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Interactive Exchange™

Swimming Upstream in Severe Asthma

New Pathways to Patient Management

Meeting Slides

Clinical Practice Guidelines

Global Strategy for Asthma Management and Prevention.

Global Initiative for Asthma, 2021.

Management of severe asthma: a European Respiratory Society/American Thoracic Society guideline.

Holguin F, et al. Eur Respir J. 2020;55(1):1900588.

Clinical Practice Tools

Centers for Disease Control and Prevention (CDC) Asthma Action Plans

These tools for asthma control were created following the evidence-based guidance published by the National Institutes of Health.   

Asthma Control Test (ACT)

This 5-question test evaluates asthma control over the past 4 weeks on a 5-point Likert scale. A score of <20 on the ACT suggests asthma that is uncontrolled.

Nathan RA, et al. J Allergy Clin Immunol. 2004;113(1):59-65.

Asthma Control Questionnaire (ACQ)

This 7-question assessment tool measures asthma control over the past 7 days. Six questions are self-administered by the patient, and 1 question requires a clinician’s input. Scores range from 1 (totally controlled) to 6 (severely uncontrolled).

Juniper EF, et al. Eur Respir J. 1999;14(4):902-907.

Asthma Therapy Assessment Questionnaire (ATAQ)

This 4-question test assesses asthma control over the past 4 weeks. Each question has a possible score of 0 or 1; if the sum of the 4 question scores is >1, the patient’s asthma may be uncontrolled.

Vollmer WM, et al. Am J Respir Crit Care Med. 1999;160(5 Pt 1):1647-1652.

Shared Decision-Making Tool

The CHEST Foundation, Allergy and Asthma Network, and American College of Allergy, Asthma & Immunology (ACAAI) have developed a shared decision-making tool for adults with severe asthma so that they may work collaboratively with clinicians to improve self-management skills, choose the best treatment plan, and increase adherence.

Patient Advocacy Organizations and Resources

Asthma and Allergy Foundation of America (AAFA)

AAFA is dedicated to improving the quality of life for people with asthma and allergic diseases through education, advocacy, and research.

American College of Allergy, Asthma & Immunology (ACAAI)

The ACAAI fosters a culture of collaboration and congeniality in which members work toward the common goals of patient care, education, advocacy, and research.

American Lung Association

The American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease through education, advocacy, and research.

American Thoracic Society (ATS)

The mission of the ATS is to improve health worldwide by advancing research, clinical care, and public health in respiratory disease, critical illness, and sleep disorders.

CHEST Foundation

The CHEST Foundation creates trusted patient education resources and disease awareness campaigns that empower patients to engage in better managing their health.

Suggested Readings

Understanding asthma phenotypes, endotypes, and mechanisms of disease.

Kuruvilla ME, et al. Clin Rev Allergy Immunol. 2019;56(2): 219-233.-233.

New targeted therapies for uncontrolled asthma.

Corren J. J Allergy Clin Immunol Pract. 2019;7(5):1394-1403

Oral corticosteroid exposure and adverse effects in asthmatic patients.

Sullivan PW, et al. J Allergy Clin Immunol. 2018;141(1):110-116.e7.

T2-“low” asthma: overview and management strategies.

Fitzpatrick AM, et al. J Allergy Clin Immunol Pract. 2020;8(2):452-463.

Treatment options in type-2 low asthma.

Hinks TSW, et al. Eur Respir J. 2021;57(1):2000528.

Tezepelumab in Adults with Uncontrolled Asthma.

Corren J, et al. N Engl J Med. 2017;377(10):936-946.

Efficacy and safety of tezepelumab in adults and adolescents with severe, uncontrolled asthma: results from the phase 3 NAVIGATOR study.

Menzies-Gow A, et al. J Allergy Clin Immunol. 2021;147(2):AB249.

Astegolimab (anti-ST2) efficacy and safety in adults with severe asthma: a randomized clinical trial.

Kelsen SG, et al. J Allergy Clin Immunol. 2021;S0091-6749(21)00609-6.

Randomized, double-blind, placebo-controlled study of brodalumab, a human anti-IL-17 receptor monoclonal antibody, in moderate to severe asthma.

Busse WW, et al. Am J Respir Crit Care Med. 2013;188(11):1294-1302.

