Browsing by Author "Kulus, M"

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    Patient-centered digital biomarkers for allergic respiratory diseases and asthma: The ARIA-EAACI approach - ARIA-EAACI Task Force Report
    Bousquet, J; Shamji, MH; Anto, JM; Schünemann, HJ; Canonica, GW; Jutel, M; Del Giacco, S; Zuberbier, T; Pfaar, O; Fonseca, JA; Sousa-Pinto, B; Klimek, L; Czarlewski, W; Bedbrook, A; Amaral, R; Ansotegui, IJ; Bosnic-Anticevich, S; Braido, F; Loureiro, CC; Gemicioglu, B; Haahtela, T; Kulus, M; Kuna, P; Kupczyk, M; Matricardi, PM; Regateiro, FS; Samolinski, B; Sofiev, M; Toppila-Salmi, S; Valiulis, A; Ventura, MT; Barbara, C; Bergmann, KC; Bewick, M; Blain, H; Bonini, M; Boulet, LP; Bourret, R; Brusselle, G; Brussino, L; Buhl, R; Cardona, V; Casale, T; Cecchi, L; Charpin, D; Cherrez-Ojeda, I; Chu, DK; Cingi, C; Costa, EM; Cruz, AA; Devillier, P; Dramburg, S; Fokkens, WJ; Gotua, M; Heffler, E; Ispayeva, Z; Ivancevich, JC; Joos, G; Kaidashev, I; Kraxner, H; Kvedariene, V; Larenas-Linnemann, DE; Laune, D; Lourenço, O; Louis, R; Makela, M; Makris, M; Maurer, M; Melen, E; Micheli, Y; Morais-Almeida, M; Mullol, J; Niedoszytko, M; O'Hehir, R; Okamoto, Y; Olze, H; Papadopoulos, NG; Papi, A; Patella, V; Pétré, B; Pham-Thi, N; Puggioni, F; Quirce, S; Roche, N; Rouadi, PW; Sa-Sousa, A; Sagara, H; Sastre, J; Scichilone, N; Sheikh, A; Sova, M; Ulrik, CS; Taborda-Barata, L; Todo-Bom, A; Torres, MJ; Tsiligianni, I; Usmani, OS; Valovirta, E; Vasankari, T; Vieira, RJ; Wallace, D; Waserman, S; Zidarn, M; Yorgancioglu, A; Zhang, L; Chivato, T; Ollert, M
    Biomarkers for the diagnosis, treatment and follow-up of patients with rhinitis and/or asthma are urgently needed. Although some biologic biomarkers exist in specialist care for asthma, they cannot be largely used in primary care. There are no validated biomarkers in rhinitis or allergen immunotherapy (AIT) that can be used in clinical practice. The digital transformation of health and health care (including mHealth) places the patient at the center of the health system and is likely to optimize the practice of allergy. Allergic Rhinitis and its Impact on Asthma (ARIA) and EAACI (European Academy of Allergy and Clinical Immunology) developed a Task Force aimed at proposing patient-reported outcome measures (PROMs) as digital biomarkers that can be easily used for different purposes in rhinitis and asthma. It first defined control digital biomarkers that should make a bridge between clinical practice, randomized controlled trials, observational real-life studies and allergen challenges. Using the MASK-air app as a model, a daily electronic combined symptom-medication score for allergic diseases (CSMS) or for asthma (e-DASTHMA), combined with a monthly control questionnaire, was embedded in a strategy similar to the diabetes approach for disease control. To mimic real-life, it secondly proposed quality-of-life digital biomarkers including daily EQ-5D visual analogue scales and the bi-weekly RhinAsthma Patient Perspective (RAAP). The potential implications for the management of allergic respiratory diseases were proposed.
