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Asthma exacerbations: predisposing factors and prediction rules

Greenberg, Steven

Current Opinion in Allergy and Clinical Immunology: June 2013 - Volume 13 - Issue 3 - p 225–236
doi: 10.1097/ACI.0b013e32836096de
OUTCOME MEASURES: Edited by Henry Milgrom and Ralph Mösges

Purpose of review Asthma is a multifaceted disease that is associated with decreased lung function, multiple symptoms, varying levels of asthma control, and risk of acute exacerbations. The ability to predict the risk of developing acute exacerbations may improve the management of asthmatics and facilitate identification of these patients for interventional studies.

Recent findings Factors that are associated with different manifestations of asthma differ. Biomarkers that are correlated with airways hyper-responsiveness do not necessarily correlate with risk of future exacerbations. Genetic factors that segregate with exacerbation risk are beginning to emerge. Outcome measures that demonstrate predictive validity have been developed and may facilitate patient management and provide novel clinically meaningful endpoints in clinical trials.

Summary This review will emphasize underlying factors associated with asthma exacerbations and clinical prediction rules that correlate with the risk of developing severe exacerbations of asthma.

Respiratory & Immunology, Clinical Research, Merck Research Laboratories, Kenilworth, New Jersey, USA

Correspondence to Steven Greenberg, MD, Merck K-15/4395, 2015 Galloping Hill Road, Kenilworth, NJ 07033, USA. Tel: +1 908 740 7306; fax: +1 908 740 4263; e-mail:

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