In this Issue June 2006

"COPD and Asthma – What’s the difference and why does it matter?”

Allergic Rhinitis and Asthma Summit

The IPCRG 3rd World Conference Highlights Bulletin

National Asthma Council Australia Website

Research Funding Opportunities 

Conference Diary 2006

"COPD and Asthma – What’s the difference and why does it matter?"

At the recent General Practitioner Conference and Exhibition (GPCE) held in Sydney from the 26 -28th May 2006, the National Asthma Council Australia presented the workshop "COPD and Asthma – What’s the difference and why does it matter?” on behalf of the Australian Lung Foundation (ALF).

The workshop content was developed in consultation with the ALF Executive, NAC and COPD and asthma experts Professor Justin Beilby, Dr H. John Fardy and Professor Peter Frith.

Twelve, hour-long workshops were held during the three day conference covering:

• general practice presentations of COPD and asthma,

• differential diagnosis,

• monitoring, and

• appropriate management and drug treatment.

Professor Nicholas Glasgow, Dr Chris Hogan and Dr Steven Rudolphy shared the presentation duties, individually enriching the program with their own expertise and particular interests.

Each session was well received by participants with lively questions and answers to finish. Topics of special interest included:

• smoking cessation,

• management of COPD and the role of pulmonary rehabilitation,

• the use of spirometry to differentiate between asthma and COPD and

• spirometry as a tool to show patients their deterioration in lung function.

Other questions referred to presenters included advice on prescribing drugs and medications, especially in regard to PBS restrictions and combination products, the use of corticosteroids in certain groups at risk and appropriate vaccinations for these patients.

Each participant received an NAC kit comprising the "1-8 Asthma Information Papers - A guide for health professionals” and “Roles of Influenza and pneumococcal vaccinations in subgroups with asthma, COPD, diabetes or heart disease”. The ALF included the “COPD Action Plan”.

Special mention was given to these resources during the workshops along with the National Asthma Council’s Asthma Management Handbook and Spirometry Handbook. All of these resources are available online.

Useful Resources

Asthma Information Papers - A Guide for Health Professionals

Roles of influenza and pneumococcal vaccinations in subgroups with asthma, COPD, diabetes or heart disease

Asthma Management Handbook

Spirometry Handbook

COPD Action Plan (ALF)
http://www.lungnet.com.au/copd/copd_action_plan.html

Allergic Rhinitis and Asthma Summit

The National Asthma Council works strategically, with and through its member bodies, The Thoracic Society of Australia and New Zealand, The Royal Australian College of General Practitioners, the Pharmaceutical Society of Australia, Asthma Foundations of Australia, and The Australasian Society of Clinical Immunology and Allergy, other relevant organisations and individual experts.

Recently, as part of the NAC's close working and consultation relationship with the Australasian Society of Clinical Immunology and Allergy, a one-day summit was held to discuss allergic rhinitis and asthma.

Summit Background

Asthma and allergic disease cannot be separated. In asthma, allergic inflammation is the major underlying abnormality affecting the airways.¹ Exposure to common aeroallergens such as house dust mite, animal dander, pollen or mould can initiate and maintain airway inflammation in most people with asthma.²

Australia has the second highest prevalence of asthma in the world.  The reasons for this are unclear. However, it is known that:

• the prevalence of asthma in Australia is approximately one in four children, one in seven adolescents and one in ten adults^3,4
• the prevalence of asthma in Australia doubled between 1982 and 1992.⁵

There is a strong link between asthma and allergy and between asthma and allergic rhinitis in particular:

• More than 80% of people with asthma have evidence of allergic sensitisation⁶
• 58% of people with asthma also have allergic rhinitis⁷
• 38% of patients with allergic rhinitis also have asthma⁸
• rhinitis of any cause is a risk factor for asthma (including allergic rhinitis)^9,10
• rhinitis preceded asthma in 59-85% of patients with both conditions
• patients with rhinitis and asthma have more difficulty controlling asthma, are more expensive to treat and attend the Emergency Department more often¹¹
• treatment of allergic rhinitis with a topical steroid can reduce:
  - seasonal asthma symptoms by 3-10 fold
  - frequency of seasonal asthma symptoms⁷

There is an increasing body of knowledge about the prevention of allergic disease including asthma:

• Evidence suggests that the increased prevalence of asthma and allergy may relate to improved living conditions in early life with reduced exposure to ‘good’ bacteria. A recent seminal study carried out in Europe has shown that feeding newborn babies ‘good’ bacteria in the first six months of life reduced the incidence of allergic disease in the first year of life^12,13.
• There is also now some evidence that immunotherapy can lead to the prevention of asthma in children with rhinitis¹⁴.

Summit Outcome

The Allergic Rhinitis and Asthma Summit outcome should be available in late August 2006.