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    Concepts for the Development of Person-Centered, Digitally Enabled, Artificial Intelligence-Assisted ARIA Care Pathways (ARIA 2024)
    Bousquet, J; Schünemann, HJ; Sousa-Pinto, B; Zuberbier, T; Togias, A; Samolinski, B; Bedbrook, A; Czarlewski, W; Hofmann-Apitius, M; Litynska, J; Vieira, RJ; Anto, JM; Fonseca, JA; Brozek, J; Bognanni, A; Brussino, L; Canonica, GW; Cherrez-Ojeda, I; Cruz, AA; de las Vecillas, L; Dykewicz, M; Gemicioglu, B; Giovannini, M; Haahtela, T; Jacobs, M; Jacomelli, C; Klimek, L; Kvedariene, V; Larenas-Linnemann, DE; Louis, G; Lourenço, O; Leemann, L; Morais-Almeida, M; Neves, AL; Nadeau, KC; Nowak, A; Palamarchuk, Y; Palkonen, S; Papadopoulos, NG; Parmelli, E; Pereira, AM; Pfaar, O; Regateiro, FS; Savouré, M; Taborda-Barata, L; Toppila-Salmi, SK; Torres, MJ; Valiulis, A; Ventura, MT; Williams, S; Yepes-Nunez, JJ; Yorgancioglu, A; Zhang, L; Zuberbier, J; Latiff, AHA; Abdullah, B; Agache, I; Al-Ahmad, M; Al-Nesf, MA; Al Shaikh, NA; Amaral, R; Ansotegui, IJ; Asllani, J; Balotro-Torres, MC; Bergman, KC; Bernstein, JA; Bindslev-Jensen, C; Blaiss, MS; Bonaglia, C; Bonini, M; Bossé, I; Braido, F; Caballero-Fonseca, F; Camargos, P; Carreiro-Martins, P; Casale, T; Castillo-Vizuete, JA; Cecchi, L; Teixeira, MD; Chang, YS; Loureiro, CC; Christoff, G; Ciprandi, G; Cirule, I; Correia-de-Sousa, J; Costa, EM; Cvetkovski, B; de Vries, G; Del Giacco, S; Devillier, P; Dokic, D; Douagui, H; Durham, SR; Enecilla, ML; Fiocchi, A; Fokkens, WJ; Fontaine, JF; Gawlik, R; Gereda, JE; Gil-Mata, S; Giuliano, AFM; Gotua, M; Gradauskiene, B; Guzman, MA; Hossny, E; Hrubisko, M; Iinuma, T; Irani, C; Ispayeva, Z; Ivancevich, JC; Jartti, T; Jesenák, MS; Julge, K; Jutel, M; Kaidashev, I; Bennoor, KS; Khaltaev, N; Kirenga, B; Kraxner, H; Kull, I; Kulus, M; Kuna, P; Kupczyk, M; Kurchenko, A; La Grutta, S; Lane, S; Miculinic, N; Lee, SM; Tuyet, LLT; Lkhagvaa, B; Louis, R; Mahboub, B; Makela, M; Makris, M; Maurer, M; Melén, E; Milenkovic, B; Mohammad, Y; Moniuszko, M; Montefort, S; Moreira, A; Moreno, P; Mullol, J; Nadif, R; Nakonechna, A; Navarro-Locsin, CG; Neffen, HE; Nekam, K; Niedoszytko, M; Nunes, E; Nyembue, D; O'Hehir, R; Ollert, M; Ohta, K; Okamoto, Y; Okubo, K; Olze, H; Padukudru, MA; Palomares, O; Pali-Scholl, I; Panzner, P; Palosuo, K; Park, HS; Passalacqua, G; Patella, V; Pawankar, R; Pétré, B; Pitsios, C; Plavec, D; Popov, TA; Puggioni, F; Quirce, S; Raciborski, F; Ramonaité, A; Recto, M; Repka-Ramirez, S; Roberts, G; Robles-Velasco, K; Roche, N; Rodriguez-Gonzalez, M; Romualdez, JA; Rottem, M; Rouadi, PW; Salapatas, M; Sastre, J; Serpa, FS; Sayah, Z; Scichilone, N; Senna, G; Sisul, JC; Solé, D; Soto-Martinez, ME; Sova, M; Sozinova, O; Stevanovic, K; Ulrik, CS; Szylling, A; Tan, FM; Tantilipikorn, P; Todo-Bom, A; Tomic-Spiric, V; Tsaryk, V; Tsiligianni, I; Urrutia-Pereira, M; Rostan, MV; Sofiev, M; Valovirta, E; Van Eerd, M; Van Ganse, E; Vasankari, T; Vichyanond, P; Viegi, G; Wallace, D; Wang, DY; Waserman, S; Wong, G; Worm, M; Yusuf, OM; Zaitoun, F; Zidarn, M
