Browsing by Author "Kalpaklioglu, AF"

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    Socioeconomic status has direct impact on asthma control: Turkish adult asthma registry
    Arslan, B; Türk, M; Hayme, S; Aydin,Ö; Gokmen, D; Buhari, GK; Sozener, ZC; Gemicioglu, B; Bulut, I; Beyaz, S; Orcen, C; Ozdemir, SK; Keren, M; Damadoglu, E; Yakut, T; Kalpaklioglu, AF; Baccioglu, A; Yalim, SA; Yilmaz, I; Kalkan, IK; Niksarlioglu, EYO; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Gelincik, AA; Dirol, H; Goksel, O; Karaoglanoglu, S; Erkekol, FO; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Seker, U; Oguzulgen, IK; Basyigit, I; Baris, SA; Ucar, EY; Erdogan, T; Polatli, M; Ediger, D; Gunaydin, FE; Pur, L; Katran, ZY; Sekibag, Y; Aykac, EF; Mungan, D; Gul, O; Cengiz, A; Akkurt, B; Ozden, S; Demir, S; Unal, D; Aslan, AF; Can, A; Gumusburun, R; Bogatekin, G; Akten, HS; Inan, S; Erdinc, M; Ogus, AC; Kavas, M; Yulug, DP; Cakmak, ME; Kaya, SB; Alpagat, G; Ozgur, ES; Uzun, O; Gulen, ST; Pekbak, G; Kizilirmak, D; Havlucu, Y; Donmez, H; Cetin, GP; Soyyigit, S; Kara, BY; Karakis, GP; Dursun, AB; Kendirlinan, R; Ozturk, AB; Sevinc, C; Simsek, GO; Abadoglu, O; Cerci, P; Yucel, T; Yorulmaz, I; Tezcaner, ZC; Tatar, EC; Suslu, AE; Ozer, S; Dursun, E; Yorgancioglu, A; Celik, GE; Uysal, MA
    BackgroundAsthma is one of the most common causes of chronic respiratory disease, and countries with low socioeconomic status have both a high prevalence of asthma and asthma-related death.ObjectiveIn this study, we aimed to determine socioeconomic levels of asthmatic patients according to a national database and investigate the effects of social markers on disease control in our region.MethodsThis is an analysis of data from 2053 adult asthma patients from a multicentre chart study in Turkey. Socioeconomic status (SES) data were collected from questionnaires and this form was sent to the patients via e-mail. Parameters related to social status and poor disease control were analyzed.ResultsIlliteracy (OR:2.687 [95% CI: 1.235-5.848]; p = 0.013) and lower household income (OR:1,76 [95% CI: 1.002-3.09]; p = 0.049) were found as independent risk factors for hospitalization in the multivariate logistic regression analysis. Therewithal, being aged between 40 and 60 (OR: 1.435 [95% CI: 1.074-1.917]; p = 0.015), illiteracy (OR: 2.188 [95% CI: 1.262-3.795]; p = 0.005) and being employed (OR: 1.466 [95% CI: 1.085-1.847]; p = 0.011) were considered as independent risk factors for systemic corticosteroid use at least 3 days within last 1 year.ConclusionAs a result of our national database, education level, household income and working status briefly socioeconomic status have impacts on asthma control. Identification of social markers in asthma and better recognition of risk factors based on the population gives us clues to provide better asthma control in the future.
