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Fabienne Jaun

Department of Clinical Research
Profiles & Affiliations

Projects & Collaborations

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SHARP - Severe Heterogeneous Asthma Research collaboration

Research Networks (Institutional Membership)  | 2 Project Members

The Swiss Severe Asthma Registry is a Member of SHARP- Severe Heterogeneous Asthma Research collaboration - Patient centred: A European Respiratory Society (ERS) Clinical Research Collaboration.

SHARP is a clinical research collaboration bringing together four key stakeholders to develop and deliver cutting edge severe asthma research: patients (people affected by severe asthma), clinicians, scientists and pharmaceutical industry.

SHARP aims to affect a step-change in asthma research culture across Europe, placing emphasis on ambitions that serve the collective needs of the asthma research community and bringing people with asthma to the centre of the research environment in a real-world context.

The Visions of SHARP are:

  • Develop definitions of severe asthma that is used by all. Currently severe asthma means different things depending where one lives
  • End dependency on oral corticosteroids to achieve asthma control
  • Access to severe asthma specialists for all severe asthma patients
  • To understand the heterogeneity in mechanisms of severe asthma
  • Prevention of severe asthma

 

At the Moment Switzerland is actively involved in several projects and providing data from Switzerland.

In addition, we are belonging to the core group (represented by Fabienne Jaun) of the SHARP signature Project; Description of the Severe Asthma Population in European countries collaborating with SHARP.

This is a collaborative project within 23 SHARP participating countries to describe and summarise the data from the SHARP registries on severe asthma patients’ demographical, clinical, and disease characteristics.

Description of the project:

  • Patients with severe asthma account for a large portion of the disease burden, although they represent a relatively small portion, around 5-8 %. Severe asthma is characterised by heterogeneity, with many phenotypes, which, together with its prevalence, challenges us to reveal its characteristics and underlying mechanisms.
  • We need large real-world registries in different countries to understand and reveal the characteristics of the various severe asthma phenotypes, which would improve asthma patient care.
  • The Severe Heterogeneous Asthma Registry, Patient-centred (SHARP) Clinical Research Collaboration has created a network of national registries and severe asthma centers that work together to perform registry-based real-world research and clinical studies on a pan-European scale.
  • The Descriptive manuscript project aims to summarise the data from the SHARP registry throughout most European countries on severe asthma patients’ demographical, clinical, and disease characteristics.
  • This study focuses on the variables most commonly evaluated by severe asthma clinicians, including, but not limited, data about the age of asthma onset, sex, body mass index (BMI), smoking history, lung function, asthma control (as expressed by symptom burden and exacerbations in the previous year), medications used (with emphasis on oral corticosteroids and biological therapies), biomarkers such as FeNO and blood eosinophils, and common comorbidities.
  • So far, over 9,500 patients with severe asthma from 23 registries have been analysed.
  • Our preliminary results indicate that most patients with severe asthma in the SHARP CRC were female, with a long history of adult-onset asthma and affected lung function.
  • Significant heterogeneity was observed in asthma control, medication use, smoking history, and comorbidities.
  • We continue to collect more patients, with the planned analysis including further characterising patients based on clinically relevant outcomes.
  • Our findings will have important implications for individuals with severe asthma, healthcare professionals, and policymakers in Europe and suggest potential future recommendations for improving the management and outcomes of severe asthma in Europe.

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Oral corticosteroids for post-infectious cough in adults: A double-blind randomised placebo-controlled trial in Swiss family practices (OSPIC)

