@article{f13c284afd034150bb32e7d195d3f879,
title = "Asthma outcomes: Exacerbations",
abstract = "Background: The goals of asthma treatment include preventing recurrent exacerbations. Yet there is no consensus about the terminology for describing or defining {"}exacerbation{"} or about how to characterize an episode's severity. Objective: National Institutes of Health institutes and other federal agencies convened an expert group to propose how asthma exacerbation should be assessed as a standardized asthma outcome in future asthma clinical research studies. Methods: We used comprehensive literature reviews and expert opinion to compile a list of asthma exacerbation outcomes and classified them as either core (required in future studies), supplemental (used according to study aims and standardized), or emerging (requiring validation and standardization). This work was discussed at a National Institutes of Health-organized workshop in March 2010 and finalized in September 2011. Results: No dominant definition of {"}exacerbation{"} was found. The most widely used definitions included 3 components, all related to treatment, rather than symptoms: (1) systemic use of corticosteroids, (2) asthma-specific emergency department visits or hospitalizations, and (3) use of short-acting β-agonists as quick-relief (sometimes referred to as {"}rescue{"} or {"}reliever{"}) medications. Conclusions: The working group participants propose that the definition of {"}asthma exacerbation{"} be {"}a worsening of asthma requiring the use of systemic corticosteroids to prevent a serious outcome.{"} As core outcomes, they propose inclusion and separate reporting of several essential variables of an exacerbation. Furthermore, they propose the development of a standardized, component-based definition of {"}exacerbation{"} with clear thresholds of severity for each component.",
author = "Anne Fuhlbrigge and David Peden and Apter, {Andrea J.} and Boushey, {Homer A.} and Camargo, {Carlos A.} and James Gern and Heymann, {Peter W.} and Martinez, {Fernando D.} and David Mauger and Teague, {William G.} and Carol Blaisdell",
note = "Funding Information: The Asthma Outcomes workshop was funded by contributions from the National Institute of Allergy and Infectious Diseases; the National Heart, Lung, and Blood Institute; the Eunice Kennedy Shriver National Institute of Child Health and Human Development; the National Institute of Environmental Health Sciences; the Agency for Healthcare Research and Quality; and the Merck Childhood Asthma Network , as well as by a grant from the Robert Wood Johnson Foundation . Contributions from the National Heart, Lung, and Blood Institute; the National Institute of Allergy and Infectious Diseases; the Eunice Kennedy Shriver National Institute of Child Health and Human Development; the National Institute of Environmental Health Sciences; and the US Environmental Protection Agency funded the publication of this article and all other articles in this supplement. Funding Information: Disclosure of potential conflict of interest: A. Fuhlbrigge is on the Merck Respiratory Advisory Board and is a consultant for the Lovelace Respiratory and Research Institute. D. Peden has received research support from the NIH/NIAID, MedImmune, the US Environmental Protection Agency, and Aquinox Pharmaceuticals . A. J. Apter has received research support from the NHLBI and is on the AAAAI Board of Directors . H. A. Boushey has provided ad-hoc consultation for Kalobics; is on the Pharmaxis advisory committee; is on the ad-hoc advisory committee for Merck and GlaxoSmithKline; has provided consultation for Genentech and Johnson & Johnson; and has received research support from GlaxoSmithKline and Genentech . C. A. Camargo, Jr, is a consultant for Dey, Genentech, Merck, Novartis, and Pfizer; and has received research support from GlaxoSmithKline and Sanofi-Aventis . J. Gern is on the Scientific Advisory Board and has stock options in 3V Biosciences, and has received consulting fees from Centocor, Boehringer Ingelheim, GlaxoSmithKline, Biota, MedImmune, and Theraclone. P. W. Heymann has received research support from the NIH and Novartis . F. D. Martinez has consulted for MedImmune and received lecture honorarium from Abbott. W. G. Teague is a speaker for Merck and Genentech, and has received research support from the NIH/NHLBI and the American Lung Association . C. Blaisdell is on the American Academy of Pediatrics Executive Board and is an abstract reviewer for the Pediatric Academic Society. The rest of the authors declare that they have no relevant conflicts of interest. ",
year = "2012",
month = mar,
doi = "10.1016/j.jaci.2011.12.983",
language = "English (US)",
volume = "129",
pages = "S34--S48",
journal = "Journal of Allergy and Clinical Immunology",
issn = "0091-6749",
publisher = "Mosby Inc.",
number = "3 SUPPL.",
}