    The traditional healthcare model is focused on diseases (medicine and natural science) and does not acknowledge patients' resources and abilities to be experts in their own lives based on their lived experiences. Improving healthcare safety, quality, and coordination, as well as quality of life, is an important aim in the care of patients with chronic conditions. Person-centered care needs to ensure that people's values and preferences guide clinical decisions. This paper reviews current knowledge to develop (1) digital care pathways for rhinitis and asthma multimorbidity and (2) digitally enabled, person-centered care.(1) It combines all relevant research evidence, including the so-called real-world evidence, with the ultimate goal to develop digitally enabled, patient-centered care. The paper includes (1) Allergic Rhinitis and its Impact on Asthma (ARIA), a 2-decade journey, (2) Grading of Recommendations, Assessment, Development and Evaluation (GRADE), the evidence-based model of guidelines in airway diseases, (3) mHealth impact on airway diseases, (4) From guidelines to digital care pathways, (5) Embedding Planetary Health, (6) Novel classification of rhinitis and asthma, (7) Embedding real-life data with population-based studies, (8) The ARIA-EAACI (European Academy of Allergy and Clinical Immunology) strategy for the management of airway diseases using digital biomarkers, (9) Artificial intelligence, (10) The development of digitally enabled, ARIA person-centered care, and (11) The political agenda. The ultimate goal is to propose ARIA 2024 guidelines centered around the patient to make them more applicable and sustainable. (c) 2024 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).
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    Digitally-enabled, patient-centred care in rhinitis and asthma multimorbidity: The ARIA-MASK-air® approach
    Bousquet, J; Anto, JM; Sousa-Pinto, B; Czarlewski, W; Bedbrook, A; Haahtela, T; Klimek, L; Pfaar, O; Kuna, P; Kupczyk, M; Regateiro, FS; Samolinski, B; Valiulis, A; Yorgancioglu, A; Arnavielhe, S; Basagaña, X; Bergmann, KC; Bosnic-Anticevich, S; Brussino, L; Canonica, GW; Cardona, V; Cecchi, L; Chaves-Loureiro, C; Costa, E; Cruz, AA; Gemicioglu, B; Fokkens, WJ; Ivancevich, JC; Kraxner, H; Kvedariene, V; Larenas-Linnemann, DE; Laune, D; Louis, R; Makris, M; Maurer, M; Melén, E; Micheli, Y; Morais-Almeida, M; Mullol, J; Niedoszytko, M; Okamoto, Y; Papadopoulos, NG; Patella, V; Pham-Thi, N; Rouadi, PW; Sastre, J; Scichilone, N; Sheikh, A; Sofiev, M; Taborda-Barata, L; Toppila-Salmi, S; Tsiligianni, I; Valovirta, E; Ventura, MT; Vieira, RJ; Zidarn, M; Amaral, R; Ansotegui, IJ; Bédard, A; Benveniste, S; Bewick, M; Bindslev-Jensen, C; Blain, H; Bonini, M; Bourret, R; Braido, F; Carreiro-Martins, P; Charpin, D; Cherrez-Ojeda, I; Chivato, T; Chu, DK; Cingi, C; Del Giacco, S; de Blay, F; Devillier, P; De Vries, G; Doulaptsi, M; Doyen, V; Dray, G; Fontaine, JF; Gomez, RM; Hagemann, J; Heffler, E; Hofmann, M; Jassem, E; Jutel, M; Keil, T; Kritikos, V; Kull, I; Kulus, M; Lourenço, O; Mathieu-Dupas, E; Menditto, E; Mösges, R; Murray, R; Nadif, R; Neffen, H; Nicola, S; O'Hehir, R; Olze, H; Palamarchuk, Y; Pepin, JL; Pétré, B; Picard, R; Pitsios, C; Puggioni, F; Quirce, S; Raciborski, F; Reitsma, S; Roche, N; Rodriguez-Gonzalez, M; Romantowski, J; Sa-Sousa, A; Serpa, FS; Savouré, M; Shamji, MH; Sova, M; Sperl, A; Stellato, C; Todo-Bom, A; Tomazic, PV; Vandenplas, O; Van Eerd, M; Vasankari, T; Viart, F; Waserman, S; Fonseca, JA; Zuberbier, T