Useful Resources

Asthma and Allergy - What you should know

Asthma and Allergy - A guide for health professionals

References

1. Woolcock AJ. Asthma. In: Murray JF, Nadel JA, eds. Textbook of Respiratory Medicine. Second Ed. Philadelphia: W.B.Saunders, 1994;2:1245-1258.

2. Arshad SH, Babu KS, Holgate ST. Anti-IgE therapy in allergy and asthma. London: Martin Dunitz, 2001.

3. Robertson CF, Dalton MF, Peat JK, Haby MM, Bauman A, Kennedy JD, Landau LI. Asthma and other atopic diseases in Australian children. Australian arm of the International Study of Asthma and Allergy in Childhood. Med J Aust 1998;168(9):434-8.

4. Abramson M, Kutin J, Czarny D, Walters EH. The prevalence of asthma and respiratory symptoms among young adults: is it increasing in Australia? J Asthma 1996;33(3):189-96.

5. Peat JK, van den Berg RH, Green WF, Mellis CM, Leeder SR, Woolcock AJ. Changing prevalence of asthma in Australian children. BMJ 1994;308(6944):1591-6.

6. Australian Government Department of Health and Ageing. Asthma and Allergy, A guide for health professionals, March 2005.

7. Welsh et al. Mayo Clinic, Proc. 1987;62:125.

8. Pederson et al. Allergy 1983;38:25-9.

9. Leynaert B, Bousquet J, Neukirch C, Liard R, Neukirch F. Perennial rhinitis: an independent risk factor for asthma in nonatopic subjects (results from the European community respiratory health survey) J Allergy Clin Immunology 1999;104:301-4.

10. Settipane R, Hagy G, Settipane G. Long-term risk factors for developing asthma and allergic rhinitis: a 23 year follow-up study of college students. Allergy Proceedings 1994;15:21-25.

11. Rasmussen F et al. Risk factors for hospital admission for asthma from childhood to young adulthood: A longitudinal population study. J Allergy Clin Immunol 2002; 110(2): 220-227.

12. Kalliomaki M, Salminen S, Arvilommi H et al. 2001. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet 357:1076-79.

13. Kalliomaki M, Salminen S, Poussa T. 2003. Probiotics and prevention of atopic disease: 4-year follow-up of a randomised placebo-controlled trial. Lancet 361:1869-71.

14. Department of Health and Ageing, Quality Use of Medicines Workshop Summary Report – Asthma Consumer Issues (AFV), May, 2004.

The IPCRG 3rd World Conference Highlights Bulletin

The International Primary Care Respiratory Group 3rd World Conference, “Respiratory Disease in Primary Care – Quality of Care”, took place in Oslo, Norway, earlier this month. The conference covered all facets of respiratory health including asthma, allergy, chronic lung disease, tuberculosis, pneumonia, infectious diseases and cough.

Ms Kathy Hope, NAC project manager, attended the conference and is preparing a report on the proceedings. If you would like to receive a copy of this special ‘highlights’ review simply register by following the link
Register for the NAC’s IPCRG Oslo Report

National Asthma Council Australia Website

The National Asthma Council website has now reached two significant activity milestones. During the past year the website has had a half a million visits and over one million pages viewed. The value and popularity of our website reflects the continuing contribution of our network of leading GPs, respiratory physicians, allergists, pharmacists, asthma educators and consumer advocates.

• For the twelve months to the end of May 2006, the NAC website had over 500,000 visits to the website. 

• For the twelve months to the end of November 2005, just in excess of one million pages were viewed.

Towards the end of April the NAC added a summary page covering the top asthma management resource tools most accessed on the website.  The "Asthma Management Tools" page is now well inside the top twenty pages viewed on the site in less than two months.

We are always pleased to receive any feedback you may wish to provide about the website.

Research Funding Opportunities

Two Research Grants Available for 2007

The Asthma Foundation of Victoria is awarding two Research Grants for research projects benefiting people with asthma to be undertaken in Victoria during the 2007 calendar year.

These are:

•  The Helen Macpherson Smith Trust Grant for general asthma research.

• The Asthma Foundation of Victoria Research Grant of children’s/adolescent asthma research

Both grants will be for an amount up to $25,000 (plus GST).

Application Forms and Conditions of Award are available from The Asthma Foundation of Victoria on (03) 9326 7088 or email Garry Irving,  girving@asthma.org.au

Both the 2007 Grant Application Form and the Grant Conditions are available from the Asthma Foundation of Victoria website  www.asthma.org.au.  

Conditions of Award 2007
(http://www.asthma.org.au/Portals/0/Research%20Grant_Conditions%202007.pdf)

Research Grant Application Form 2007
(http://www.asthma.org.au/Portals/0/ResearchGrants_Application%20Form%202007.doc)

The closing date for Grant applications for 2007 is Friday 11 August 2006.

The Foundation particularly encourages applications from young researchers commencing their investigative research careers.