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    Picturing asthma in Turkey: results from the Turkish adult asthma registry
    Celik, GE; Aydin, O; Gokmen, D; Buhari, GK; Sozener, ZC; Gemicioglu, B; Bulut, I; Beyaz, S; Orcen, C; Ozdemir, SK; Keren, M; Damadoglu, E; Yakut, T; Kalpaklioglu, AF; Baccioglu, A; Yalim, SA; Yilmaz, I; Kalkan, IK; Uysal, MA; Niksarlioglu, EY; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Gelincik, AA; Dirol, H; Goksel, O; Karaoglanoglu, S; Erkekol, FO; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Seker, U; Oguzulgen, IK; Basyigit, I; Baris, SA; Ucar, EY; Erdogan, T; Polatli, M; Ediger, D; Gunaydin, FE; Turk, M; Pur, L; Katran, ZY; Sekibag, Y; Aykac, EF; Mungan, D; Gul, O; Cengiz, A; Akkurt, B; Ozden, S; Demir, S; Unal, D; Aslan, AF; Can, A; Gumusburun, R; Bogatekin, G; Akten, HS; Inan, S; Erdinc, M; Ogus, AC; Kavas, M; Yulug, DP; Cakmak, ME; Kaya, SB; Alpagat, G; Ozgur, ES; Uzun, O; Gulen, ST; Pekbak, G; Kizilirmak, D; Havlucu, Y; Donmez, H; Arslan, B; Cetin, GP; Soyyigit, S; Kara, BY; Karakis, GP; Dursun, AB; Kendirlinan, R; Ozturk, AB; Sevinc, C; Simsek, GO; Abadoglu, O; Cerci, P; Yucel, T; Yorulmaz, I; Tezcaner, ZC; Tatar, EC; Suslu, AE; Ozer, S; Dursun, E; Yorgancioglu, A
    IntroductionNational data on asthma characteristics and the factors associated with uncontrolled asthma seem to be necessary for every country. For this purpose, we developed the Turkish Adult Asthma Registry for patients with asthma aiming to take a snapshot of our patients, thereby assigning the unmet needs and niche areas of intervention.MethodsCase entries were performed between March 2018 and March 2022. A web-based application was used to record data. Study outcomes were demographic features, disease characteristics, asthma control levels, and phenotypes.ResultsThe registry included 2053 patients from 36 study centers in Turkey. Female subjects dominated the group (n = 1535, 74.8%). The majority of the patients had allergic (n = 1158, 65.3%) and eosinophilic (n = 1174, 57.2%) asthma. Six hundred nineteen (32.2%) of the patients had obese asthma. Severe asthma existed in 670 (32.6%) patients. Majority of cases were on step 3-5 treatment (n: 1525; 88.1%). Uncontrolled asthma was associated with low educational level, severe asthma attacks in the last year, low FEV1, existence of chronic rhinosinusitis and living in particular regions.ConclusionThe picture of this registry showed a dominancy of middle-aged obese women with moderate-to-severe asthma. We also determined particular strategic targets such as low educational level, severe asthma attacks, low FEV1, and chronic rhinosinusitis to decrease uncontrolled asthma in our country. Moreover, some regional strategies may also be needed as uncontrolled asthma is higher in certain regions. We believe that these data will guide authorities to reestablish national asthma programs to improve asthma service delivery.
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    Trends in prescribing montelukast in patients with asthma in real-life: Results from the Turkish adult asthma registry
    Beyaz, S; Erdinç, M; Hayme, S; Aslan, AF; Aydin,Ö; Gökmen, D; Buhari, GK; Sözener, ZC; Gemicioglu, B; Bulut, I; Örçen, C; Özdemir, SK; Keren, M; Damadoglu, E; Yakut, T; Kalpaklioglu, AF; Baccioglu, A; Yalim, SA; Yilmaz, I; Kalkan, IK; Uysal, MA; Niksarlioglu, EYÖ; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Gelincik, AA; Dirol, H; Göksel,Ö; Karaoglanoglu, S; Erkekol, FÖ; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Seker,Ü; Oguzülgen, IK; Basyigit, I; Baris, SA; Uçar, EY; Erdogan, T; Polatli, M; Ediger, D; Günaydin, FE; Türk, M; Pür, L; Katran, ZY; Sekibag, Y; Aykaç, EF; Mungan, D; Gül,Ö; Cengiz, A; Akkurt, B; Özden, S; Demir, S; Ünal, D; Can, A; Guemuesburun, R; Bogatekin, G; Akten, HS; Inan, S; Ögüs, AC; Kavas, M; Yulug, DP; Çakmak, ME; Kaya, SB; Alpagat, G; Özgür, ES; Uzun, O; Gülen, ST; Pekbak, G; Kizilirmak, D; Havlucu, Y; Doenmez, H; Arslan, B; Çetin, GP; Soyyigit, S; Kara, BY; Karakis, GP; Dursun, AB; Kendirlinan, R; Öztürk, AB; Sevinç, C; Simsek, GÖ; Abadoglu,Ö; Çerçi, P; Yücel, T; Yorulmaz, I; Tezcaner, ZÇ; Tatar, EÇ; Süslü, AE; Özer, S; Dursun, E; Yorgancioglu, A; Çelik, GE
    Montelukast, a leukotriene receptor antagonist (LTRA) approved for the treatment of asthma and allergic rhinitis, is widely used, though real-world data on its application in asthma management remain limited. This registry-based study evaluated the use of montelukast in adult asthma patients, examining demographic and disease characteristics, asthma control status, asthma phenotypes, presence of atopy, and treatment regimens. Among 2053 patients analyzed, 61.76% (n = 1268; mean age: 46.2 +/- 14.3 years), predominantly females (similar to 76%), received montelukast. Montelukast users showed higher rates of allergic rhinitis (P < 0.001), hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) (P = 0.008), and chronic rhinosinusitis (P = 0.008). Montelukast group also had higher atopy and total IgE levels and tended to be more eosinophilic. Montelukast was commonly preferred in allergic, eosinophilic, NSAID-exacerbated respiratory disease, and severe asthma phenotypes (P < 0.001). Patients receiving Steps 4 and 5 treatments are more likely to be prescribed montelukast (P < 0.001). Montelukast usage was higher among patients with uncontrolled asthma [ACT< 20 (OR:1.29, 95%CI:1.052-1.582, P = 0.014)]. In addition, logistic regression analyses identified the main factors associated with increased montelukast use as; female gender (OR:1.33, 95%CI:1.041-1.713, P = 0.02), presence of atopy (OR:1.46, 95%CI:1.157-1.864, P = 0.002), comorbid allergic rhinitis (OR:2.12, 95%CI:1.679-2.293, P < 0.001), and severe asthma (OR:2.18, 95%CI:1.712-2.784, P < 0.001). These findings reveal that montelukast use is prevalent among asthma patients, particularly in females, middle-aged adults, and those with comorbid allergic rhinitis, uncontrolled asthma, or specific asthma phenotypes, underscoring the factors that influence its prescription in asthma management. (c) 2025 Codon Publications. Published by Codon Publications.
