Respi4Doctors is een digitaal platform waarop AstraZeneca informatie en diensten omtrent de behandeling van respiratoire aandoeningen aanbiedt.
Publications
In dit onderdeel worden recente wetenschappelijke publicaties beschreven.
Despite progress in asthma management, several studies confirm that when symptoms worsen, most patients simply increase their use of SABA and are less likely to increase use of their controller medication.1
In a recent publication from O’Byrne et al. published in the European Respiratory Journal1, international experts hypothesize that this pattern of SABA over-reliance is attributable to several paradoxes in our treatment approach and advice, which are confusing to patients. In the interview below, Prof. Dupont from UZ Leuven shares his opinion on these paradoxes and potential pragmatic solutions.
1. O’Byrne et al. Eur Respir J 2017; 50: 1701103
Obv een artikel verschenen in ‘De Medische Referentie’*
* De Medische Referentie, Dec 2018/Jan 2019
NS ID XL-0613-RD12/2018-LB Local code 1370
Despite progress in asthma management, several studies confirm that when symptoms worsen, most patients simply increase their use of SABA and are less likely to increase use of their controller medication.1
In a recent publication from O’Byrne et al. published in the European Respiratory Journal1, international experts hypothesize that this pattern of SABA over-reliance is attributable to several paradoxes in our treatment approach and advice, which are confusing to patients. They also propose potential solutions to these paradoxes.
This slide kit provides more details on this recent publication from the European Respiratory Journal.
1. O’Byrne et al. Eur Respir J 2017; 50: 1701103
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The paradoxes of asthma management: time for a new approach?
P.M. O’Byrne, C. Jenkins and E.D. Bateman. Eur Respir J 2017; 50: 1701103
Background:
- Despite progress in asthma management, national and international surveys continue to reveal an asthma control in only 50% of the patients, in part due to an over-reliance on SABA.
- Several studies confirm that when symptoms worsen, most patients simply increase their use of SABA and are less likely to increase use of their controller medication.
- Hypothesis: This pattern is attributable to several paradoxes in our treatment approach and advice, which are confusing to patients.
5 paradoxes in asthma management:


Practical solutions to these paradoxes and the continuum of care approach:
- Potential future solution: Replace SABA alone as needed by ICS/formoterol as-needed in patients with intermittent or infrequent symptoms. Increase this to regular maintenance plus as-needed use in patients whose symptoms are persistent. This would accommodate typical patient behaviours and would be acceptable with the self-titration strategies of patients.
- Asthma is a heterogeneous disease, so this approach may be considered as oversimplification (ex: how are non-eosinophilic asthma treated in this continuum of care?).
The approach is deliberately simple for all the doctors (in primary care in particular) without access to the tools to phenotype/endotype asthma while still providing adequate and acceptable treatment for asthma patients.
Conclusion:
If clinical studies support this as an effective and safe strategy, it could ultimately eliminate the use of SABA-only products in asthma.
Reference:
P.M. O’Byrne, C. Jenkins and E.D. Bateman. Eur Respir J 2017; 50: 1701103
NS ID XL-0519-RD10/2018-LB