Concepts of disease severity, activity, control and responsiveness to treatment are linked but different. Severity refers to the loss of function of the organs induced by the disease process or to the occurrence of severe acute exacerbations. Severity may vary over time and needs regular follow-up. Control is the degree to which therapy goals are currently met. These concepts have evolved over time for asthma in guidelines, task forces or consensus meetings. The aim of this paper is to generalize the approach of the uniform definition of severe asthma presented to WHO for chronic allergic and associated diseases (rhinitis, chronic rhinosinusitis, chronic urticaria and atopic dermatitis) in order to have a uniform definition of severity, control and risk, usable in most situations. It is based on the appropriate diagnosis, availability and accessibility of treatments, treatment responsiveness and associated factors such as comorbidities and risk factors. This uniform definition will allow a better definition of the phenotypes of severe allergic (and related) diseases for clinical practice, research (including epidemiology), public health purposes, education and the discovery of novel therapies

Severe chronic allergic (and related) diseases: a uniform approach--a MeDALL--GA2LEN--ARIA position paper / WHO Collaborating Center for, Asthma; Rhinitis, ; Bousquet, J; Anto, Jm; Demoly, P; Schünemann, Hj; Togias, A; Akdis, M; Auffray, C; Bachert, C; Bieber, T; Bousquet, Pj; Carlsen, Kh; Casale, Tb; Cruz, Aa; Keil, T; Lodrup Carlsen, Kc; Maurer, M; Ohta, K; Papadopoulos, Ng; Roman Rodriguez, M; Samolinski, B; Agache, I; Andrianarisoa, A; Ang, Cs; Annesi Maesano, I; Ballester, F; Baena Cagnani, Ce; Basagaña, X; Bateman, Ed; Bel, Eh; Bedbrook, A; Beghe', Bianca; Beji, M; Ben Kheder, A; Benet, M; Bennoor, Ks; Bergmann, Kc; Berrissoul, F; Bindslev Jensen, C; Bleecker, Er; Bonini, S; Boner, Al; Boulet, Lp; Brightling, Ce; Brozek, Jl; Bush, A; Busse, Ww; Camargos, Pa; Canonica, Gw; Carr, W; Cesario, A; Chen, Yz; Chiriac, Am; Costa, Dj; Cox, L; Custovic, A; Dahl, R; Darsow, U; Didi, T; Dolen, Wk; Douagui, H; Dubakiene, R; El Meziane, A; Fonseca, Ja; Fokkens, Wj; Fthenou, E; Gamkrelidze, A; Garcia Aymerich, J; Gerth van Wijk, R; Gimeno Santos, E; Guerra, S; Haahtela, T; Haddad, H; Hellings, Pw; Hellquist Dahl, B; Hohmann, C; Howarth, P; Hourihane, Jo; Humbert, M; Jacquemin, B; Just, J; Kalayci, O; Kaliner, Ma; Kauffmann, F; Kerkhof, M; Khayat, G; Koffi N'Goran, B; Kogevinas, M; Koppelman, Gh; Kowalski, Ml; Kull, I; Kuna, P; Larenas, D; Lavi, I; Le, Lt; Lieberman, P; Lipworth, B; Mahboub, B; Makela, Mj; Martin, F; Martinez, Fd; Marshall, Gd; Mazon, A; Melen, E; Meltzer, Eo; Mihaltan, F; Mohammad, Y; Mohammadi, A; Momas, I; Morais Almeida, M; Mullol, J; Muraro, A; Naclerio, R; Nafti, S; Namazova Baranova, L; Nawijn, Mc; Nyembue, Td; Oddie, S; O'Hehir, Re; Okamoto, Y; Orru, Mp; Ozdemir, C; Ouedraogo, Gs; Palkonen, S; Panzner, P; Passalacqua, G; Pawankar, R; Pigearias, B; Pin, I; Pinart, M; Pison, C; Popov, Ta; Porta, D; Postma, Ds; Price, D; Rabe, Kf; Ratomaharo, J; Reitamo, S; Rezagui, D; Ring, J; Roberts, R; Roca, J; Rogala, B; Romano, A; Rosado