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    Factors influencing the prescription of add-on long-acting muscarinic antagonists in real-world asthma management: Insights from a national registry
    Gemicioglu, B; Gokmen, D; Can, A; Sevinc, C; Oguzulgen, IK; Soyyigit, S; Yakut, T; Havlucu, Y; Aydin, O; Buhari, GK; Sozener, ZC; Bulut, I; Beyaz, S; Orcen, C; Ozdemir, SK; Keren, M; Damadoglu, E; Kalpaklioglu, AF; Baccioglu, A; Yalim, SA; Yilmaz, I; Kalkan, IK; Uysal, MA; Niksarlioglu, EYO; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Gelincik, A; Dirol, H; Goksel, O; Karaoglanoglu, S; Erkekol, FO; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Seker, U; Basyigit, I; Baris, SA; Ucar, EY; Erdogan, T; Polatli, M; Ediger, D; Gunaydin, FE; Turk, M; Pur, L; Katran, ZY; Sekibag, Y; Aykac, EF; Mungan, D; Gul, O; Cengiz, A; Akkurt, B; Ozden, S; Demir, S; Unal, D; Aslan, AF; Gumusburun, R; Bogatekin, G; Akten, HS; Inan, S; Erdinc, M; Ogus, AC; Kavas, M; Yulug, DP; Cakmak, ME; Kaya, SB; Alpagat, G; Ozgur, ES; Uzun, O; Gulen, ST; Pekbak, G; Kizilirmak, D; Donmez, H; Arslan, B; Cetin, GP; Kara, BY; Dursun, AB; Karakis, GP; Kendirlinan, R; Ozturk, AB; Simsek, GO; Abadoglu, O; Cerci, P; Yucel, T; Yorulmaz, I; Tezcaner, ZC; Tatar, EC; Suslu, AE; Ozer, S; Dursun, E; Yorgancioglu, A; Çelik, GE
    Current guidelines recommend adding long-acting muscarinic antagonists (LAMAs) in patients with uncontrolled asthma, despite the use of moderate to high doses of inhaled steroid-long-acting beta agonists (ICS/LABA). This study aims to analyze the factors related to the prescription of add-on LAMA in clinical practice for asthma patients, shedding light on physicians' preferences. This study included adult asthma patients on add-on LAMA and ICS/LABA monitored for at least one year in a national registry comprising 2053 asthmatics. Patients' characteristics and disease profiles were analyzed to identify factors associated with the prescription of add-on LAMA across the entire cohort. A comparative analysis was performed among three groups: MART (ICS/formoterol as a maintenance and reliever therapy) plus LAMA, Conventional (ICS/LABA as a maintenance and short-acting beta agonist as reliever) plus LAMA and Triple (ICS/ LABA/LAMA single inhaler). LAMAs were added to ICS/LABA in 11.7 % of patients in the national registry. Logistic regression analysis revealed that older age, low FEV1 (%), Asthma Control Test (ACT) scores less than 20, and severe exacerbation were the main factors influencing the initiation of LAMA in our registry. However, demographic characteristics of asthma, control status, pulmonary function test results were similar among the three groups of LAMA users (p > 0.05). Physicians used LAMAs without phenotyping based on allergic status or eosinophil levels (p > 0.05). Mepolizumab was added after LAMA in all patients, while omalizumab was initiated before LAMA in 16.9 % of the patients receiving LAMA along with biologics. Add-on LAMAs were predominantly prescribed for older, uncontrolled, and exacerbated asthma patients with low FEV1.
