al. Inhaled corticosteroids for recurrent respiratory symptoms in preschool children in general practice: randomized controlled trial. Pulm Pharmacol Ther. 2008;21:88–97
  72. Sly RM. Continuing decreases in asthma mortality in the United States. Ann Allergy Asthma Immunol. 2004;92:313–318
  73. McCoy L, Redelings M, Sorvillo F, Simon P. A multiple cause-of-death analysis of asthma mortality in the United States, 1990-2001. J Asthma. 2005;42:757–763
  74. Akinbami LJ. The state of childhood asthma, United States, 1980-2005. Advance Data. 2006;381:1–24
  75. Krishnan V, Diette GB, Rand S, Bilderback AL, Merriman B, Hansel NN, et al. Mortality in patients hospitalized for asthma exacerbations in the United States. Am J Respir Crit Care Med. 2006;174:633–638
  76. Nelson HS, Weiss ST, Bleecker ER, Yancey SW, Dorinsky PM SMART Study Group. The Salmeterol Multicenter Asthma Research Trial: a comparison of usual pharmacotherapy for asthma or usual pharmacotherapy plus salmeterol. Chest. 2006;129:15–26
  77. Bai TR, Vonk JM, Postma DS, Boezen HM. Severe exacerbations predict excess lung function decline in asthma. Eur Respir J. 2007;30:452–456
  78. Sears MR. Lung function decline in asthma. Eur Respir J. 2007;30:411–413
  79. Schatz M, Zeiger RS, Vollmer WM, Mosen D, Cook EF. Determinants of future long-term asthma control. J Allergy Clin Immunol. 2006;118:1048–1053

 Series editors: Donald Y. M. Leung, MD, PhD, and Dennis K. Ledford, MD

PII: S0091-6749(08)01484-X

doi: 10.1016/j.jaci.2008.08.003

The Journal of Allergy and Clinical Immunology
Volume 122, Issue 4 , Pages 662-668 , October 2008

Article Tools

* Image Usage & Resolution