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RESEARCH PRODUCT
The Severe Asthma Network in Italy: Findings and Perspectives
Giovanni RollaGirolamo PelaiaMariangiola CrivellaroMaria Teresa CostantinoMaria Pia FoschinoEnrico HefflerAlice D'addaCarlo LombardiGabriella GuarnieriPierluigi PaggiaroNunzio CrimiFrancesco BlasiFrancesco BlasiEleonora SaviManuela LatorreCarla GaleoneNicola ScichiloneGiselda ColomboGiorgio Walter CanonicaGiovanni PassalacquaM D'amatoFrancesco MenzellaVincenzo PatellaFrancesca PuggioniRoberta ParentePaolo SolidoroGiuseppe SpadaroSarah BarbutoErminia RidoloElisabetta FaveroMatteo BradicichMarco CaminatiGianna CamiciottoliGianenrico Sennasubject
AdultMalemedicine.medical_specialtyRegistrySevere asthmaExacerbationBronchiectasis; Comorbidities; Late-onset asthma; Nasal polyps; Registry; SANI; Severe asthma; Immunology and AllergyOmalizumabComorbiditySettore MED/10 - Malattie Dell'Apparato RespiratorioComorbiditiesAtopy03 medical and health sciencesBronchiectasi0302 clinical medicineFood allergyInternal medicineLate-onset asthmaNasal polypsBronchiectasis; Comorbidities; Late-onset asthma; Nasal polyps; Registry; SANI; Severe asthma; Adult; Aged; Asthma; Bronchiectasis; Comorbidity; Eosinophils; Female; Humans; Immunoglobulin E; Italy; Male; Middle Aged; Nasal Polyps; Registries; RhinitisMedicineHumansBronchiectasis Comorbidities Late-onset asthma Nasal polyps Registry SANI Severe asthma Immunology and AllergyImmunology and Allergy030212 general & internal medicineRegistriesAsthmaAgedRhinitisBronchiectasisbusiness.industryNasal polypSANIImmunoglobulin EMiddle Agedmedicine.diseaseAsthmaBronchiectasisEosinophils030228 respiratory systemItalyAsthma Control QuestionnaireFemaleComorbiditiebusinessMepolizumabmedicine.drugdescription
Background Severe Asthma Network in Italy (SANI) is a registry of patients recruited by accredited centers on severe asthma. Objective To analyze epidemiological, clinical, inflammatory, functional, and treatment characteristics of severe asthmatics from the SANI registry. Methods All consecutive patients with severe asthma were included into the registry, without exclusion criteria to have real-life data on demographics, asthma control, treatments (including biologics), inflammatory biomarkers, and comorbidities. Results A total of 437 patients (mean age: 54.1 years, 57.2% females, 70.7% atopics, 94.5% in Global Initiative for Asthma severity step V) were enrolled into the study. The mean annual exacerbation rate was 3.75. The mean blood eosinophil level was 536.7 cells/mcL, and the average serum total IgE was 470.3 kU/L. Approximately 64% of patients were on regular oral corticosteroid treatment, 57% with omalizumab and 11.2% with mepolizumab. Most common comorbidities were rhinitis, nasal polyposis, and bronchiectasis. Patients with nasal polyposis had higher age of disease onset, higher blood eosinophil count, and lower frequency of atopy and atopic eczema. Bronchiectasis was associated with more frequent severe exacerbations, higher blood eosinophils, and total IgE. Stratifying patients, those with late-onset asthma were less frequently atopic (with less frequent allergic rhinitis and food allergy), and more frequently with nasal polyposis and higher serum total IgE levels. Conclusions This study revealed a high frequency of relevant comorbidities and that a substantial proportion of patients have late-onset asthma; all these features define specific different disease phenotypes. Severe asthma complexity and comorbidities require multidisciplinary approaches, led by specifically trained pulmonologists and allergists.
year | journal | country | edition | language |
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2019-05-01 |