Activity
Swimming Upstream in Severe Asthma

New Pathways to Patient Management

Relevant Resources

Clinical Updates in Systemic Lupus Erythematosus

Improved Diagnostic and Management Strategies

Advances in Immunosupressive Therapy for Solid Organ Transplantation

Long-Term Management Strategies to Improve Patient Outcomes

Clinical Updates on the Management of Gout

Evidence-Based Strategies for Improved Patient Outcomes

Chronic Obstructive Pulmonary Disease, Asthma, or Both

Differential Diagnosis and Comprehensive Management Strategies

Improving Outcomes in Chronic Obstructive Pulmonary Disease

Optimizing Maintenance Therapy Across Healthcare Settings

Managing Gout in Primary Care

Evolving Strategies for Diagnosis and Long-Term Management

Improving Outcomes in Rheumatoid Arthritis

Treating to Target, IL-6-Directed Therapies, and Evolving Management Algorithms

Clearing the Air

Improving Outcomes for Patients with COPD

Comprehensive Management of Chronic Obstructive Pulmonary Disease

Collaborative Approaches to Guideline-Concordant Patient Care

Clinical Updates in the Management of Severe Asthma

New Strategies for Individualizing Long-term Care

Improving Outcomes in Severe Asthma

A New Era in Precision Medicine

Clinical Updates in Rheumatoid Arthritis

Evolving Treatment Algorithms and Expert Perspectives on Biosimilars

Going Deeper on Atopic Dermatitis

Pathophysiology to the Management of Moderate-to-Severe Disease

Caring for Patients with Severe Asthma

Evolving Best Practices to Optimize Outcomes

Clinical Issues in Severe Asthma

Consensus and Controversies on the Road to Precision Medicine

Looking Beneath The Surface In Atopic Dermatitis

Targeting Immune Dysregulation and Delivering Comprehensive Care

Breathing Life Into COPD Management

Ongoing Monitoring, Pulmonary Rehabilitation, and Individualized Care

Evolving Treatment Paradigms For Rheumatoid Arthritis

Translating Comprehensive Patient Evaluations Into Personalized Therapy

Clinical Updates in Rheumatoid Arthritis

New Perspectives on Targeting Remission and Individualizing Therapy

Clinical Issues in Severe Asthma

Debates and Discussions About Personalizing Patient Management

A Better Look at Rheumatoid Arthritis

Using Imaging to Improve Patient Outcomes

Clinical Issues in Rheumatoid Arthritis

Discussions and Debates on the Evolving Roles of Targeted Synthetic DMARDs

Advancing the Care of Severe Asthma

Differential Diagnosis, Multidisciplinary Management, and Patient Engagement

Focusing on Patients With Severe Asthma

From Guideline Recommendations to Daily Clinical Decision-Making

Pathways to Better Outcomes in Systemic Lupus Erythematosus

Translating Pathophysiology into Targeted Treatments

The Big Picture of IBD

An Interactive Experience Highlighting Recent Clinical Advances

Clearing the Air in Severe Asthma Management

Improving Patient Outcomes Through Shared Clinical Decision Making

Clinical Issues in Rheumatoid Arthritis

Debates & Discussions on the Evolving Role of JAK Inhibitors

Clearing the Air in Severe Asthma Management

Improving Patient Outcomes Through Shared Clinical Decision Making

Marching Forward in Atopic Dermatitis

Digging Deep on Shared Decision-Making

Clinical Issues in Rheumatoid Arthritis

The Evolving Role of JAK Inhibitors

JAKi in RA Practice

Unpacking the Evidence for Their Use Today and Tomorrow

Airing It Out

A Case-Based Conversation on Managing Asthma and Chronic Rhinosinusitis With Nasal Polyposis

COPD in Managed Care

The Clinical and Utilization Benefits of Exacerbation Prevention

Finding the Right Path in Severe Asthma

Mechanistic Insights and Emerging Treatment Options

COPD Cases and Conversations

A Focus on Exacerbation Prevention

Demystifying New Evidence for COPD Management

Best Practices for Primary Care

What’s New in Systemic Lupus Erythematosus?

Unlocking Novel Paths to Patient Care

Updates on Chronic Rhinosinusitis with Nasal Polyps

Evolving Best Practices for Patient Management

Expert Views on the Changing Landscape in RA

The Increasing Role of JAK Inhibitors

Updates in Systemic Lupus Erythematosus

Unlocking Novel Paths to Patient Care

A Breath of Fresh Air in Pediatric Asthma

Shared Decision-making in the Era of Biologics

Where are We Now In Moderate-to-Severe Asthma?

