Browsing by Author "Loureiro, CC"

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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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    Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases
    Bousquet, JJ; Schünemann, HJ; Togias, A; Erhola, M; Hellings, PW; Zuberbier, T; Agache, I; Ansotegui, IJ; Anto, JM; Bachert, C; Becker, S; Bedolla-Barajas, M; Bewick, M; Bosnic-Anticevich, S; Bosse, I; Boulet, LP; Bourrez, JM; Brusselle, G; Chavannes, N; Costa, E; Cruz, AA; Czarlewski, W; Fokkens, WJ; Fonseca, JA; Gaga, M; Haahtela, T; Illario, M; Klimek, L; Kuna, P; Kvedariene, V; Le, LTT; Larenas-Linnemann, D; Laune, D; Lourenço, OM; Menditto, E; Mullo, J; Okamoto, Y; Papadopoulos, N; Nhân, PT; Picard, R; Pinnock, H; Roche, N; Roller-Wirnsberger, RE; Rolland, C; Samolinski, B; Sheikh, A; Toppila-Salmi, S; Tsiligianni, I; Valiulis, A; Valovirta, E; Vasankari, T; Ventura, MT; Walker, S; Williams, S; Akdis, CA; Annesi-Maesano, I; Arnavielhe, S; Basagana, X; Bateman, E; Bedbrook, A; Bennoor, KS; Benveniste, S; Bergmann, KC; Bia, S; Billo, N; Bindslev-Jensen, C; Bjermer, L; Blain, H; Bonini, M; Bonniaud, P; Bouchard, J; Briedis, V; Brightling, CE; Brozek, J; Buhl, R; Buonaiuto, R; Canonica, GW; Cardona, V; Carriazo, AM; Carr, W; Cartier, C; Casale, T; Cecchi, L; Sarabia, AMC; Chkhartishvili, E; Chu, DK; Cingi, C; Colgan, E; de Sousa, JC; Courbis, AL; Custovic, A; Cvetkosvki, B; D'Amato, G; da Silva, J; Dantas, C; Dokic, D; Dauvilliers, Y; Dedeu, A; De Feo, G; Devillier, P; Di Capua, S; Dykewickz, M; Dubakiene, R; Ebisawa, M; El-Gamal, Y; Eller, E; Emuzyte, R; Farrell, J; Fink-Wagner, A; Fiocchi, A; Fontaine, JF; Gemicioglu, B; Schmid-Grendelmeir, P; Gamkrelidze, A; Garcia-Aymerich, J; Gomez, M; Diaz, SG; Gotua, M; Guldemond, NA; Guzmán, MA; Hajjam, J; Hourihane, JO; Humbert, M; Iaccarino, G; Ierodiakonou, D; Ivancevich, JC; Joos, G; Jung, KS; Jutel, M; Kaidashev, I; Kalayci, O; Kardas, P; Keil, T; Khaitov, M; Khaltaev, N; Kleine-Tebbe, J; Kowalski, ML; Kritikos, V; Kull, I; Leonardini, L; Lieberman, P; Lipworth, B; Carlsen, KCL; Loureiro, CC; Louis, R; Mair, A; Marien, G; Mahboub, B; Malva, J; Manning, P; Keenoy, ED; Marshall, GD; Masjedi, MR; Maspero, JF; Mathieu-Dupas, E; Matricardi, PM; Melén, E; Melo-Gomes, E; Meltzer, EO; Mercier, J; Miculinic, N; Mihaltan, F; Milenkovic, B; Moda, G; Mogica-Martinezl, MD; Mohammad, Y; Montefort, S; Monti, R; Morais-Almeida, M; Mösges, R; Münter, L; Muraro, A; Murray, R; Naclerio, R; Napoli, L; Namazova-Baranova, L; Neffen, H; Nekam, K; Neou, A; Novellino, E; Nyembue, D; O'Hehir, R; Ohta, K; Okubo, K; Onorato, G; Ouedraogo, S; Pali-Schöll, I; Palkonen, S; Panzner, P; Park, HS; Pépin, JL; Pereira, AM; Pfaar, O; Paulino, E; Phillips, J; Plavec, D; Popov, TA; Portejoie, F; Price, D; Prokopakis, EP; Pugin, B; Raciborski, F; Rajabian-Söderlund, R; Reitsma, S; Rodo, X; Romano, A; Rosario, N; Rottem, M; Ryan, D; Salimäki, J; Sanchez-Borges, MM; Sisul, JC; Solé, D; Somekh, D; Sooronbaev, T; Sova, M; Spranger, O; Stellato, C; Stelmach, R; Ulrik, CS; Thibaudon, M; To, T; Todo-Bom, A; Tomazic, PV; Valero, AA; Valenta, R; Valentin-Rostan, M; van der Kleij, R; Vandenplas, O; Vezzani, G; Viart, F; Vieg, G; Wallace, D; Wagenmann, M; Wang, DY; Waserman, S; Wickman, M; Williams, DM; Wong, G; Wroczynski, P; Yiallouros, PK; Yorgancioglu, A; Yusuf, OM; Zar, HJ; Zeng, S; Zernotti, M; Zhang, L; Zhong, NS; Zidarn, M