    MASK-air((R)), a validated mHealth app (Medical Device regulation Class IIa) has enabled large observational implementation studies in over 58,000 people with allergic rhinitis and/or asthma. It can help to address unmet patient needs in rhinitis and asthma care. MASK-air((R)) is a Good Practice of DG Sante on digitally-enabled, patient-centred care. It is also a candidate Good Practice of OECD (Organisation for Economic Co-operation and Development). MASK-air((R)) data has enabled novel phenotype discovery and characterisation, as well as novel insights into the management of allergic rhinitis. MASK-air((R)) data show that most rhinitis patients (i) are not adherent and do not follow guidelines, (ii) use as-needed treatment, (iii) do not take medication when they are well, (iv) increase their treatment based on symptoms and (v) do not use the recommended treatment. The data also show that control (symptoms, work productivity, educational performance) is not always improved by medications. A combined symptom-medication score (ARIA-EAACI-CSMS) has been validated for clinical practice and trials. The implications of the novel MASK-air((R)) results should lead to change management in rhinitis and asthma.
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    Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesis
    Bousquet, J; Melén, E; Haahtela, T; Koppelman, GH; Togias, A; Valenta, R; Akdis, CA; Czarlewski, W; Rothenberg, M; Valiulis, A; Wickman, M; Akdis, M; Aguilar, D; Bedbrook, A; Bindslev-Jensen, C; Bosnic-Anticevich, S; Boulet, LP; Brightling, CE; Brussino, L; Burte, E; Bustamante, M; Canonica, GW; Cecchi, L; Celedon, JC; Loureiro, CC; Costa, E; Cruz, AA; Erhola, M; Gemicioglu, B; Fokkens, WJ; Garcia-Aymerich, J; Guerra, S; Heinrich, J; Ivancevich, JC; Keil, T; Klimek, L; Kuna, P; Kupczyk, M; Kvedariene, V; Larenas-Linnemann, DE; Lemonnier, N; Carlsen, KCL; Louis, R; Makela, M; Makris, M; Maurer, M; Momas, I; Morais-Almeida, M; Mullol, J; Naclerio, RN; Nadeau, K; Nadif, R; Niedoszytko, M; Okamoto, Y; Ollert, M; Papadopoulos, NG; Passalacqua, G; Patella, V; Pawankar, R; Pham-Thi, N; Pfaar, O; Regateiro, FS; Ring, J; Rouadi, PW; Samolinski, B; Sastre, J; Savouré, M; Scichilone, N; Shamji, MH; Sheikh, A; Siroux, V; Sousa-Pinto, B; Standl, M; Sunyer, J; Taborda-Barata, L; Toppila-Salmi, S; Torres, MJ; Tsiligianni, I; Valovirta, E; Vandenplas, O; Ventura, MT; Weiss, S; Yorgancioglu, A; Zhang, L; Latiff, AHA; Aberer, W; Agache, I; Al-Ahmad, M; Alobid, I; Ansotegui, IJ; Arshad, SH; Asayag, E; Barbara, C; Baharudin, A; Battur, L; Bennoor, KS; Berghea, EC; Bergmann, KC; Bernstein, D; Bewick, M; Blain, H; Bonini, M; Braido, F; Buhl, R; Bumbacea, RS; Bush, A; Calderon, M; Calvo-Gil, M; Camargos, P; Caraballo, L; Cardona, V; Carr, W; Carreiro-Martins, P; Casale, T; Sarabia, AMC; Chandrasekharan, R; Charpin, D; Chen, YZ; Cherrez-Ojeda, I; Chivato, T; Chkhartishvili, E; Christoff, G; Chu, DK; Cingi, C; de