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    Stepwise Approach in Asthma Revisited 2023: Expert Panel Opinion of Turkish Guideline of Asthma Diagnosis and Management Group
    Çelik, GE; Aydin, Ö; Damadoglu, E; Baççioglu, A; Özdemir, SK; Bavbek, S; Ediger, D; Erkekol, FÖ; Gemicioglu, B; Isik, SR; Kalpaklioglu, AF; Kalyoncu, AF; Karakaya, G; Keren, M; Mungan, D; Oguzülgen, IK; Yildiz, F; Yilmaz, I; Yorgancioglu, A
    Introduction of inhaled corticosteroids (ICS) has been the cornerstone of the long-term management of asthma. ICSs either alone or in combination with long-acting beta-2 agonists have been shown to be associated with favorable asthma outcomes. However, asthma con-trol is still reported to be below expectations all around the world. Research in the last decades focusing on the use of ICS/formoterol both as maintenance and as needed (maintenance and reliever therapy approach) showed improved asthma outcomes. As a result of recent developments, Turkish Asthma Guidelines group aimed to revise asthma treatment recommendations. In general, we recommend physi-cians to consider the risk factors for poor asthma outcomes, patients' compliance and expectations and then to determine a personalized treatment plan. Importantly, the use of short-acting beta-2 agonists alone as a symptom reliever in asthma patients not using regular ICS is no longer recommended. In stepwise treatment approach, we primarily recommend to use ICS-based controllers and initiate ICS as soon as possible. We define 2 different treatment tracks in stepwise approaches as maintenance and reliever therapy or fixed-dose therapy and equally recommend each track depending on the patient's risks as well as decision of physicians in a personalized manner. For both tracks, a strong recommendation was made in favor of using add-on treatments before initiating phenotype-specific treatment in step 5. A strong recommendation was also made in favor of using biologic agents and/or aspirin treatment after desensitization in severe asthma when indicated.
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    (Un)Awareness of Allergy
    Kalpaklioglu, AF; Kalkan, IK; Akcay, A; Reisli, I; Can, D; Uzuner, N; Yuksel, H; Kirmaz, C; Gulen, F; Ediger, D
    Background: Allergy is associated with considerable morbidity. Objective: The aim of this multicenter study was to provide insight into allergy knowledge and perceptions among the population. Methods: During the World Allergy Day, several allergy clinics conducted public meetings to encourage the awareness of and education in allergy. At the beginning, participants filled out a questionnaire to assess their knowledge about what is allergy and to determine by whom those symptoms are cared. Results: A total of 256 participants (187 women/69 men, mean age, 31.2 +/- 12.5 years) completed the survey. Of the 202 participants with symptoms, 58.9% had physician-diagnosed allergic disease. Among the 19 symptoms evaluated, 56.5% of the symptoms were recognized as related with allergy, and this increased in compliance with education level (r = +0.427; P < 0.001) but not with diagnosed allergy (P = 0.34). Sneezing was the most common symptom thought to be related with allergy-related symptom (77.5%), whereas loss of smell was the least one (37.9%). Participants were more likely to be cared by an allergologist (72.9%) followed by other specialties, when experiencing allergy. Conclusions: Increasing the awareness for allergic symptoms is the key not only for the diagnosis but also for the optimal treatment. Therefore, education is an important component of prevention and control of allergic diseases.
