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. 2022 Dec:205:107030.
doi: 10.1016/j.rmed.2022.107030. Epub 2022 Oct 29.

The Italian severe/uncontrolled asthma registry (RItA): A 12-month clinical follow-up

Sara Maio  1 , Nicola Murgia  2 , Sofia Tagliaferro  3 , Anna Angino  3 , Giuseppe Sarno  3 , Laura Carrozzi  4 , Francesco Pistelli  4 , Elena Bacci  5 , Pier Luigi Paggiaro  6 , Manuela Latorre  7 , Sandra Baldacci  3 , Giovanni Viegi  3
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Free article

The Italian severe/uncontrolled asthma registry (RItA): A 12-month clinical follow-up

Sara Maio et al. Respir Med. 2022 Dec.
Free article

Abstract

Background: follow-up studies on registries of severe/uncontrolled asthma (SUA) patients are scanty.

Objective: to analyze baseline and follow-up characteristics of SUA patients and their longitudinal patterns.

Methods: 180 adult patients (age ≥15 yrs) were investigated at baseline and 12-month follow-up through the Italian SUA registry (RItA). Latent transition analysis (LTA) was performed to detect cross-sectional SUA phenotypes and longitudinal patterns. Risk factors for longitudinal patterns were assessed through logistic regression.

Results: a significant/borderline improvement of asthma control outcomes in the last 2-4 weeks emerged at follow-up with respect to baseline for: daily activities limitations (Δ -16%), frequent diurnal symptoms (Δ -25%), uncontrolled asthma symptoms according to ACT (Δ -26%). Last 12-month use of oral corticosteroids was less frequent at follow-up than at baseline (Δ -25%). Health status improvement was confirmed by lung function test results. Through LTA, two longitudinal patterns were detected considering last 12-month control outcomes: "persistence/worsening" (53.9%), "under control/improvement" (46.1%). A lower likelihood of having "persistence/worsening" SUA was exhibited by patients under anti-IgE (OR 0.38, 95% CI 0.17-0.84) and inhaled corticosteroids-bronchodilator association treatment (OR 0.13, 95% CI 0.01-1.26, borderline value), while a higher likelihood was shown by older age at first asthma diagnosis (OR 1.04, 95% CI 1.01-1.07).

Conclusion: the implementation of a SUA registry, the availability of patient-level data and the application of an innovative longitudinal analysis allowed to observe a general improvement in asthma control, one year after baseline, and a lower risk of SUA "persistence/worsening" in patients under anti-IgE and regular ICS-bronchodilator association use.

Keywords: Asthma control; Longitudinal patterns; Phenotypes; Registry; anti-IgE treatment.

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Conflict of interest statement

Declaration of competing interest Nicola Murgia, grants from GSK, personal fees from AstraZeneca, grants and personal fees from Chiesi, and personal fees from Menarini, outside the submitted work; Laura Carrozzi, grants for educational activities and a randomised clinical trial from GSK, Guidotti, F.I.R.M.A., Sanofi, and Chiesi, outside the submitted work; Elena Bacci, personal grants for educational activities from GSK, Sanofi, and AstraZeneca, outside the submitted work; Pier Luigi Paggiaro, personal grants for educational activities from Chiesi, GSK, Guidotti, Lusofarmaco, and Sanofi, outside the submitted work. The other authors have no conflict of interest to declare.

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