Sousa, JC; Corrigan, C; Custovic, A; D'Amato, G; Del Giacco, S; De Blay, F; Devillier, P; Didier, A; Teixeira, MD; Dokic, D; Douagui, H; Doulaptsi, M; Durham, S; Dykewicz, M; Eiwegger, T; El-Sayed, ZA; Emuzyte, R; Fiocchi, A; Fyhrquist, N; Gomez, RM; Gotua, M; Guzman, MA; Hagemann, J; Hamamah, S; Halken, S; Halpin, DMG; Hofmann, M; Hossny, E; Hrubisko, M; Irani, C; Ispayeva, Z; Jares, E; Jartti, T; Jassem, E; Julge, K; Just, J; Jutel, M; Kaidashev, I; Kalayci, O; Kalyoncu, AF; Kardas, P; Kirenga, B; Kraxner, H; Kull, I; Kulus, M; La Grutta, S; Lau, S; Thi, LL; Levin, M; Lipworth, B; Lourenço, O; Mahboub, B; Martinez-Infante, E; Matricardi, P; Miculinic, N; Migueres, N; Mihaltan, F; Mohammad, Y; Moniuszko, M; Montefort, S; Neffen, H; Nekam, K; Nunes, E; Tshipukane, DN; O'Hehir, R; Ogulur, I; Ohta, K; Okubo, K; Ouedraogo, S; Olze, H; Pali-Schöll, I; Palomares, O; Palosuo, K; Panaitescu, C; Panzner, P; Park, HS; Pitsios, C; Plavec, D; Popov, TA; Puggioni, F; Quirce, S; Recto, M; Repka-Ramirez, MS; Cordeiro, CR; Roche, N; Rodriguez-Gonzalez, M; Romantowski, J; Rosario, N; Rottem, M; Sagara, H; Serpa, FS; Sayah, Z; Scheire, S; Schmid-Grendelmeier, P; Sisul, JC; Sole, D; Soto-Martinez, M; Sova, M; Sperl, A; Spranger, O; Stelmach, R; Ulrik, CS; Thomas, M; To, T; Todo-Bom, A; Tomazic, PV; Urrutia-Pereira, M; Valentin-Rostan, M; Van Ganse, E; van Hage, M; Vasankari, T; Vichyanond, P; Viegi, G; Wallace, D; Wang, DY; Williams, S; Worm, M; Yiallouros, P; Yusuf, O; Zaitoun, F; Zernotti, M; Zidarn, M; Zuberbier, J; Fonseca, JA; Zuberbier, T; Anto, JM
    Asthma, rhinitis, and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of one-airway-one-disease, coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitization and multimorbidity, (iii) advances in mHealth for novel phenotype definitions, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches, and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper- and lower-airway allergic diseases with skin, gut, and neuropsychiatric multimorbidities, is the Epithelial Barrier Hypothesis. This review determined that the one-airway-one-disease concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme allergic (asthma) phenotype combining asthma, rhinitis, and conjunctivitis. Rhinitis alone and rhinitis and asthma multimorbidity represent two distinct diseases with the following differences: (i) genomic and transcriptomic background (Toll-Like Receptors and IL-17 for rhinitis alone as a local disease; IL-33 and IL-5 for allergic and non-allergic multimorbidity as a systemic disease), (ii) allergen sensitization patterns (mono- or pauci-sensitization versus polysensitization), (iii) severity of symptoms, and (iv) treatment response. In conclusion, rhinitis alone (local disease) and rhinitis with asthma multimorbidity (systemic disease) should be considered as two distinct diseases, possibly modulated by the microbiome, and may be a model for understanding the epidemics of chronic and autoimmune diseases.
