Profile of mild/moderate asthma patients: Baseline data from the MANI cohort
- PMID: 40689384
- PMCID: PMC12271777
- DOI: 10.1016/j.waojou.2025.101082
Profile of mild/moderate asthma patients: Baseline data from the MANI cohort
Abstract
Although 90% of asthmatic patients suffer from mild and moderate disease, little is known about the burden on health status and quality of life, the long-term trajectory of disease severity, and the socio-economic impact. The Mild Moderated Asthma Network of Italy (MANI) is a real-world, cross-sectional, prospective, observational cohort study designed to explore these issues. Here we aimed to provide an identikit of asthmatic patients receiving treatment according to GINA steps 1-4, and enrolled in the centers of excellence participating in the MANI. Among 679 analyzed patients, 63% were female, and the mean age was 50 ± 16 years. Asthma was mild in 15.8% of patients (GINA steps 1-2) and moderate in 84.2% (GINA steps 3-4). The mean age of asthma diagnosis was 34.3 ± 17.7 years, 50% of patients were suffering from allergic rhinitis, and 13% from nasal polyposis. Mean FEV1% was 91.4 ± 19.4%, predicted with a FEV1/FVC ratio of 74.7 ± 11.9. The mean asthma control test value was 21.2 ± 3.73, and AQLQ score was 5.74 ± 1.07. Among the included patients, 17.2% had at least one asthma exacerbation in the previous year, with 14.2% requiring systemic steroids; 6.2% were referred to an emergency room in the year prior to enrollment; 2.2% required an asthma-related hospitalization; and 0.6% had been admitted to an Intensive Care Unit (ICU). Unscheduled visits were necessary for 3.8% of patients, 6.5% reported ≥5 lost work days due to asthma, and 11.5% declared ≥10 lost days of spare time. About 70% of patients were receiving treatment according to GINA Track 1. Uncontrolled cases constituted 16.7% of patients treated according to GINA steps 1-2, and 26.3% of patients treated according to GINA steps 3-4 were uncontrolled. Compared to patients with mild asthma, those with moderate asthma had more impaired lung function (FEV1% 88.5 ± 18.4 vs 94.4 ± 17.9, p = 0.05; FEV1/FVC 73.0 ± 9.76 vs 79.6 ± 9.56, p > 0.001), exhibited greater need for systemic corticosteroids for treating exacerbations (13.8% vs 2.3%, p = 0.032), and showed greater adherence to therapy (TAI score 50.0 ± 5.66 vs 45.7 ± 8.42, p < 0.001). Overall, mild/moderate asthma exhibited a substantial clinical and care impact. Patients treated with GINA steps 3-4 constituted the vast majority of patients attending specialist centers. A quarter of these patients were uncontrolled, and therefore need re-evaluation or treatment upgrade. Expanding recruitment of the MANI study will allow further phenotyping of these patients.
Keywords: Asthma; Control; Mild; Moderate; Rea life.
© 2025 The Authors.
Conflict of interest statement
MB received financial grants and consulting fees from AstraZeneca, Chiesi, Glaxo Smith Kline, Lallemand, Omron, Sanofi; he declares speaker fees from AstraZeneca, Chiesi, Glaxo Smith Kline, Lusofarmaco, Menarini, Omron, Sanofi; as well as financial support for attending meetings and/or travel from AstraZeneca, Lusofarmaco, Sanofi. FP received consulting fees, payment for lectures and for participation on a Data Safety Monitoring Board or Advisory Board from: Sanofi, Regeneron, AstraZeneca, Glaxo Smith Kline, Mundipharma, Alk Abello, Stallergenes Greer, Menarini, and Chiesi. PS received financial grants from Insmed Inc., AstraZeneca, GSK, Novartis, and Roche. GS received consulting fees from Pfizer, AstraZeneca, Insmed, and Quiagen. FB received financial grants from AstraZeneca, Chiesi Farmaceutici S.p.A and Insmed Inc.; he worked as a paid consultant for A. Menarini and Zambon; he received speaker fees from AstraZeneca, Chiesi Farmaceutici S.p.A., Glaxo Smith Kline, Guidotti, Grifols, Insmed Inc., A. Menarini, Novartis AG, Sanofi-Genzyme, Viatris Inc., Vertex Pharmaceuticals and Zambon. GWC reports having received research grants as well as being lecturer or having received advisory board fees from: A. Menarini, Allergy Therapeutics, AstraZeneca, Chiesi Farmaceutici, Faes, Firma, Guidotti-Malesci, Glaxo Smith Kline, Hal Allergy, Innovacaremd, Novartis, OmPharma, RedMaple, Sanofi-Aventis, Sanofi-Genzyme, Stallergenes-Greer, Uriach Pharma, ThermoFisher, Valeas. PP received grants for educational activities from AstraZeneca, Chiesi Farmaceutici, Glaxo Smith Kline, Guidotti, and Sanofi; he declares grants for participation to advisory board from Chiesi Farmaceutici, Glaxo Smith Kline, and Sanofi. IB received consulting fees from Sanofi; payment for lectures from AstraZeneca, Glaxo Smith Kline, and Sanofi; grants for participation to Participation on a Data Safety Monitoring Board or Advisory Board from Sanofi and Menarini. FC declares SIP/IRS 2024 Research Fellowship; she received payment for lectures from Chiesi Farmaceutici S.p.A., Doxa Pharma, GSK, Sanofi, as well as financial support for attending meetings and/or travel from AstraZeneca, GSK, Guidotti-Malesci, and Sanofi. MM received speaker fees from AstraZeneca. GP reports payment or honoraria for lectures from Glaxo Smith Kline, LoFarma, and Astrazeneca. DR received consulting fees from AstraZeneca and honoraria for lectures and presentations as a speaker from: Berlin Chemie, Menarini, Glaxo Smith Kline, AstraZeneca, Roche. FB received consulting fees from Sanofi, AstraZeneca, Menarini International and GSK; he reports payment for lectures presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca, GSK, Chiesi Farmaceutici S.p.A, Menarini group, and Sanofi. The other authors declare that they have no relevant conflicts of interest.
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