Research Project  | 4 Project Members

Cough is one of the most common causes for seeking medical advice in general practices. Post-infectious cough is defined as lasting 3 to 8 weeks after an upper respiratory tract infection (URTI). It can be very bothersome, disabling in daily activities with substantial impact on physical and psychosocial health, leading to impaired quality of life (QoL). Recommendations for the management of post-infectious cough in primary care are scarce and incoherent. To provide a wide overview of treatment options for patients with post-infectious cough, we conducted and recently published a systematic review and meta-analysis of randomised clinical trials (RCTs) assessing the patient-relevant benefits and potential harms of available treatments. Only six eligible RCTs assessing different treatment regimens (i.e. inhaled fluticasone propionate, inhaled budesonide, salbutamol plus ipratropium-bromide, montelukast, nociception-opioid-1-receptor agonist, codeine, and gelatine) were identified. None of these RCTs found clear patient-relevant benefits and most had an unclear or high risk of bias.Post-infectious cough is thought to be mediated by inflammatory processes that are also present in exacerbations of asthma or chronic obstructive pulmonary diseases (COPD). There is strong evidence that oral corticosteroids for 5 days provide patient-relevant benefit without relevant harm for these conditions. Our systematic search identified no RCTs evaluating oral corticosteroids for post-infectious cough. Thus, a high quality RCT assessing the benefits and harms of orally administered corticosteroids for post-infectious cough is needed.Aim: To assess whether a 5-day treatment with oral corticosteroids provides patient-relevant benefits by improving the cough-related QoL and reducing the duration and intensity of post-infectious cough in adult primary care patients.Methods: The proposed study is a multicentre, 1:1 randomised, parallel-group, placebo-controlled, superiority trial with blinded patients, general practitioners (GP), and outcome assessors in a primary health care setting. We plan to include 204 patients aged 18 or older seeing their GP for a cough lasting 3 to 8 weeks following an URTI. Any concurrent disease possibly explaining the symptoms, such as pneumonia, asthma, COPD, gastroesophageal reflux disease, allergic rhinitis, or cancer will be ruled out before trial inclusion. Patients will receive oral corticosteroid treatment (equivalent of 40 mg prednisone once daily) for 5 days or placebo for 5 days.The primary outcome is cough-related QoL assessed by the Leicester Cough Questionnaire (LCQ) score 14 days after randomisation. Secondary outcomes are i) cough-related QoL (at day 7, 28, and 3 months), ii) cough-related QoL sub-domains physical, psychological, and social, iii) overall cessation of cough, iv) re-consultations at GP and/or hospitalisations, v) total adverse events (AE), and vi) serious adverse events (SAE). All outcomes will be assessed through follow-up phone calls by study nurses 7, 14, 28 days, and 3 months after randomisation. Clinical follow-up visits with the GP are at the discretion of the patient and the GP.Assumptions for sample size estimation are informed by our systematic review. 204 patients are required to detect a statistically significant minimal clinically important difference of 1.3 of the LCQ score at 14 days (primary outcome; power 80%, two-sided significance level 5%, drop-out-rate 10%). Primary analysis will be done with ANCOVA (analysis of covariance) according to the intention to treat principle. Baseline LCQ scores, duration of cough, age, sex, and smoking status will be covariates.Importance: This will be the first RCT investigating whether oral corticosteroids are beneficial and safe in patients with post-infectious cough, which would have a substantial impact on the well-being and management of these patients in Switzerland and beyond.

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Swiss Severe Asthma Register (SAR)

Research Project  | 2 Project Members

Asthma is a chronic respiratory airway disease that affects more than 300 million people worldwide. Severe Asthma (SA) affects around 5-10% of all asthma patients yet accounts for half of the asthma related costs and carries a high burden of disease . Since the introduction of highly targeted treatments (monoclonal antibodies) in 2005, the treatment of severe asthma has been revolutionized. Nowadays, most of the patients with a severe asthma are treated with monoclonal antibodies. However, in Switzerland as in other countries, we have had only a little knowledge about the real-life situation of patients with SA, regarding long-term clinical management and therapeutic outcomes. Recognizing that knowledge gap, multiple countries, including Switzerland, have established national registries observing severe asthma and build up an international network of clinical registries.


The overall aim of this cohort is to gain comprehensive information about severe asthma in Switzerland, with the focus on the following:

  • Describing SA Patient characteristics in Switzerland
  • Treatment regimens over time
  • Clinical course of SA patients over time including changes and influencing factors of asthma related outcomes