Research explains the causes behind recurrent asthma attacks

• Asthma affects about 10% of the general population and is characterised by episodic shortness of breath, cough and wheezing.
• Most asthma patients are well controlled by inhaled medications, but a small subset suffers from recurrent severe attacks requiring oral prednisolone, hospital admissions, sometimes with a fatal outcome.
• Such attacks are a major cause of morbidity and medical expenditure, and until recently the causes were poorly understood.
• In this study, Elisabeth H. Bel (Department of Pulmonary Diseases, Leiden University Medical Center, The Netherlands) and her team described risk factors of recurrent severe asthma attacks.
• They evaluated 136 patients with severe asthma according to a systematic protocol, and identified a clinical profile of the patients at risk.
• Five factors, most notably not directly related to asthma itself, appeared to be risk factors of recurrent severe asthma attacks.
• These include clinical entities varying from psychiatric disease, chronic sinusitis, severe heartburn, to respiratory infections, and obstructive sleep apnoea.
• In all patients with such attacks at least one of these entities was found and half of the patients presented three or more factors.
• The authors conclude that asthmatic patients with frequent severe attacks should be evaluated for these, so far unrecognised, factors.
• Rigorous treatment of these risks will probably result in fewer attacks, which will greatly improve quality of life and reduce medical expenditure.
• The European Respiratory Journal is the peer-reviewed scientific publication of the European Respiratory Society (more than 7,500 specialists in lung diseases and respiratory medicine in Europe, the United States and Australia).