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| METAFORUM: A MEETING OF THE MINDS |
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| Leading experts gathered at the prestigious Royal College of Physicians in London on 20–21 April 2004 to review and address why morbidity, mortality, and patient quality of life remain poor for many asthma patients despite improved knowledge of asthma, its mediators, availability of clear guidelines, and effective treatment options.
The discussion, chaired by Professor Stephen Holgate of University of Southampton in England, was made possible through an unrestricted educational grant by Merck Sharp & Dohme and involved a multi-disciplinary group of more than 40 experts in asthma and its management from 17 countries in Europe.
The meeting name, MetaForum, reflects the aims to convene a comprehensive and all encompassing discussion about current issues in asthma management (Meta), by bringing together leading experts for debate and discussion (Forum)
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| DEBATING AND DISCUSSING THE EVIDENCE |
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| The MetaForum aimed to review the science of airway inflammation and highlight and discuss patients’ perspectives, as well as review the real-life consequences of inadequate asthma management.
Integral to the meeting was the first presentation of results from a new and extensive analysis of 24 regional patients and prescriber surveys covering more than 60,000 patients from across Europe. The purpose of this analysis is to provide a thorough review of current understanding, knowledge, communication and actions surrounding asthma therapy.
The structured review suggests that communication between patients and clinicians is not ideal and is partly responsible for poor compliance and symptom control. Patients tend not to provide clinicians with clear information about the impact of asthma on their lives or the fact that they still experience asthma symptoms. The results of the structured review also suggested that patients do not fully understand the role inflammation plays in asthma and that poorly controlled asthma can have a significant impact on their quality of life.
Clinical evidence presented at the meeting, showed that asthma symptoms occur as a result of exposure to a range of environmental agents such as allergens, air pollutants, and viruses, which trigger the release of inflammatory mediators within the large and small airways. Standard therapy with inhaled corticosteroids (ICS) alone can address airway inflammation caused by steroid-sensitive mediators but does not affect other powerful mediators such as cysteinyl leukotrienes in the airways of asthmatic patients.
Leukotrienes are released by white blood cells that bind to cells in the airways and cause spasm of the smooth muscle, swelling, and inflammation. In order to effectively control asthma symptoms multiple sources of airway inflammation need to be managed, this can be achieved with the addition of leukotriene receptor antagonists (LTRAs) to standard treatment.
Other key topics of discussion included the current status of complete asthma therapy across Europe, the role of patient organisations, patient education and the responsibility of the media.
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| REACHING A CONSENSUS |
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| The overall focus of the meeting was to arrive at a formal consensus that would look towards improving asthma care and patient quality of life. In the final session of the MetaForum, Professor Holgate worked with the panel and audience to reach consensus on the ongoing areas for action and next steps. The finalized Consensus Statement formally endorsed by Professor Holgate is now available and will be endorsed by the other members of the group in the coming weeks. |
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| PANELISTS |
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| Chair: Professor Stephen Holgate, University of Southampton, UK
• Professor Giorgio Walter Canonica, Genoa University, Italy
• Dr. Graham Currie, Raigmore Hospital, UK
• Professor Philippe Godard, Hôpital Arnaud de Villeneuve, France
• Professor Tari Haahtela, Skin and Allergy Hospital, Helsinki University Hospital, Finland
• Professor Michael Hyland, University of Plymouth, UK
• Mark Lewis, Medical Knowledge Group, UK
• Professor David Price, University of Aberdeen, UK
• Professor Louis Renaud, University of Liege, Belgium
• Brian Trench, Dublin City University, Ireland
• Dr. Erkka Valovirta, European Federation of Allergy and Airway Diseases Patients Associations (EFA), Finland
• Professor Ulrich Wahn, Humboldt University, Germany
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| SPONSORS |
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| The MetaForum has been held under the auspices of the University of Southampton and was supported by an unrestricted educational grant from Merck Sharp & Dohme. However, the views expressed during the meeting and the final consensus are independent of Merck Sharp & Dohme. |
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