    Background In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted patient activation, (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Sante as a Good Practice in the field of digitally-enabled, integrated, person-centred care. Conclusion In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
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    ARIA digital anamorphosis: Digital transformation of health and care in airway diseases from research to practice
    Bousquet, J; Anto, JM; Bachert, C; Haahtela, T; Zuberbier, T; Czarlewski, W; Bedbrook, A; Bosnic-Anticevich, S; Canonica, GW; Cardona, V; Costa, E; Cruz, AA; Erhola, M; Fokkens, WJ; Fonseca, JA; Illario, M; Ivancevich, JC; Jutel, M; Klimek, L; Kuna, P; Kvedariene, V; Le, L; Larenas-Linnemann, DE; Laune, D; Lourenço, OM; Melén, E; Mullol, J; Niedoszytko, M; Odemyr, M; Okamoto, Y; Papadopoulos, NG; Patella, V; Pfaar, O; Pham-Thi, N; Rolland, C; Samolinski, B; Sheikh, A; Sofiev, M; Ulrik, CS; Todo-Bom, A; Tomazic, PV; Toppila-Salmi, S; Tsiligianni, I; Valiulis, A; Valovirta, E; Ventura, MT; Walker, S; Williams, S; Yorgancioglu, A; Agache, I; Akdis, CA; Almeida, R; Ansotegui, IJ; Annesi-Maesano, I; Arnavielhe, S; Basagaña, X; Bateman, ED; Bédard, A; Bedolla-Barajas, M; Becker, S; Bennoor, KS; Benveniste, S; Bergmann, KC; Bewick, M; Bialek, S; Billo, NE; Bindslev-Jensen, C; Bjermer, L; Blain, H; Bonini, M; Bonniaud, P; Bosse, I; Bouchard, J; Boulet, LP; Bourret, R; Boussery, K; Braido, F; Briedis, V; Briggs, A; Brightling, CE; Brozek, J; Brusselle, G; Brussino, L; Buhl, R; Buonaiuto, R; Calderon, MA; Camargos, P; Camuzat, T; Caraballo, L; Carriazo, AM; Carr, W; Cartier, C; Casale, T; Cecchi, L; Sarabia, ACM; Chavannes, NH; Chkhartishvili, E; Chu, DRK; Cingi, C; de Sousa, JC; Costa, DJ; Courbis, AL; Custovic, A; Cvetkosvki, B; D'Amato, G; da Silva, J; Dantas, C; Dokic, D; Dauvilliers, Y; De Feo, G; De Vries, G; Devillier, P; Di Capua, S; Dray, G; Dubakiene, R; Durham, SR; Dykewicz, M; Ebisawa, M; Gaga, M; El-Gamal, Y; Heffler, E; Emuzyte, R; Farrell, J; Fauquert, JL; Fiocchi, A; Fink-Wagner, A; Fontaine, JF; Perez, JMF; Gemicioglu, B; Gamkrelidze, A; Garcia-Aymerich, J; Gevaert, P; Gomez, RM; Diaz, SG; Gotua, M; Guldemond, NA; Guzmán, MA; Hajjam, J; Villalobos, YHR; Humbert, M; Iaccarino, G; Ierodiakonou, D; Iinuma, T; Jassem, E; Joos, G; Jung, KS; Kaidashev, I; Kalayci, O; Kardas, P; Keil, T; Khaitov, M; Khaltaev, N; Kleine-Tebbe, J; Kouznetsov, R; Kowalski, ML; Kritikos, V; Kull, I; La Grutta, S; Leonardini, L; Ljungberg, H; Lieberman, P; Lipworth, B; Carlsen, KLC; Lopes-Pereira, C; Loureiro, CC; Louis, R; Mair, A; Mahboub, B; Makris, M; Malva, J; Manning, P; Marshall, GD; Masjedi, MR; Maspero, JF; Carreiro-Martins, P; Makela, M; Mathieu-Dupas, E; Maurer, M; Keenoy, ED; Melo-Gomes, E; Meltzer, EO; Menditto, E; Mercier, J; Micheli, Y; Miculinic, N; Mihaltan, F; Milenkovic, B; Mitsias, DI; Moda, G; Mogica-Martinez, MD; Mohammad, Y; Montefort, S; Monti, R; Morais-Almeida, M; Mösges, R; Münter, L; Muraro, A; Murray, R; Naclerio, R; Napoli, L; Namazova-Baranova, L; Neffen, H; Nekam, K; Neou, A; Nordlund, B; Novellino, E; Nyembue, D; O'Hehir, R; Ohta, K; Okubo, K; Onorato, GL; Orlando, V; Ouedraogo, S; Palamarchuk, J; Pali-Schöll, I; Panzner, P; Park, HS; Passalacqua, G; Pépin, JL; Paulino, E; Pawankar, R; Phillips, J; Picard, R; Pinnock, H; Plavec, D; Popov, TA; Portejoie, F; Price, D; Prokopakis, EP; Psarros, F; Pugin, B; Puggioni, F; Quinones-Delgado, P; Raciborski, F; Rajabian-Söderlund, R; Regateiro, FS; Reitsma, S; Rivero-Yeverino, D; Roberts, G; Roche, N; Rodriguez-Zagal, E; Rolland, C; Roller-Wirnsberger, RE; Rosario, N; Romano, A; Rottem, M; Ryan, D; Salimäki, J; Sanchez-Borges, MM; Sastre, J; Scadding, GK; Scheire, S; Schmid-Grendelmeier, P; Schünemann, HJ; Serpa, FS; Shamji, M; Sisul, JC; Sofiev, M; Solé, D; Somekh, D; Sooronbaev, T; Sova, M; Spertini, F; Spranger, O; Stellato, C; Stelmach, R; Thibaudon, M; To, T; Toumi, M; Usmani, O; Valero, AA; Valenta, R; Valentin-Rostan, M; Pereira, MU; van