From Comprehensive Patient Evaluations to Individualized Evidence-based Care

COPD Cases & Conversations

Preventing COPD Exacerbations to Improve Outcomes

Clinical Issues in COVID-19

Debates and Discussions about Monoclonal Antibody Therapies

MINIMIZING PATIENT RISKS FROM COVID-19

An Update on Monoclonal Antibody Therapies

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SELECT * FROM `resources` `t` WHERE `t`.`id` IN (180, 181, 172, 171, 168, 167, 164, 163, 153, 151, 149, 144, 142, 138, 137, 136, 131, 127, 126, 117, 116, 110, 104, 98, 97, 95, 92, 90, 86, 82, 79, 78, 77, 75, 68, 67, 63, 62, 60, 58, 57, 54, 53, 47, 46, 34, 35, 32, 28, 22, 5)
1 0.003003 0.003003 0.003003 0.003003
SELECT `activities`.`id` AS `t1_c0`, `activities`.`group_id` AS `t1_c1`, `activities`.`resource_id` AS `t1_c2`, `activities`.`title` AS `t1_c3`, `activities`.`type` AS `t1_c4`, `activities`.`facultyNames` AS `t1_c5`, `activities`.`shortDescription` AS `t1_c6`, `activities`.`fullDescription` AS `t1_c7`, `activities`.`creditAmount` AS `t1_c8`, `activities`.`shortAddress` AS `t1_c9`, `activities`.`creditType` AS `t1_c10`, `activities`.`startDate` AS `t1_c11`, `activities`.`finishDate` AS `t1_c12`, `activities`.`sponsors` AS `t1_c13`, `activities`.`status` AS `t1_c14`, `activities`.`createDate` AS `t1_c15`, `activities`.`image` AS `t1_c16`, `activities`.`image_featured` AS `t1_c17`, `activities`.`archived` AS `t1_c18`, `activities`.`managers_list` AS `t1_c19`, `activities`.`is_send_pp_email` AS `t1_c20`, `activities`.`muvi_sync_date` AS `t1_c21`, `activities`.`expert_questions` AS `t1_c22` FROM `activities` `activities` WHERE (`activities`.`resource_id`=:ypl0)
1 0.001549 0.001549 0.001549 0.001549
SHOW COLUMNS FROM `resources`
1 0.001403 0.001403 0.001403 0.001403
SHOW COLUMNS FROM `activities`
1 0.001274 0.001274 0.001274 0.001274
SHOW COLUMNS FROM `users`
1 0.001209 0.001209 0.001209 0.001209
select id, status from activities where FIND_IN_SET(:shortAddress, shortAddress)
2 0.001142 0.000571 0.000296 0.000846
SHOW COLUMNS FROM `interactions`
1 0.001034 0.001034 0.001034 0.001034
SHOW COLUMNS FROM `resource_videos`
1 0.000985 0.000985 0.000985 0.000985
SELECT * FROM `users` `t` WHERE session=:session LIMIT 1
2 0.000964 0.000482 0.000473 0.000491
select id from resources where FIND_IN_SET(:shortAddress, shortAddress)
2 0.000847 0.000423 0.000257 0.000590
SELECT * FROM `resources` `t` WHERE `t`.`id`=169 LIMIT 1
1 0.000478 0.000478 0.000478 0.000478
SHOW CREATE TABLE `resources`
1 0.000342 0.000342 0.000342 0.000342
SHOW CREATE TABLE `users`
1 0.000318 0.000318 0.000318 0.000318
SHOW CREATE TABLE `activities`
1 0.000318 0.000318 0.000318 0.000318
SHOW CREATE TABLE `resource_videos`
1 0.000314 0.000314 0.000314 0.000314
SHOW CREATE TABLE `interactions`
1 0.000303 0.000303 0.000303 0.000303
SELECT `videos`.`id` AS `t1_c0`, `videos`.`vzaar_id` AS `t1_c1`, `videos`.`title` AS `t1_c2`, `videos`.`description` AS `t1_c3`, `videos`.`resource_id` AS `t1_c4`, `videos`.`type` AS `t1_c5` FROM `resource_videos` `videos` WHERE (`videos`.`resource_id`=:ypl0)
1 0.000229 0.000229 0.000229 0.000229
# Query Time (s)
0
