Analysis of comorbidities and multimorbidity in adult patients in the International Severe Asthma Registry
Q2
- Autores:
-
Scelo, Ghislaine
Torres-Duque, Carlos A.
Maspero, Jorge
Tran, Trung N.
Murray, Ruth
Martin, Neil
Menzies-Gow, Andrew N.
Hew, Mark
Peters, Matthew J.
Gibson, Peter G.
Christoff, George C.
Popov, Todor A.
Côté, Andréanne
Bergeron, Celine
Dorscheid, Delbert
FitzGerald, J. Mark
Chapman, Kenneth R.
Boulet, Louis Philippe
Bhutani, Mohit
Sadatsafavi, Mohsen
Jiménez-Maldonado, Libardo
Duran-Silva, Mauricio
Rodriguez, Bellanid
Celis-Preciado, Carlos Andrés
Cano-Rosales, Diana Jimena
Solarte, Ivan
Fernández Sánchez, Maria José
Parada-Tovar, Patricia
von Bülow, Anna
Bjerrum, Anne Sofie
Ulrik, Charlotte S.
Assing, Karin Dahl
Makowska Rasmussen, Linda
Hansen, Susanne
Altraja, Alan
Bourdin, Arnaud
Taille, Camille
Charriot, Jeremy
Roche, Nicolas
Papaioannou, Andriana I.
Kostikas, Konstantinos
Papadopoulos, Nikolaos G.
Salvi, Sundeep
Long, Deirdre
Mitchell, Patrick D.
Costello, Richard
Sirena, Concetta
Cardini, Cristina
Heffler, Enrico
Puggioni, Francesca
Canonica, Giorgio Walter
Guida, Giuseppe
Iwanaga, Takashi
Al-Ahmad, Mona
Larenas Linnemann, Désirée
Larenas Linnemann, Désirée
García, Ulises
Kuna, Piotr
Fonseca, João A.
Al-Lehebi, Riyad
Koh Siyue, Mariko
Kook Rhee, Chin
Cosio, Borja G.
Perez de Llano, Luis
Perng (Steve), Diahn-Warng
Wan-Chun Huang, Erick
Wang, Hao-Chien
Tsai, Ming-Ju
Mahboub, Bassam
Jaber Salameh, Laila Ibraheem
Jackson, David
Busby, John
Heaney, Liam G.
Pfeffer, Paul
Grippen Goddard, Amanda
Wang, Eileen
Hoyte, Flavia
Wechsler, Michael E.
Chapman, Nicholas
Katial, Rohit
Carter, Victoria
Bulathsinhala, Lakmini
Eleangovan, Neva
Ariti, Con
Lyu, Juntao
Price, David
Porsbjerg, Celeste
- Tipo de recurso:
- Article of investigation
- Fecha de publicación:
- 2023
- Institución:
- Pontificia Universidad Javeriana
- Repositorio:
- Repositorio Universidad Javeriana
- Idioma:
- eng
- OAI Identifier:
- oai:repository.javeriana.edu.co:10554/65399
- Acceso en línea:
- https://www.annallergy.org/article/S1081-1206(23)00630-0/fulltext#%20
http://hdl.handle.net/10554/65399
https://doi.org/10.1016/j.anai.2023.08.021
- Palabra clave:
- Allergic rhinitis
Anxiety/depression
Chronic obstructive pulmonary disease
Chronic rhinosinusitis
Diabetes, Dyslipidemia
Gastroesophageal reflux disease
Hypertension
Nasal polys
Obesity
Osteoporosis
Sleep apnea
- Rights
- License
- Atribución-NoComercial 4.0 Internacional
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Repositorio Universidad Javeriana |
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| dc.title.spa.fl_str_mv |
Analysis of comorbidities and multimorbidity in adult patients in the International Severe Asthma Registry |
| title |
Analysis of comorbidities and multimorbidity in adult patients in the International Severe Asthma Registry |
| spellingShingle |
Analysis of comorbidities and multimorbidity in adult patients in the International Severe Asthma Registry Allergic rhinitis Anxiety/depression Chronic obstructive pulmonary disease Chronic rhinosinusitis Diabetes, Dyslipidemia Gastroesophageal reflux disease Hypertension Nasal polys Obesity Osteoporosis Sleep apnea |
| title_short |
Analysis of comorbidities and multimorbidity in adult patients in the International Severe Asthma Registry |
| title_full |