Pinto, J; Ryan, D; Sanchez Borges, M; Scadding, Gk; Sheikh, A; Simons, Fe; Siroux, V; Schmid Grendelmeier, Pd; Smit, Ha; Sooronbaev, T; Stein, Rt; Sterk, Pj; Sunyer, J; Terreehorst, I; Toskala, E; Tremblay, Y; Valenta, R; Valeyre, D; Vandenplas, O; van Weel, C; Vassilaki, M; Varraso, R; Viegi, G; Wang, Dy; Wickman, M; Williams, D; Wöhrl, S; Wright, J; Yorgancioglu, A; Yusuf, Om; Zar, Hj; Zernotti, Me; Zidarn, M; Zhong, N; Zuberbier, T.; Anto, Jm; Demoly, P; Schünemann, Hj; Togias, A; Akdis, M; Auffray, C; Bachert, C; Bieber, T; Bousquet, Pj; Carlsen, Kh; Casale, Tb; Cruz, Aa; Keil, T; Lodrup Carlsen, Kc; Maurer, M; Ohta, K; Papadopoulos, Ng; Roman Rodriguez, M; Samolinski, B; Agache, I; Andrianarisoa, A; Ang, Cs; Annesi Maesano, I; Ballester, F; Baena Cagnani, Ce; Basagaña, X; Bateman, Ed; Bel, Eh; Bedbrook, A; B., Beghe'; Beji, M; Ben Kheder, A; Benet, M; Bennoor, Ks; Bergmann, Kc; Berrissoul, F; Bindslev Jensen, C; Bleecker, Er; Bonini, S; Boner, Al; Boulet, Lp; Brightling, Ce; Brozek, Jl; Bush, A; Busse, Ww; Camargos, Pa; Canonica, Gw; Carr, W; Cesario, A; Chen, Yz; Chiriac, Am; Costa, Dj; Cox, L; Custovic, A; Dahl, R; Darsow, U; Didi, T; Dolen, Wk; Douagui, H; Dubakiene, R; El Meziane, A; Fonseca, Ja; Fokkens, Wj; Fthenou, E.. - In: INTERNATIONAL ARCHIVES OF ALLERGY AND IMMUNOLOGY. - ISSN 1018-2438. - ELETTRONICO. - 158(2012), pp. 216-231. [10.1159/000332924]

Severe chronic allergic (and related) diseases: a uniform approach--a MeDALL--GA2LEN--ARIA position paper.

BEGHE', Bianca;
2012

Abstract

Concepts of disease severity, activity, control and responsiveness to treatment are linked but different. Severity refers to the loss of function of the organs induced by the disease process or to the occurrence of severe acute exacerbations. Severity may vary over time and needs regular follow-up. Control is the degree to which therapy goals are currently met. These concepts have evolved over time for asthma in guidelines, task forces or consensus meetings. The aim of this paper is to generalize the approach of the uniform definition of severe asthma presented to WHO for chronic allergic and associated diseases (rhinitis, chronic rhinosinusitis, chronic urticaria and atopic dermatitis) in order to have a uniform definition of severity, control and risk, usable in most situations. It is based on the appropriate diagnosis, availability and accessibility of treatments, treatment responsiveness and associated factors such as comorbidities and risk factors. This uniform definition will allow a better definition of the phenotypes of severe allergic (and related) diseases for clinical practice, research (including epidemiology), public health purposes, education and the discovery of novel therapies