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    UCRAID (Ukrainian Citizen and refugee electronic support in Respiratory diseases, Allergy, Immunology and Dermatology) action plan
    Bousquet, J; Samolinski, B; Kaidashev, I; Maurer, M; Roche, N; Sousa-Pinto, B; Kurchenko, A; Stepanenko, R; Tsaryk, V; Klimek, L; Ventura, MT; Bedbrook, A; Czarlewski, W; Lysanets, Y; Kupczyk, M; Skolimowski, L; Kulus, M; Del Giacco, S; Ollert, M; Garcia-Aymerich, J; Cordeiro, CR; Yorgancioglu, A; Schlapbach, C; Amaral, R; Bonaglia, C; Bossé, I; Buquicchio, R; Christou, D; Fedoruk, G; Fontanesi, P; Gemicioglu, B; Giuliano, AFM; Lepore, P; Nakonechna, A; Neisinger, S; Pereira, AM; Ramanauskaite, A; Raciborski, F; Sitkauskiene, B; Sokhatska, O; Stepanenko, V; Stevanovic, K; Syzon, O; Kvedariene, V; de Vries, G; van Eerd, M; Valiulis, A; Fonseca, JA; Anto, JM; Haahtela, T; Schünemann, H; Zuberbier, T
    Eight million Ukrainians have taken refuge in the European Union. Many have asthma and/or allergic rhinitis and/or urticaria, and around 100,000 may have a severe disease. Cultural and language barriers are a major obstacle to appropriate management. Two widely available mHealth apps, MASK air (R) (Mobile Airways Sentinel NetworK) for the management of rhinitis and asthma and CRUSE (R) (Chronic Urticaria Self Evaluation) for patients with chronic spontaneous urticaria, were updated to include Ukrainian versions that make the documented information available to treating physicians in their own language. The Ukrainian patients fill in the questionnaires and daily symptom-medication scores for asthma, rhinitis (MASK air) or urticaria (CRUSE) in Ukrainian. Then, following the GDPR, patients grant their physician access to the app by scanning a QR code displayed on the physician's computer enabling the physician to read the app contents in his/her own language. This service is available freely. It takes less than a minute to show patient data to the physician in the physician's web browser. UCRAID- developed by ARIA (Allergic Rhinitis and its Impact on Asthma) and UCARE (Urticaria Centers of Reference and Excellence)- is under the auspices of the Ukraine Ministry of Health as well as European (European Academy of Allergy and Clinical immunology, EAACI, European Respiratory Society, ERS, European Society of Dermatologic Research, ESDR) and national societies.
