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. 2018 Mar;73(3):683-695.
doi: 10.1111/all.13342. Epub 2017 Nov 22.

RItA: The Italian severe/uncontrolled asthma registry

S Maio  1 , S Baldacci  1 , M Bresciani  1 , M Simoni  1 , M Latorre  2 , N Murgia  3 , F Spinozzi  3 , M Braschi  4 , L Antonicelli  4 , B Brunetto  5 , P Iacovacci  5 , P Roazzi  5 , C Pini  5 , M Pata  6 , L La Grasta  6 , P Paggiaro  2 , G Viegi  1   7 ; AGAVE group
Collaborators, Affiliations

RItA: The Italian severe/uncontrolled asthma registry

S Maio et al. Allergy. 2018 Mar.

Abstract

Background: The Italian severe/uncontrolled asthma (SUA) web-based registry encompasses demographic, clinical, functional, and inflammatory data; it aims to raise SUA awareness, identifying specific phenotypes and promoting optimal care.

Methods: Four hundred and ninety three adult patients from 27 Italian centers (recruited in 2011-2014) were analyzed.

Results: Mean age was 53.8 years. SUA patients were more frequently female (60.6%), with allergic asthma (83.1%). About 30% showed late onset of asthma diagnosis/symptoms (>40 years); the mean age for asthma symptoms onset was 30.2 years and for asthma diagnosis 34.4 years. 97.1% used ICS (dose 2000 BDP), 93.6% LABA in association with ICS, 53.3% LTRAs, 64.1% anti-IgE, 10.7% theophylline, and 16.0% oral corticosteroids. Mean FEV1 % pred of 75.1%, median values of 300/mm3 of blood eosinophil count, 323 kU/L of serum total IgE, and 24 ppb of FENO were shown. Most common comorbidities were allergic rhinitis (62.4%), gastroesophageal reflux (42.1%), sinusitis (37.9%), nasal polyposis (30.2%), and allergic conjunctivitis (30.2%). 55.7% of SUA patients had exacerbations in the last 12 months, 9.7% emergency department visits, and 7.3% hospitalizations. Factors associated with exacerbation risk were obesity (OR, 95% CI 2.46, 1.11-5.41), psychic disorders (2.87, 0.89-9.30-borderline), nasal polyps (1.86, 0.88-3.89-borderline), partial/poor asthma treatment adherence (2.54, 0.97-6.67-borderline), and anti-IgE use in a protective way (0.26, 0.12-0.53). Comparisons to severe asthma multicenter studies and available registries showed data consistency across European and American populations.

Conclusions: An international effort in the implementation of SUA patients' registries could help to better understand the clinical features and to manage severe asthma, representing a non-negligible socioeconomic burden for health services.

Keywords: comorbidity; eosinophilic inflammation; exacerbations; pharmacological treatment; severe/uncontrolled asthma.

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