der Kleij, R; Van Eerd, M; Vandenplas, O; Vasankari, T; Carneiro, AV; Vezzani, G; Viart, F; Viegi, G; Wallace, D; Wagenmann, M; Wang, DY; Waserman, S; Wickman, M; Williams, DM; Wong, G; Wroczynski, P; Yiallouros, PK; Yusuf, OM; Zar, HJ; Zeng, SE; Zernotti, ME; Zhang, L; Shan Zhong, N; Zidarn, M
    Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are 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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    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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    Relevance of individual bronchial symptoms for asthma diagnosis and control in patients with rhinitis: A MASK-air study
    Sousa-Pinto, B; Louis, G; Vieira, RJ; Czarlewski, W; Anto, JM; Amaral, R; Sá-Sousa, A; Brussino, L; Canonica, GW; Loureiro, CC; Cruz, AA; Gemicioglu, B; Haahtela, T; Kupczyk, M; Kvedariene, V; Larenas-Linnemann, DE; Pham-Thi, N; Puggioni, F; Regateiro, FS; Romantowski, J; Sastre, J; Scichilone, N; Taborda-Barata, L; Ventura, MT; Agache, I; Bedbrook, A; Benfante, A; Bergmann, KC; Bosnic-Anticevich, S; Bonini, M; Boulet, LP; Brusselle, G; Buhl, R; Cecchi, L; Charpin, D; Costa, EM; Del Giacco, S; Jutel, M; Klimek, L; Kuna, P; Laune, D; Makela, M; Morais-Almeida, M; Nadif, R; Niedoszytko, M; Papadopoulos, NG; Papi, A; Pfaar, O; Rivero-Yeverino, D; Roche, N; Samolinski, B; Shamji, MH; Sheikh, A; Ulrik, CS; Usmani, OS; Valiulis, A; Yorgancioglu, A; Zuberbier, T; Fonseca, JA; Pétré, B; Louis, R; Bousquet, J
    RationaleIt is unclear how each individual asthma symptom is associated with asthma diagnosis or control.ObjectivesTo assess the performance of individual asthma symptoms in the identification of patients with asthma and their association with asthma control.MethodsIn this cross-sectional study, we assessed real-world data using the MASK-air (R) app. We compared the frequency of occurrence of five asthma symptoms (dyspnea, wheezing, chest tightness, fatigue and night symptoms, as assessed by the Control of Allergic Rhinitis and Asthma Test [CARAT] questionnaire) in patients with probable, possible or no current asthma. We calculated the sensitivity, specificity and predictive values of each symptom, and assessed the association between each symptom and asthma control (measured using the e-DASTHMA score). Results were validated in a sample of patients with a physician-established diagnosis of asthma.Measurement and Main ResultsWe included 951 patients (2153 CARAT assessments), with 468 having probable asthma, 166 possible asthma and 317 no evidence of asthma. Wheezing displayed the highest specificity (90.5%) and positive predictive value (90.8%). In patients with probable asthma, dyspnea and chest tightness were more strongly associated with asthma control than other symptoms. Dyspnea was the symptom with the highest sensitivity (76.1%) and the one consistently associated with the control of asthma as assessed by e-DASTHMA. Consistent results were observed when assessing patients with a physician-made diagnosis of asthma.ConclusionsWheezing and chest tightness were the asthma symptoms with the highest specificity for asthma diagnosis, while dyspnea displayed the highest sensitivity and strongest association with asthma control.
