9 research outputs found
SSRI and SNRI use during pregnancy and the risk of persistent pulmonary hypertension of the newborn
Antidepressant Use in Pregnancy and the Risk of Attention Deficit with or without Hyperactivity Disorder in Children
Use of trimethoprim-sulfamethoxazole during pregnancy and risk of spontaneous abortion: a nested case control study
A small HSP, Lo18, interacts with the cell membrane and modulates lipid physical state under heat shock conditions in a lactic acid bacterium
Use of antibiotics during pregnancy and the risk of major congenital malformations: a population based cohort study
Severe, eosinophilic asthma in primary care in Canada: a longitudinal study of the clinical burden and economic impact based on linked electronic medical record data
Abstract Background Stratification of patients with severe asthma by blood eosinophil counts predicts responders to anti-interleukin (IL)-5 (mepolizumab and reslizumab) and anti-IL-5 receptor α (benralizumab) therapies. This study characterized patients with severe asthma who could qualify for these biologics in a primary care setting. Methods We retrospectively selected patients from July 1, 2010, to June 30, 2014, using a linked electronic medical records (EMR) database (IMS Evidence 360 EMR Canada) for >â950,000 patients in primary care in Ontario, Canada. Patients aged â„â12 years with â„â2 documented asthma diagnoses were identified as having severe asthma based on prescriptions for high-dosage inhaled corticosteroids (ICS) plus either a leukotriene receptor antagonist, long-acting ÎČ2-agonist (LABA), or theophylline filled on the same day. Patientsâ asthma was considered severe also if they received a prescription for ICS with oral corticosteroids (OCS) or an additional prescription for omalizumab. Patient characteristics, asthma-related medications, and blood eosinophil counts were captured using observed care patterns for the year prior to ICS/LABA and/or OCS prescription. Health care resource use (HCRU) and costs were captured throughout the 1-year follow-up period. Results We identified 212 patients who met the criteria for severe asthma. These patients required an average of 6.5 physician visits during the 1-year follow-up period (95% confidence interval 5.7â7.3), and 20 (9%) were referred to respiratory specialists. Overall, 56 patients (26%) with severe asthma had complete blood counts, of whom 23 (41%) had blood eosinophil countsââ„â300 cells/ÎŒL and might be considered for anti-eosinophil therapies. Patients with severe asthma and blood eosinophil countsââ„â300 cells/ÎŒL had more respiratory specialist referrals (17% vs. 12%) than patients with blood eosinophilsâ<â300 cells/ÎŒL. Conclusions Our data suggest that during 2010â2014, Ontario primary care patients with severe asthma and high blood eosinophil counts had greater HRCU than those with lower counts. Approximately 41% of patients with severe asthma could qualify for anti-eosinophil drugs based on blood eosinophil counts. However, the eosinophilic status of most patients was unknown. It is appropriate to increase awareness of the use of blood eosinophil counts to identify patients who could be considered for anti-eosinophil therapies