Analysis of comorbidities and multimorbidity in adult patients in the International Severe Asthma Registry |
| title_fullStr |
Analysis of comorbidities and multimorbidity in adult patients in the International Severe Asthma Registry |
| title_full_unstemmed |
Analysis of comorbidities and multimorbidity in adult patients in the International Severe Asthma Registry |
| title_sort |
Analysis of comorbidities and multimorbidity in adult patients in the International Severe Asthma Registry |
| dc.creator.fl_str_mv |
Scelo, Ghislaine Torres-Duque, Carlos A. Maspero, Jorge Tran, Trung N. Murray, Ruth Martin, Neil Menzies-Gow, Andrew N. Hew, Mark Peters, Matthew J. Gibson, Peter G. Christoff, George C. Popov, Todor A. Côté, Andréanne Bergeron, Celine Dorscheid, Delbert FitzGerald, J. Mark Chapman, Kenneth R. Boulet, Louis Philippe Bhutani, Mohit Sadatsafavi, Mohsen Jiménez-Maldonado, Libardo Duran-Silva, Mauricio Rodriguez, Bellanid Celis-Preciado, Carlos Andrés Cano-Rosales, Diana Jimena Solarte, Ivan Fernández Sánchez, Maria José Parada-Tovar, Patricia von Bülow, Anna Bjerrum, Anne Sofie Ulrik, Charlotte S. Assing, Karin Dahl Makowska Rasmussen, Linda Hansen, Susanne Altraja, Alan Bourdin, Arnaud Taille, Camille Charriot, Jeremy Roche, Nicolas Papaioannou, Andriana I. Kostikas, Konstantinos Papadopoulos, Nikolaos G. Salvi, Sundeep Long, Deirdre Mitchell, Patrick D. Costello, Richard Sirena, Concetta Cardini, Cristina Heffler, Enrico Puggioni, Francesca Canonica, Giorgio Walter Guida, Giuseppe Iwanaga, Takashi Al-Ahmad, Mona Larenas Linnemann, Désirée Larenas Linnemann, Désirée García, Ulises Kuna, Piotr Fonseca, João A. Al-Lehebi, Riyad Koh Siyue, Mariko Kook Rhee, Chin Cosio, Borja G. Perez de Llano, Luis Perng (Steve), Diahn-Warng Wan-Chun Huang, Erick Wang, Hao-Chien Tsai, Ming-Ju Mahboub, Bassam Jaber Salameh, Laila Ibraheem Jackson, David Busby, John Heaney, Liam G. Pfeffer, Paul Grippen Goddard, Amanda Wang, Eileen Hoyte, Flavia Wechsler, Michael E. Chapman, Nicholas Katial, Rohit Carter, Victoria Bulathsinhala, Lakmini Eleangovan, Neva Ariti, Con Lyu, Juntao Price, David Porsbjerg, Celeste |
| dc.contributor.author.none.fl_str_mv |
Scelo, Ghislaine Torres-Duque, Carlos A. Maspero, Jorge Tran, Trung N. Murray, Ruth Martin, Neil Menzies-Gow, Andrew N. Hew, Mark Peters, Matthew J. Gibson, Peter G. Christoff, George C. Popov, Todor A. Côté, Andréanne Bergeron, Celine Dorscheid, Delbert FitzGerald, J. Mark Chapman, Kenneth R. Boulet, Louis Philippe Bhutani, Mohit Sadatsafavi, Mohsen Jiménez-Maldonado, Libardo Duran-Silva, Mauricio Rodriguez, Bellanid Celis-Preciado, Carlos Andrés Cano-Rosales, Diana Jimena Solarte, Ivan Fernández Sánchez, Maria José Parada-Tovar, Patricia von Bülow, Anna Bjerrum, Anne Sofie Ulrik, Charlotte S. Assing, Karin Dahl Makowska Rasmussen, Linda Hansen, Susanne Altraja, Alan Bourdin, Arnaud Taille, Camille Charriot, Jeremy Roche, Nicolas Papaioannou, Andriana I. Kostikas, Konstantinos Papadopoulos, Nikolaos G. Salvi, Sundeep Long, Deirdre Mitchell, Patrick D. Costello, Richard Sirena, Concetta Cardini, Cristina Heffler, Enrico Puggioni, Francesca Canonica, Giorgio Walter Guida, Giuseppe Iwanaga, Takashi Al-Ahmad, Mona Larenas Linnemann, Désirée Larenas Linnemann, Désirée García, Ulises Kuna, Piotr Fonseca, João A. Al-Lehebi, Riyad Koh Siyue, Mariko Kook Rhee, Chin Cosio, Borja G. Perez de Llano, Luis Perng (Steve), Diahn-Warng Wan-Chun Huang, Erick Wang, Hao-Chien Tsai, Ming-Ju Mahboub, Bassam Jaber Salameh, Laila Ibraheem Jackson, David Busby, John Heaney, Liam G. Pfeffer, Paul Grippen Goddard, Amanda Wang, Eileen Hoyte, Flavia Wechsler, Michael E. Chapman, Nicholas Katial, Rohit Carter, Victoria Bulathsinhala, Lakmini Eleangovan, Neva Ariti, Con Lyu, Juntao Price, David Porsbjerg, Celeste |