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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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    Adherence to inhaled corticosteroids and long-acting β2-agonists in asthma: A MASK-air study
    Sousa-Pinto, B; Louis, R; Anto, JM; Amaral, R; Sá-Sousa, A; Czarlewski, W; Brussino, L; Canonica, GW; Loureiro, CC; Cruz, AA; Gemicioglu, B; Haahtela, T; Kupczyk, M; Kvedariene, V; Larenas-Linnemann, DE; Okamoto, Y; Ollert, M; Pfaar, O; Pham-Thi, N; Puggioni, F; Regateiro, FS; Romantowski, J; Sastre, J; Scichilone, N; Taborda-Barata, L; Ventura, MT; Agache, I; Bedbrook, A; Becker, S; Bergmann, KC; Bosnic-Anticevich, S; Bonini, M; Boulet, LP; Brusselle, G; Buhl, R; Cecchi, L; Charpin, D; de Blay, F; Del Giacco, S; Ivancevich, JC; Jutel, M; Klimek, L; Kraxner, H; Kuna, P; Laune, D; Makela, M; Morais-Almeida, M; Nadif, R; Niedoszytko, M; Papadopoulos, NG; Papi, A; Patella, V; Pétré, B; Yeverino, DR; Cordeiro, CR; Roche, N; Rouadi, PW; Samolinski, B; Savouré, M; Shamji, MH; Sheikh, A; Ulrik, CS; Usmani, OS; Valiulis, A; Yorgancioglu, A; Zuberbier, T; Fonseca, JA; Costa, EM; Bousquet, J
    Introduction Adherence to controller medication is a major problem in asthma management, being difficult to assess and tackle. mHealth apps can be used to assess adherence. We aimed to assess the adherence to inhaled corticosteroids+long-acting beta 2-agonists (ICS+LABA) in users of the MASK-air((R)) app, comparing the adherence to ICS+formoterol (ICS+F) with that to ICS+other LABA. Materials and methods We analysed complete weeks of MASK-air((R)) data (2015-2022; 27 countries) from patients with self-reported asthma and ICS+LABA use. We compared patients reporting ICS+F versus ICS+other LABA on adherence levels, symptoms and symptom-medication scores. We built regression models to assess whether adherence to ICS+LABA was associated with asthma control or short-acting beta-agonist (SABA) use. Sensitivity analyses were performed considering the weeks with no more than one missing day. Results In 2598 ICS+LABA users, 621 (23.9%) reported 4824 complete weeks and 866 (33.3%) reported weeks with at most one missing day. Higher adherence (use of medication =80% of weekly days) was observed for ICS+other LABA (75.1%) when compared to ICS+F (59.3%), despite both groups displaying similar asthma control and work productivity. The ICS+other LABA group was associated with more days of SABA use than the ICS+F group (median=71.4% versus 57.1% days). Each additional weekly day of ICS+F use was associated with a 4.1% less risk in weekly SABA use (95%CI=-6.5;-1.6%;p=0.001). For ICS+other LABA, the percentage was 8.2 (95%CI=-11.6;-5.0%;p<0.001). Conclusions In asthma patients adherent to the MASK-air app, adherence to ICS+LABA was high. ICS+F users reported lower adherence but also a lower SABA use and a similar level of control.