RItA: The Italian severe/uncontrolled asthma registry

Abstract

Background

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

Methods

493 adult patients from 27 Italian centres (recruited in 2011-2014) were analyzed.

Results

Mean age was 53.8yrs. SUA patients were more frequently female (60.6%), with allergic asthma (83.1%). About 30% showed late onset of asthma diagnosis/symptoms (>40yrs); the mean age for asthma symptoms onset was 30.2yrs and for asthma diagnosis 34.4yrs. 97.1% used ICS (dose 2000 BDP), 93.6% LABA in association with ICS, 53.3% LTRAs, 64.1% anti-IgE, 10.7% theophylline, 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, 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%), allergic conjunctivitis (30.2%).

55.7% of SUA patients had exacerbations in the last 12 months, 9.7% emergency department visits, 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), anti-IgE use in a protective way (0.26, 0.12-0.53).

Comparisons to severe asthma multicentre 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 socio-economic burden for health services.

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