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    Concurrent validity, cut-offs and ability to change of patient-reported outcome measures for rhinitis and asthma in MASK-air®
    Bousquet, J; Sousa-Pinto, B; Anto, JM; Bedbrook, A; Czarlewski, W; Ansotegui, IJ; Bergmann, KC; Braido, F; Brussino, L; Cecchi, L; Loureiro, CC; Cruz, AA; Devillier, P; Fiocchi, A; Gemicioglu, B; Haahtela, T; Ivancevich, JC; Klimek, L; Kulus, M; Kuna, P; Kupczyk, M; Kvedariene, V; Larenas-Linnemann, DE; Louis, G; Louis, R; Makris, M; Morais-Almeida, M; Niedoszytko, M; Ohta, K; Ollert, M; Papadopoulos, N; Patella, V; Pétré, B; Pfaar, O; Puggioni, F; Quirce, S; Regateiro, FS; Roche, N; Rouadi, PW; Samolinski, B; Sastre, J; Schleich, F; Scichilone, N; Taborda-Barata, L; Toppila-Salmi, S; Valiulis, A; Koyuncu, IV; Ventura, MT; Yorgancioglu, A; Fonseca, JA; Zuberbier, T
    Patient-reported outcome measures (PROMs) are used to assess a patient's health status at a particular point in time. They are essential in the development of person-centred care. This paper reviews studies performed on PROMs for assessing AR and asthma control, in particular VAS scales that are included in the app MASK-air (R) (Mobile Airways Sentinel networK) for asthma and rhinitis. VASs were initially developed on paper and pencil and tested for their criterion validity, cut-offs and responsiveness. Then, a multicentric, multinational, double-blind, placebo-controlled, randomised control trial (DB-PC-RCT) using an electronic VAS form was carried out. Finally, with the development of MASK-air (R) in 2015, previously validated VAS questions were adapted to the digital format and further methodologic evaluations were performed. VAS for asthma, rhinitis, conjunctivitis, work and EQ-5D are included in the app. Additionally, two control-medication scores for allergic symptoms of asthma (e-DASTHMA) were validated for their criterion validity, cut-offs and responsiveness.
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    Development and validation of an electronic daily control score for asthma (e-DASTHMA): a real-world direct patient data study
    Sousa-Pinto, B; Jácome, C; Pereira, AM; Regateiro, FS; Almeida, R; Czarlewski, W; Kulus, M; Shamji, MH; Boulet, LP; Bonini, M; Brussino, L; Canonica, GW; Cruz, AA; Gemicioglu, B; Haahtela, T; Kupczyk, M; Kvedariene, V; Larenas-Linnemann, D; Louis, R; Niedoszytko, M; Nhan, PT; Puggioni, F; Romantowski, J; Sastre, J; Scichilone, N; Taborda-Barata, L; Ventura, MT; Vieira, RJ; Agache, I; Bedbrook, A; Bergmann, KC; Amaral, R; Azevedo, LF; Bosnic-Anticevich, S; Brusselle, G; Buhl, R; Cecchi, L; Charpin, D; Loureiro, CC; de Blay, F; Del Giacco, S; Devillier, P; Jassem, E; Joos, G; Jutel, M; Klimek, L; Kuna, P; Laune, D; Pech, JL; Makela, M; Morais-Almeida, M; Nadif, R; Neffen, HE; Ohta, K; Papadopoulos, NG; Papi, A; Pétré, B; Pfaar, O; Yeverino, DR; Cordeiro, CR; Roche, N; Sá-Sousa, A; Samolinski, B; Sheikh, A; Ulrik, CS; Usmani, OS; Valiulis, A; Vandenplas, O; Vieira-Marques, P; Yorgancioglu, A; Zuberbier, T; Anto, JM; Fonseca, JA; Bousquet, J
    Background Validated questionnaires are used to assess asthma control over the past 1-4 weeks from reporting. However, they do not adequately capture asthma control in patients with fluctuating symptoms. Using the Mobile Airways Sentinel Network for airway diseases (MASK-air) app, we developed and validated an electronic daily asthma control score (e-DASTHMA). Methods We used MASK-air data (freely available to users in 27 countries) to develop and assess different daily control scores for asthma. Data-driven control scores were developed based on asthma symptoms reported by a visual analogue scale (VAS) and self-reported asthma medication use. We included the daily monitoring data from all MASK-air users aged 16-90 years (or older than 13 years to 90 years in countries with a lower age of digital consent) who had used the app in at least 3 different calendar months and had reported at least 1 day of asthma medication use. For each score, we assessed construct validity, test-retest reliability, responsiveness, and accuracy. We used VASs on dyspnoea and work disturbance, EQ-5D-VAS, Control of Allergic Rhinitis