select id, status from activities where FIND_IN_SET(:shortAddress, shortAddress)
0.000846
1
select id from resources where FIND_IN_SET(:shortAddress, shortAddress)
0.000590
2
select id, status from activities where FIND_IN_SET(:shortAddress, shortAddress)
0.000296
3
select id from resources where FIND_IN_SET(:shortAddress, shortAddress)
0.000257
4
SHOW COLUMNS FROM `resources`
0.001403
5
SHOW CREATE TABLE `resources`
0.000342
6
SELECT * FROM `resources` `t` WHERE `t`.`id`=169 LIMIT 1
0.000478
7
SHOW COLUMNS FROM `interactions`
0.001034
8
SHOW CREATE TABLE `interactions`
0.000303
9
SHOW COLUMNS FROM `resource_videos`
0.000985
10
SHOW CREATE TABLE `resource_videos`
0.000314
11
SELECT `videos`.`id` AS `t1_c0`, `videos`.`vzaar_id` AS `t1_c1`, `videos`.`title` AS `t1_c2`, `videos`.`description` AS `t1_c3`, `videos`.`resource_id` AS `t1_c4`, `videos`.`type` AS `t1_c5` FROM `resource_videos` `videos` WHERE (`videos`.`resource_id`=:ypl0)
0.000229
12
SHOW COLUMNS FROM `activities`
0.001274
13
SHOW CREATE TABLE `activities`
0.000318
14
SHOW COLUMNS FROM `users`
0.001209
15
SHOW CREATE TABLE `users`
0.000318
16
SELECT * FROM `users` `t` WHERE session=:session LIMIT 1
0.000491
17
INSERT INTO `users` (`role`, `sendEmails`, `sendSms`, `source`, `session`, `lastLogin`, `phone`, `createDate`) VALUES (:yp0, :yp1, :yp2, :yp3, :yp4, :yp5, :yp6, :yp7)
0.007129
18
SELECT * FROM `users` `t` WHERE session=:session LIMIT 1
0.000473
19
UPDATE `users` SET `lastLogin`=:yp0 WHERE `users`.`id`=2491902
0.004908
20
SELECT `activities`.`id` AS `t1_c0`, `activities`.`group_id` AS `t1_c1`, `activities`.`resource_id` AS `t1_c2`, `activities`.`title` AS `t1_c3`, `activities`.`type` AS `t1_c4`, `activities`.`facultyNames` AS `t1_c5`, `activities`.`shortDescription` AS `t1_c6`, `activities`.`fullDescription` AS `t1_c7`, `activities`.`creditAmount` AS `t1_c8`, `activities`.`shortAddress` AS `t1_c9`, `activities`.`creditType` AS `t1_c10`, `activities`.`startDate` AS `t1_c11`, `activities`.`finishDate` AS `t1_c12`, `activities`.`sponsors` AS `t1_c13`, `activities`.`status` AS `t1_c14`, `activities`.`createDate` AS `t1_c15`, `activities`.`image` AS `t1_c16`, `activities`.`image_featured` AS `t1_c17`, `activities`.`archived` AS `t1_c18`, `activities`.`managers_list` AS `t1_c19`, `activities`.`is_send_pp_email` AS `t1_c20`, `activities`.`muvi_sync_date` AS `t1_c21`, `activities`.`expert_questions` AS `t1_c22` FROM `activities` `activities` WHERE (`activities`.`resource_id`=:ypl0)
0.001549
21
SELECT r.id, COUNT(r.id) relevance FROM resources r join `resource_topics` rtj on rtj.`resource_id`=r.id WHERE rtj.`topic_id` in (SELECT topic_id from `resource_topics` rt where rt.`resource_id`=:rid AND rt.topic_id>0) AND r.id <> :rid AND r.status = 'active' Group by r.id order by relevance DESC, r.`createDate` DESC
0.003499
22
SELECT * FROM `resources` `t` WHERE `t`.`id` IN (180, 181, 172, 171, 168, 167, 164, 163, 153, 151, 149, 144, 142, 138, 137, 136, 131, 127, 126, 117, 116, 110, 104, 98, 97, 95, 92, 90, 86, 82, 79, 78, 77, 75, 68, 67, 63, 62, 60, 58, 57, 54, 53, 47, 46, 34, 35, 32, 28, 22, 5)
0.003003
Log Messages
Message (details) Level Category Time