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Severe chronic allergic (and related) diseases: a uniform approach--a MeDALL--GA2LEN--ARIA position paper / WHO Collaborating Center for, Asthma; Rhinitis, ; Bousquet, J; Anto, Jm; Demoly, P; Schünemann, Hj; Togias, A; Akdis, M; Auffray, C; Bachert, C; Bieber, T; Bousquet, Pj; Carlsen, Kh; Casale, Tb; Cruz, Aa; Keil, T; Lodrup Carlsen, Kc; Maurer, M; Ohta, K; Papadopoulos, Ng; Roman Rodriguez, M; Samolinski, B; Agache, I; Andrianarisoa, A; Ang, Cs; Annesi Maesano, I; Ballester, F; Baena Cagnani, Ce; Basagaña, X; Bateman, Ed; Bel, Eh; Bedbrook, A; Beghe', Bianca; Beji, M; Ben Kheder, A; Benet, M; Bennoor, Ks; Bergmann, Kc; Berrissoul, F; Bindslev Jensen, C; Bleecker, Er; Bonini, S; Boner, Al; Boulet, Lp; Brightling, Ce; Brozek, Jl; Bush, A; Busse, Ww; Camargos, Pa; Canonica, Gw; Carr, W; Cesario, A; Chen, Yz; Chiriac, Am; Costa, Dj; Cox, L; Custovic, A; Dahl, R; Darsow, U; Didi, T; Dolen, Wk; Douagui, H; Dubakiene, R; El Meziane, A; Fonseca, Ja; Fokkens, Wj; Fthenou, E; Gamkrelidze, A; Garcia Aymerich, J; Gerth van Wijk, R; Gimeno Santos, E; Guerra, S; Haahtela, T; Haddad, H; Hellings, Pw; Hellquist Dahl, B; Hohmann, C; Howarth, P; Hourihane, Jo; Humbert, M; Jacquemin, B; Just, J; Kalayci, O; Kaliner, Ma; Kauffmann, F; Kerkhof, M; Khayat, G; Koffi N'Goran, B; Kogevinas, M; Koppelman, Gh; Kowalski, Ml; Kull, I; Kuna, P; Larenas, D; Lavi, I; Le, Lt; Lieberman, P; Lipworth, B; Mahboub, B; Makela, Mj; Martin, F; Martinez, Fd; Marshall, Gd; Mazon, A; Melen, E; Meltzer, Eo; Mihaltan, F; Mohammad, Y; Mohammadi, A; Momas, I; Morais Almeida, M; Mullol, J; Muraro, A; Naclerio, R; Nafti, S; Namazova Baranova, L; Nawijn, Mc; Nyembue, Td; Oddie, S; O'Hehir, Re; Okamoto, Y; Orru, Mp; Ozdemir, C; Ouedraogo, Gs; Palkonen, S; Panzner, P; Passalacqua, G; Pawankar, R; Pigearias, B; Pin, I; Pinart, M; Pison, C; Popov, Ta; Porta, D; Postma, Ds; Price, D; Rabe, Kf; Ratomaharo, J; Reitamo, S; Rezagui, D; Ring, J; Roberts, R; Roca, J; Rogala, B; Romano, A; Rosado Pinto, J; Ryan, D; Sanchez Borges, M; Scadding, Gk; Sheikh, A; Simons, Fe; Siroux, V; Schmid Grendelmeier, Pd; Smit, Ha; Sooronbaev, T; Stein, Rt; Sterk, Pj; Sunyer, J; Terreehorst, I; Toskala, E; Tremblay, Y; Valenta, R; Valeyre, D; Vandenplas, O; van Weel, C; Vassilaki, M; Varraso, R; Viegi, G; Wang, Dy; Wickman, M; Williams, D; Wöhrl, S; Wright, J; Yorgancioglu, A; Yusuf, Om; Zar, Hj; Zernotti, Me; Zidarn, M; Zhong, N; Zuberbier, T.; Anto, Jm; Demoly, P; Schünemann, Hj; Togias, A; Akdis, M; Auffray, C; Bachert, C; Bieber, T; Bousquet, Pj; Carlsen, Kh; Casale, Tb; Cruz, Aa; Keil, T; Lodrup Carlsen, Kc; Maurer, M; Ohta, K; Papadopoulos, Ng; Roman Rodriguez, M; Samolinski, B; Agache, I; Andrianarisoa, A; Ang, Cs; Annesi Maesano, I; Ballester, F; Baena Cagnani, Ce; Basagaña, X; Bateman, Ed; Bel, Eh; Bedbrook, A; B., Beghe'; Beji, M; Ben Kheder, A; Benet, M; Bennoor, Ks; Bergmann, Kc; Berrissoul, F; Bindslev Jensen, C; Bleecker, Er; Bonini, S; Boner, Al; Boulet, Lp; Brightling, Ce; Brozek, Jl; Bush, A; Busse, Ww; Camargos, Pa; Canonica, Gw; Carr, W; Cesario, A; Chen, Yz; Chiriac, Am; Costa, Dj; Cox, L; Custovic, A; Dahl, R; Darsow, U; Didi, T; Dolen, Wk; Douagui, H; Dubakiene, R; El Meziane, A; Fonseca, Ja; Fokkens, Wj; Fthenou, E.. - In: INTERNATIONAL ARCHIVES OF ALLERGY AND IMMUNOLOGY. - ISSN 1018-2438. - ELETTRONICO. - 158(2012), pp. 216-231. [10.1159/000332924]