and Asthma Test (CARAT), CARAT asthma, and Work Productivity and Activity Impairment: Allergy Specific (WPAI:AS) questionnaires as comparators. We performed an internal validation using MASK-air data from Jan 1 to Oct 12, 2022, and an external validation using a cohort of patients with physician-diagnosed asthma (the INSPIRERS cohort) who had had their diagnosis and control (Global Initiative for Asthma [GINA] classification) of asthma ascertained by a physician. Findings We studied 135 635 days of MASK-air data from 1662 users from May 21, 2015, to Dec 31, 2021. The scores were strongly correlated with VAS dyspnoea (Spearman correlation coefficient range 0.68-0.82) and moderately correlated with work comparators and quality-of-life-related comparators (for WPAI:AS work, we observed Spearman correlation coefficients of 0.59-0.68). They also displayed high test-retest reliability (intraclass correlation coefficients range 0.79-0.95) and moderate-to-high responsiveness (correlation coefficient range 0.69-0.79; effect size measures range 0.57-0.99 in the comparison with VAS dyspnoea). The best-performing score displayed a strong correlation with the effect of asthma on work and school activities in the INSPIRERS cohort (Spearman correlation coefficients 0.70; 95% CI 0.61-0.78) and good accuracy for the identification of patients with uncontrolled or partly controlled asthma according to GINA (area under the receiver operating curve 0.73; 95% CI 0.68-0.78). Interpretation e-DASTHMA is a good tool for the daily assessment of asthma control. This tool can be used as an endpoint in clinical trials as well as in clinical practice to assess fluctuations in asthma control and guide treatment optimisation. Funding None. Copyright (c) 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license.
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    Asthma and rhinitis control in adolescents and young adults: A real-world MASK-air study
    Sousa-Pinto, B; Valiulis, A; Melén, E; Koppelman, GH; Papadopoulos, NG; Makela, M; Haahtela, T; Bonini, M; Braido, F; Brussino, L; Cruz, AA; Fiocchi, A; Giovannini, M; Gemicioglu, B; Kulus, M; Kuna, P; Kupczyk, M; Kvedariene, V; Larenas-Linnemann, DE; Louis, R; Morais-Almeida, M; Niedoszytko, M; Ollert, M; Pfaar, O; Regateiro, FS; Roberts, G; Samolinski, B; Savouré, M; Taborda-Barata, L; Toppila-Salmi, S; Ventura, MT; Vazquez-Ortiz, M; Vieira, RJ; Fonseca, JA; Yorgancioglu, A; Zuberbier, T; Anto, JM; Bousquet, J; Nhan, PT
    Background: In allergic rhinitis and asthma, adolescents and young adult patients are likely to differ from older patients. We compared adolescents, young adults and adults on symptoms, control levels, and medication adherence. Methods: In a cross-sectional study (2015-2022), we assessed European users of the MASK-air mHealth app of three age groups: adolescents (13-18 years), young adults (18-26 years), and adults (>26 years). We compared them on their reported rhinitis and asthma symptoms, use and adherence to rhinitis and asthma treatment and app adherence. Allergy symptoms and control were assessed by means of visual analogue scales (VASs) on rhinitis or asthma, the combined symptom-medication score (CSMS), and the electronic daily control score for asthma (e-DASTHMA). We built multivariable regression models to compare symptoms or medication accounting for potential differences in demographic characteristics and baseline severity. Results: We assessed 965 adolescent users (15,252 days), 4595 young adults (58,161 days), and 15,154 adult users (258,796 days). Users of all three age groups displayed similar app adherence. In multivariable models, age groups were not found to significantly differ in their adherence to rhinitis or asthma medication. These models also found that adolescents reported lower VAS on global allergy, ocular, and asthma symptoms (as well as lower CSMS) than young adults and adults. Conclusions: Adolescents reported a better rhinitis and asthma control than young adults and adults, even though similar medication adherence levels were observed across age groups. These results pave the way for future studies on understanding how adolescents control their allergic diseases.