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Bousquet, J. et al. Uniform definition of asthma severity, control, and exacerbations: document presented for the World Health Organization Consultation on Severe Asthma. J. Allergy Clin. Immunol. 126, 926-938

University Hospital, Hôpital Arnaud de Villeneuve, Montpellier, France.
The Journal of allergy and clinical immunology (Impact Factor: 11.25). 10/2010; 126(5):926-38. DOI: 10.1016/j.jaci.2010.07.019
Source: PubMed

ABSTRACT Asthma is a global health problem affecting around 300 million individuals of all ages, ethnic groups and countries. It is estimated that around 250,000 people die prematurely each year as a result of asthma. Concepts of asthma severity and control are important in evaluating patients and their response to treatment, as well as for public health, registries, and research (clinical trials, epidemiologic, genetic, and mechanistic studies), but the terminology applied is not standardized, and terms are often used interchangeably. A common international approach is favored to define severe asthma, uncontrolled asthma, and when the 2 coincide, although adaptation may be required in accordance with local conditions. A World Health Organization meeting was convened April 5-6, 2009, to propose a uniform definition of severe asthma. An article was written by a group of experts and reviewed by the Global Alliance against Chronic Respiratory Diseases review group. Severe asthma is defined by the level of current clinical control and risks as "Uncontrolled asthma which can result in risk of frequent severe exacerbations (or death) and/or adverse reactions to medications and/or chronic morbidity (including impaired lung function or reduced lung growth in children)." Severe asthma includes 3 groups, each carrying different public health messages and challenges: (1) untreated severe asthma, (2) difficult-to-treat severe asthma, and (3) treatment-resistant severe asthma. The last group includes asthma for which control is not achieved despite the highest level of recommended treatment and asthma for which control can be maintained only with the highest level of recommended treatment.

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    • "Asthma affects about 300 million people of all ages and ethnic groups worldwide [1], with an estimated increase in prevalence to 400 million by 2025 [2]. The economic burden in terms of direct (hospitalization , use of emergency room visits, therapy) and indirect (missed days of work/school) costs adds to the emotional, physical and social impact of asthma, with consequent quality of life deterioration for both patients and their families [3]. "
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    • "It is estimated that 300 million people worldwide suffer from asthma. According to the World Health Organization, this is expected to rise to 400 million by 2025, and almost 250,000 deaths per year are attributed to asthma (Bousquet et al., 2010). While evidence and theories implicate a variety of contributing factors from cellular to organ levels, asthma is perhaps best characterised as an emergent phenomena that is fundamentally a disease of airway constriction and obstruction. "
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