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    Elderly and aged asthma have different characteristics: results of a multicenter study
    Damadoglu, E; Öztürk Aktas, Ö; Gemicioglu, B; Yilmaz, N; Bozkus, F; Ayhan, V; Kalpaklioglu, AF; Öner Erkekol, F; Havlucu, Y; Erel, F; Aydin, Ö; Ekici, A; Baççioglu, A; Argun Baris, S; Köycü Buhari, G; Ceyhan, B; Göksel, Ö; Köse, M; Dursun, AB; Yildiz, F; Yorgancioglu, A; Isik, SR; Ediger, D; Oguzülgen, IK; Demir, AU; Karakaya, G; Kalyoncu, AF
    Background/ aim: Characteristics of asthma in the elderly population is not well-known. The aim of the present study was to evaluate asthma in the elderly population, to compare disease characteristics between patients diagnosed <60 (aged asthma) and >= 60 (elderly asthma) years of age. Materials and methods: The study was a prospective, multicenter, cross-sectional type. A questionnaire was filled out to patients 60 years of age and over, that have been followed for asthma for at least 3 months. Asthma Control Test (ACT), eight-item Morisky Medication Adherence Scale (MMAS-8) was filled out, inhaler device technique was assessed. Results: A total of 399 patients were included from 17 tertiary care centers across the country. Mean age was 67.11 years and 331 (83%) were female. The age at asthma diagnosis was >= 60 in 146 (36.6%) patients. Patients diagnosed >= 60 years were older (p < 0.001), had higher education level (p < 0.001), more commonly had first -degree relative with asthma (p = 0.038), asthma related comorbidities (p = 0.009) and accompanying rhinitis/rhinosinusitis (p = 0.005), had better asthma control (p = 0.001), were using less controller medications (p = 0.014). Inhaler technique was correct in 37% of the patients with no difference in between the groups. Treatment compliance was better in elderly asthma patients (p < 0.001). In the multivariate logistic regression analysis, having well -controlled asthma (odds ratio = 1.61, CI = 1.04-2.51), and high medication adherence rate (odds ratio = 2.43, CI = 1.48-4.0) were associated with being in the elderly asthma group. Conclusion: The characteristics of asthma are different among patients aged 60 years and over which seems to be related to onset age of asthma. In our cohort, the elderly asthma patients had higher education level, and treatment adherence and asthma control was better. Patients diagnosed >= 60 years of age did not have more severe disease.
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    Asthma patients with obesity have a unique phenotype: a subanalysis of the Turkish adult asthma registry
    Celebi Sozener, Z; Oguzulgen, IK; Ozalp Ates, FS; Baccioglu, A; Argun Baris, S; Ediger, D; Gunaydin, FE; Sevinc, C; Seker, U; Yilmaz Kara, B; Beyaz, S; Mungan, D; Aydin, O; Gokmen, D; Buhari, GK; Gemicioglu, B; Bulut, I; Orcen, C; Kepil Ozdemir, S; Keren, M; Damadoglu, E; Yakut, T; Kalpaklioglu, AF; Alan Yalim, S; Yilmaz, I; Koca Kalkan, I; Uysal, MA; Ozgun Niksarlioglu, EY; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Akkor Gelincik, A; Dirol, H; Goksel, O; Karaoglanoglu, S; Oner Erkekol, F; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Basyigit, I; Yilmazel Ucar, E; Erdogan, T; Polatli, M; Turk, M; Pur, L; Yegin Katran, Z; Sekibag, Y; Aykac, EF; Gul, O; Cengiz, A; Akkurt, B; Ozden, S; Demir, S; Unal, D; Aslan, AF; Can, A; Gumusburun, R; Bogatekin, G; Akten, HS; Inan, S; Erdinc, M; Ogus, AC; Kavas, M; Polat Yulug, D; Cakmak, ME; Kaya, SB; Alpagat, G; Ozgur, ES; Uzun, O; Gulen, ST; Pekbak, G; Kizilirmak, D; Havlucu, Y; Donmez, H; Arslan, B; Cetin, GP; Soyyigit, S; Pasaoglu Karakis, G; Dursun, AB; Kendirlinan, R; Ozturk, AB; Omeroglu Simsek, G; Abadoglu, O; Cerci, P; Yucel, T; Yorulmaz, I; Tezcaner, ZC; Cadalli Tatar, E; Suslu, AE; Ozer, S; Dursun, E; Yorgancioglu, A; Celik, GE
    Objective: The obese-asthma phenotype has gradually increased in the last few years. We aimed to assess the differences between obese and non-obese patients with asthma. Methods: This research is a subanalysis of the Turkish Adult Asthma Registry (TAAR). Clinical presentation, disease control, severity, and demographics of obese and non-obese (normal-weight, overweight) patients were compared. Results: The obesity rate in TAAR was 32.2% (n=619/1919; 18-83years; 527F/92 M). Patients with asthma and obesity had higher rates of childhood obesity, longer symptom duration, later onset of asthma, and more severe asthma. These patients were more likely to be female, older, less educated, and live in rural areas. Patients with obesity had more scheduled visits and emergency visits compared with non-obese patients, but similar asthma control, oral corticosteroid use, hospitalizations, intensive care unit admissions, and unscheduled visits. They also had a higher frequency of T2-high but lower frequency of possible T2-low phenotypes compared with normal-weight asthmatics. The risk of severe asthma in patients with obesity was 6.04 times higher for allergic than non-allergic patients and 3.58 times higher for the T2-high phenotype than for possible T2-low phenotypes. A one-unit increase in the asthma control test reduced the risk of severe asthma by 22%. Conclusions: A good definition of this phenotype is important to ensure that appropriate treatment strategies are implemented to achieve the control goal. We also believe that prevention of childhood obesity is an effective and pivotal strategy to achieve the goal of asthma control.