WHO Collaborating Center for, Asthma; Rhinitis, ; Bousquet, J; Anto, Jm; Demoly, P; Schünemann, Hj; Togias, A; Akdis, M; Auffray, C; Bachert, C; Bieber, T; Bousquet, Pj; Carlsen, Kh; Casale, Tb; Cruz, Aa; Keil, T; Lodrup Carlsen, Kc; Maurer, M; Ohta, K; Papadopoulos, Ng; Roman Rodriguez, M; Samolinski, B; Agache, I; Andrianarisoa, A; Ang, Cs; Annesi Maesano, I; Ballester, F; Baena Cagnani, Ce; Basagaña, X; Bateman, Ed; Bel, Eh; Bedbrook, A; Beghe', Bianca; Beji, M; Ben Kheder, A; Benet, M; Bennoor, Ks; Bergmann, Kc; Berrissoul, F; Bindslev Jensen, C; Bleecker, Er; Bonini, S; Boner, Al; Boulet, Lp; Brightling, Ce; Brozek, Jl; Bush, A; Busse, Ww; Camargos, Pa; Canonica, Gw; Carr, W; Cesario, A; Chen, Yz; Chiriac, Am; Costa, Dj; Cox, L; Custovic, A; Dahl, R; Darsow, U; Didi, T; Dolen, Wk; Douagui, H; Dubakiene, R; El Meziane, A; Fonseca, Ja; Fokkens, Wj; Fthenou, E; Gamkrelidze, A; Garcia Aymerich, J; Gerth van Wijk, R; Gimeno Santos, E; Guerra, S; Haahtela, T; Haddad, H; Hellings, Pw; Hellquist Dahl, B; Hohmann, C; Howarth, P; Hourihane, Jo; Humbert, M; Jacquemin, B; Just, J; Kalayci, O; Kaliner, Ma; Kauffmann, F; Kerkhof, M; Khayat, G; Koffi N'Goran, B; Kogevinas, M; Koppelman, Gh; Kowalski, Ml; Kull, I; Kuna, P; Larenas, D; Lavi, I; Le, Lt; Lieberman, P; Lipworth, B; Mahboub, B; Makela, Mj; Martin, F; Martinez, Fd; Marshall, Gd; Mazon, A; Melen, E; Meltzer, Eo; Mihaltan, F; Mohammad, Y; Mohammadi, A; Momas, I; Morais Almeida, M; Mullol, J; Muraro, A; Naclerio, R; Nafti, S; Namazova Baranova, L; Nawijn, Mc; Nyembue, Td; Oddie, S; O'Hehir, Re; Okamoto, Y; Orru, Mp; Ozdemir, C; Ouedraogo, Gs; Palkonen, S; Panzner, P; Passalacqua, G; Pawankar, R; Pigearias, B; Pin, I; Pinart, M; Pison, C; Popov, Ta; Porta, D; Postma, Ds; Price, D; Rabe, Kf; Ratomaharo, J; Reitamo, S; Rezagui, D; Ring, J; Roberts, R; Roca, J; Rogala, B; Romano, A; Rosado Pinto, J; Ryan, D; Sanchez Borges, M; Scadding, Gk; Sheikh, A; Simons, Fe; Siroux, V; Schmid Grendelmeier, Pd; Smit, Ha; Sooronbaev, T; Stein, Rt; Sterk, Pj; Sunyer, J; Terreehorst, I; Toskala, E; Tremblay, Y; Valenta, R; Valeyre, D; Vandenplas, O; van Weel, C; Vassilaki, M; Varraso, R; Viegi, G; Wang, Dy; Wickman, M; Williams, D; Wöhrl, S; Wright, J; Yorgancioglu, A; Yusuf, Om; Zar, Hj; Zernotti, Me; Zidarn, M; Zhong, N; Zuberbier, T.; Anto, Jm; Demoly, P; Schünemann, Hj; Togias, A; Akdis, M; Auffray, C; Bachert, C; Bieber, T; Bousquet, Pj; Carlsen, Kh; Casale, Tb; Cruz, Aa; Keil, T; Lodrup Carlsen, Kc; Maurer, M; Ohta, K; Papadopoulos, Ng; Roman Rodriguez, M; Samolinski, B; Agache, I; Andrianarisoa, A; Ang, Cs; Annesi Maesano, I; Ballester, F; Baena Cagnani, Ce; Basagaña, X; Bateman, Ed; Bel, Eh; Bedbrook, A; B., Beghe'; Beji, M; Ben Kheder, A; Benet, M; Bennoor, Ks; Bergmann, Kc; Berrissoul, F; Bindslev Jensen, C; Bleecker, Er; Bonini, S; Boner, Al; Boulet, Lp; Brightling, Ce; Brozek, Jl; Bush, A; Busse, Ww; Camargos, Pa; Canonica, Gw; Carr, W; Cesario, A; Chen, Yz; Chiriac, Am; Costa, Dj; Cox, L; Custovic, A; Dahl, R; Darsow, U; Didi, T; Dolen, Wk; Douagui, H; Dubakiene, R; El Meziane, A; Fonseca, Ja; Fokkens, Wj; Fthenou, E.
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