| dc.contributor.corporatename.spa.fl_str_mv |
Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Medicina Interna. Neumología |
| dc.contributor.corporatename.none.fl_str_mv |
Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Ciencias Fisiológicas |
| dc.contributor.javerianateacher.none.fl_str_mv |
Celis-Preciado, Carlos Andrés Solarte, Ivan Fernández Sánchez, Maria José |
| dc.subject.keyword.spa.fl_str_mv |
Allergic rhinitis Anxiety/depression Chronic obstructive pulmonary disease Chronic rhinosinusitis Diabetes, Dyslipidemia Gastroesophageal reflux disease Hypertension Nasal polys Obesity Osteoporosis Sleep apnea |
| topic |
Allergic rhinitis Anxiety/depression Chronic obstructive pulmonary disease Chronic rhinosinusitis Diabetes, Dyslipidemia Gastroesophageal reflux disease Hypertension Nasal polys Obesity Osteoporosis Sleep apnea |
| description |
Q2 |
| publishDate |
2023 |
| dc.date.accessioned.none.fl_str_mv |
2023-09-07T15:12:49Z |
| dc.date.available.none.fl_str_mv |
2023-09-07T15:12:49Z |
| dc.date.created.none.fl_str_mv |
2023-08-25 |
| dc.type.local.spa.fl_str_mv |
Artículo de revista |
| dc.type.coar.spa.fl_str_mv |
http://purl.org/coar/resource_type/c_2df8fbb1 |
| format |
http://purl.org/coar/resource_type/c_2df8fbb1 |
| dc.identifier.spa.fl_str_mv |
https://www.annallergy.org/article/S1081-1206(23)00630-0/fulltext#%20 |
| dc.identifier.issn.spa.fl_str_mv |
1081-1206 / 1534-4436 (Electrónico) |
| dc.identifier.uri.none.fl_str_mv |
http://hdl.handle.net/10554/65399 |
| dc.identifier.doi.spa.fl_str_mv |
https://doi.org/10.1016/j.anai.2023.08.021 |
| dc.identifier.instname.spa.fl_str_mv |
instname:Pontificia Universidad Javeriana |
| dc.identifier.reponame.spa.fl_str_mv |
reponame:Repositorio Institucional - Pontificia Universidad Javeriana |
| dc.identifier.repourl.spa.fl_str_mv |
repourl:https://repository.javeriana.edu.co |
| url |
https://www.annallergy.org/article/S1081-1206(23)00630-0/fulltext#%20 http://hdl.handle.net/10554/65399 https://doi.org/10.1016/j.anai.2023.08.021 |
| identifier_str_mv |
1081-1206 / 1534-4436 (Electrónico) instname:Pontificia Universidad Javeriana reponame:Repositorio Institucional - Pontificia Universidad Javeriana repourl:https://repository.javeriana.edu.co |
| dc.language.iso.spa.fl_str_mv |
eng |
| language |
eng |
| dc.relation.citationstartpage.spa.fl_str_mv |
1 |
| dc.relation.citationendpage.spa.fl_str_mv |
98 |
| dc.relation.ispartofjournal.spa.fl_str_mv |
Annals of Allergy, Asthma & Immunology |
| dc.rights.licence.*.fl_str_mv |
Atribución-NoComercial 4.0 Internacional |
| dc.rights.uri.*.fl_str_mv |
http://creativecommons.org/licenses/by-nc/4.0/ |
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http://purl.org/coar/access_right/c_abf2 |
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Atribución-NoComercial 4.0 Internacional http://creativecommons.org/licenses/by-nc/4.0/ http://purl.org/coar/access_right/c_abf2 |
