Page 77 - Comprehensive treatment of patients with glucocorticoid-dependent severe asthma

Predictors of benefit from high altitude treatment
Material and methods
Patients and design of the study
This is a secondary analysis of a prospective cohort study evaluating patients with severe, refractory asthma who were referred to the Dutch Asthma Centre in Davos, Switzerland, in order to optimize their disease. The Dutch Asthma Centre is localised at an altitude of 1600 meters above sea level and offers personalised, multidisciplinary, multifaceted treatment for patients with severe asthma in a low- trigger environment. The characteristics of the cohort have been described previously [12]. In short, participants were adult patients (17 to 75 years) with a diagnosis of severe refractory asthma using high doses of inhaled corticosteroids (>=1000 μg/day of fluticasone or equivalent) or chronic oral corticosteroids, combined with long-acting bronchodilators for at least 1 year. Current smokers and patients with a history of more than 15 pack- years of cigarette smoking were excluded from the study. All patients were symptomatic and had at least one severe exacerbation during the past year requiring a course of oral corticosteroids.
Assessments
Patients participating in this study were assessed and evaluated according to a systematic protocol at entry and after 12 weeks treatment.
Questionnaires
At baseline, all patients completed standard questionnaires including information on socio-demographics, asthma history, current symptoms, smoking habits and medication usage, including inhaled (ICS) and oral corticosteroids (OCS) daily dose.
The level of asthma control was assessed using the Juniper ACQ-6 score, a 6-item version of the ACQ questionnaire with the FEV1 question omitted [19]. In this questionnaire, patients recall their experiences over the past 7 days and respond to each question on a 7-point Likert scale, where 0 represents no impairment and 6 represents maximum impairment.
Asthma related quality of Life was measured using the Juniper Asthma Quality of Life Questionnaire (AQLQ), an asthma specific questionnaire that measures
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