Diagnosis and definition of severe refractory asthma: an international consensus statement from the Innovative Medicine Initiative (IMI) (original) (raw)

Diagnosis and definition of severe refractory asthma: an international consensus statement from the Innovative Medicine Initiative (IMI)

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  1. Elisabeth H Bel1,
  2. Ana Sousa2,
  3. Louise Fleming3,
  4. Andrew Bush4,
  5. K Fan Chung5,
  6. Jennifer Versnel6,
  7. Ariane H Wagener1,
  8. Scott S Wagers7,
  9. Peter J Sterk1,
  10. Chris H Compton8,
  11. on behalf of the members of the Unbiased Biomarkers for the Prediction of Respiratory Disease Outcome (U-BIOPRED) Consortium, Consensus Generation9
  12. 1Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
  13. 2GlaxoSmithKline, Stevenage, UK
  14. 3Clinical Trials and Evaluation Unit, Imperial College London, London, UK
  15. 4Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK
  16. 5Airways Disease, National Heart and Lung Institute, Imperial College, London, UK
  17. 6Asthma UK, London, UK
  18. 7BioSci Consulting, Maasmechelen, Belgium
  19. 8European Federation of Pharmaceutical Industries and Associations (EFPIA), EFPIA Headquarters, Brussels, Belgium
  20. 9European Union (EU) Innovative Medicines Initiative (IMI) Program Understanding Severe Asthma, Consortium Unbiased Biomarkers for the Prediction of Respiratory Disease Outcomes (U-BIOPRED)
  21. Correspondence to Professor Dr Elisabeth H Bel, Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; e.h.bel{at}amc.uva.nl

Abstract

Patients with severe refractory asthma pose a major healthcare problem. Over the last decade it has become increasingly clear that, for the development of new targeted therapies, there is an urgent need for further characterisation and classification of these patients. The Unbiased Biomarkers for the Prediction of Respiratory Disease Outcomes (U-BIOPRED) consortium is a pan-European public-private collaboration funded by the European Commission Innovative Medicines Initiative of the European Union. U-BIOPRED aims to subphenotype patients with severe refractory asthma by using an innovative systems biology approach. This paper presents the U-BIOPRED international consensus on the definition and diagnosis of severe asthma, aligning the latest concepts in adults as well as in children. The consensus is based on existing recommendations up to 2010 and will be used for the selection of patients for the upcoming U-BIOPRED study. It includes the differentiation between ‘problematic’, ‘difficult’ and ‘severe refractory’ asthma, and provides a systematic algorithmic approach to the evaluation of patients presenting with chronic severe asthma symptoms for use in clinical research and specialised care.

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