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PDF |
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2010-2022 |
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Atribución-NoComercial 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc/4.0/http://purl.org/coar/access_right/c_abf2Scelo, GhislaineTorres-Duque, Carlos A.Maspero, JorgeTran, Trung N.Murray, RuthMartin, NeilMenzies-Gow, Andrew N.Hew, MarkPeters, Matthew J.Gibson, Peter G.Christoff, George C.Popov, Todor A.Côté, AndréanneBergeron, CelineDorscheid, DelbertFitzGerald, J. MarkChapman, Kenneth R.Boulet, Louis PhilippeBhutani, MohitSadatsafavi, MohsenJiménez-Maldonado, LibardoDuran-Silva, MauricioRodriguez, BellanidCelis-Preciado, Carlos AndrésCano-Rosales, Diana JimenaSolarte, IvanFernández Sánchez, Maria JoséParada-Tovar, Patriciavon Bülow, AnnaBjerrum, Anne SofieUlrik, Charlotte S.Assing, Karin DahlMakowska Rasmussen, LindaHansen, SusanneAltraja, AlanBourdin, ArnaudTaille, CamilleCharriot, JeremyRoche, NicolasPapaioannou, Andriana I.Kostikas, KonstantinosPapadopoulos, Nikolaos G.Salvi, SundeepLong, DeirdreMitchell, Patrick D.Costello, RichardSirena, ConcettaCardini, CristinaHeffler, EnricoPuggioni, FrancescaCanonica, Giorgio WalterGuida, GiuseppeIwanaga, TakashiAl-Ahmad, MonaLarenas Linnemann, DésiréeLarenas Linnemann, DésiréeGarcía, UlisesKuna, PiotrFonseca, João A.Al-Lehebi, RiyadKoh Siyue, MarikoKook Rhee, ChinCosio, Borja G.Perez de Llano, LuisPerng (Steve), Diahn-WarngWan-Chun Huang, ErickWang, Hao-ChienTsai, Ming-JuMahboub, BassamJaber Salameh, Laila IbraheemJackson, DavidBusby, JohnHeaney, Liam G.Pfeffer, PaulGrippen Goddard, AmandaWang, EileenHoyte, FlaviaWechsler, Michael E.Chapman, NicholasKatial, RohitCarter, VictoriaBulathsinhala, LakminiEleangovan, NevaAriti, ConLyu, JuntaoPrice, DavidPorsbjerg, CelestePontificia Universidad Javeriana. Facultad de Medicina. Departamento de Medicina Interna. NeumologíaPontificia Universidad Javeriana. Facultad de Medicina. Departamento de Ciencias FisiológicasCelis-Preciado, Carlos AndrésSolarte, IvanFernández Sánchez, Maria José2010-20222023-09-07T15:12:49Z2023-09-07T15:12:49Z2023-08-25https://www.annallergy.org/article/S1081-1206(23)00630-0/fulltext#%201081-1206 / 1534-4436 (Electrónico)http://hdl.handle.net/10554/65399https://doi.org/10.1016/j.anai.2023.08.021instname:Pontificia Universidad Javerianareponame:Repositorio Institucional - Pontificia Universidad Javerianarepourl:https://repository.javeriana.edu.coPDFapplication/pdfengAnalysis of comorbidities and multimorbidity in adult patients in the International Severe Asthma RegistryArtículo de revistahttp://purl.org/coar/resource_type/c_2df8fbb1Q2Q2Pacientes con Asma severaBackground: Investigation for the presence of asthma comorbidities is recommended by GINA as their presence can complicate asthma management. Objective: To understand the prevalence and pattern of comorbidities and multimorbidity in adults with severe asthma and their association with asthma-related outcomes. Methods: This was a cross-sectional study using data from the International Severe Asthma Registry from 22 countries. Thirty comorbidities were identified and categorized a priori as either (1) potentially T2-related, (2) potentially oral