Manifesto on united airways diseases (UAD): an Interasma (global asthma association – GAA) document

Tiotiu-Cepuc, Iuliana;Novakova, Plamena;Baiardini, Ilaria;Bikov, Andras;Dubuske, Lawrence;et.al.
(2021) Journal of Asthma — Vol. 59, n° 4, p. 639-654 (2021)

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Authors
  • Tiotiu-Cepuc, IulianaUCLouvain
    Author
  • Novakova, PlamenaClinic of Clinical Allergy, Medical University Sofia
    Author
  • Baiardini, IlariaDepartment of Biomedical Sciences, Humanitas University
    Author
  • Bikov, AndrasManchester University NHS Foundation Trust
    Author
  • Dubuske, LawrenceDivision of Allergy and Immunology, Department of Internal Medicine, George Washington University School of Medicine and Health Sciences, George Washington University Medical Faculty Associates
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  • et. al.
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Abstract
Objective: The large amount of evidence and the renewed interest in upper and lower airways involvement in infectious and inflammatory diseases has led Interasma (Global Asthma Association) to take a position on United Airways Diseases (UAD). Methods: Starting from an extensive literature review, Interasma executive committee discussed and approved this Manifesto developed by Interasma scientific network (INES) members. Results: The manifesto describes the evidence gathered to date and defines, states, advocates, and proposes issues on UAD (rhinitis, rhinosinusitis and nasal polyposis), and concomitant/comorbid lower airways disorders (asthma, chronic obstructive pulmonary disease, bronchiectasis, cystic fibrosis, obstructive sleep apnoea) with the aim of challenging assumptions, fostering commitment, and bringing about change. UAD refers to clinical pictures characterized by the coexistence of upper and lower airways involvement, driven by a common pathophysiological mechanism, leading to a greater burden on patient's health status and requiring an integrated diagnostic and therapeutic plan. The high prevalence of UAD must be taken into account. Upper and lower airways diseases influence disease control and patient's quality of life. Conclusions: Patients with UAD need to have a timely and adequate diagnosis, treatment, and, when recommended, referral for management in a specialized center. Diagnostic testing including skin prick or serum specific IgE, lung function, fractional exhaled nitric oxide (FeNO), polysomnography, allergen-specific immunotherapies, biological therapies and home based continuous positive airway pressure (CPAP) whenever these are recommended, should be part of the management plan for UAD. Education of medical students, physicians, health professionals, patients and caregivers on the UAD is needed.
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Tiotiu-Cepuc, I., Novakova, P., Baiardini, I., Bikov, A., Chong-Neto, H., De-Sousa, J. C.-, Emelyanov, A., Heffler, E., Fogelbach, G., Kowal, K., Labor, M., Mihaicuta, S., Nedeva, D., Novakova, S., Steiropoulos, P., Ansotegui, I., Bernstein, J., Boulet, L.-P., Canonica, G., et al. (2021). Manifesto on united airways diseases (UAD): an Interasma (global asthma association – GAA) document. Journal of Asthma, 59(4), 639-654. https://doi.org/10.1080/02770903.2021.1879130 (Original work published 2021)