corticosteroid (OCS)-related or (3) mimicking/aggravating asthma. The association between comorbidities and asthma-related outcomes was investigated using multivariable models adjusted for country, age at enrollment, and sex. Results: Of 11,821 patients, 69%, 67%, and 55% had ≥1 potentially T2-related, potentially OCS-related, or mimicking/aggravating comorbidities, respectively; 57% had ≥3 comorbidities, and 33% had comorbidities in all three categories. Patients with allergic rhinitis (AR), nasal polyposis (NP), and chronic rhinosinusitis (CRS) experienced 1.12- (p=0.003), 1.16- (p<0.001) and 1.29-times (p<0.001) more exacerbations/year, respectively, than those without. Patients with NP and CRS were 40% and 46% more likely (p<0.001), respectively, to have received long-term (LT) OCS. All assessed potential OCS-related comorbidities (except obesity) were associated with greater likelihood of LTOCS use (ORs: 1.23-2.77) and, except for dyslipidemia, with greater likelihood of uncontrolled asthma (ORs: 1.29-1.68). All mimicking/aggravating comorbidities assessed were associated with more exacerbations (1.24-1.68 times more), all (except bronchiectasis) with increased likelihood of uncontrolled asthma (ORs: 1.57-1.81) and all (except COPD) with increased likelihood of LTOCS use (ORs: 1.37-1.57). Greater number of comorbidities was associated with worse outcome. Conclusion: In a global study, comorbidity or multimorbidity is reported in most adults with severe asthma and is associated with poorer asthma-related outcomes.https://orcid.org/0000-0001-8405-4513https://orcid.org/0000-0002-0100-1940https://orcid.org/0000-0001-6461-2725Revista Internacional - IndexadaA1NoAllergic rhinitisAnxiety/depressionChronic obstructive pulmonary diseaseChronic rhinosinusitisDiabetes, DyslipidemiaGastroesophageal reflux diseaseHypertensionNasal polysObesityOsteoporosisSleep apnea198Annals of Allergy, Asthma & ImmunologyORIGINALAnalysis of comorbidities and multimorbidity in adult patients in the International Severe Asthma Registry.pdfAnalysis of comorbidities and multimorbidity in adult patients in the International Severe Asthma Registry.pdfArtículoapplication/pdf2625137http://repository.javeriana.edu.co/bitstream/10554/65399/1/Analysis%20of%20comorbidities%20and%20multimorbidity%20in%20adult%20patients%20in%20the%20International%20Severe%20Asthma%20Registry.pdfed0a16e0347420f1ce86c64a9e7bb81dMD51open accessLICENSElicense.txtlicense.txttext/plain; charset=utf-82603http://repository.javeriana.edu.co/bitstream/10554/65399/2/license.txt2070d280cc89439d983d9eee1b17df53MD52open accessTHUMBNAILAnalysis of comorbidities and multimorbidity in adult patients in the International Severe Asthma Registry.pdf.jpgAnalysis of comorbidities and multimorbidity in adult patients in the International Severe Asthma Registry.pdf.jpgIM Thumbnailimage/jpeg8896http://repository.javeriana.edu.co/bitstream/10554/65399/3/Analysis%20of%20comorbidities%20and%20multimorbidity%20in%20adult%20patients%20in%20the%20International%20Severe%20Asthma%20Registry.pdf.jpgdacd75958f042db40f579a2fbb5f3ebaMD53open access10554/65399oai:repository.javeriana.edu.co:10554/653992024-01-11 18:18:06.987Repositorio Institucional - Pontificia Universidad Javerianarepositorio@javeriana.edu.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 |