6533b854fe1ef96bd12ae145
RESEARCH PRODUCT
Severe asthma: One disease and multiple definitions
Maria Teresa CostantinoLuigi MacchiaAngelo CorsicoAndrea AiroldiCarla GaleoneZappa Maria CristinaPaolo TarsiaFoschino Barbaro Maria PiaSilvia RuggeriPierluigi PaggiaroLorenzo CosmiA. FarsiVitina Maria Anna CarrieroArianna BassiFrancesca BertoliniGiovanni PassalacquaFulvia Chieco BianchiCarlo LombardiSalvatore Lo CiceroGiovanni RollaCarmen DuranteRocco RinaldoElena ParazziniArianna AruannoMaria Rita MarchiChiara FolliAlessandra ArcolaciCarlo PasculliFabio Luigi Massimo RicciardoloVittorio VivianoAlvise BertiStefano Del GiaccoAndrea ManfrediRoberta BarlassinaAgata Valentina FrazzettoPierachille SantusLuisa BrussinoAnna Del ColleMarco BonaviaDina ViscaNicola ScichilonePatrizia PignattiEnrico HefflerFrancesca RaccaGiuseppe SantiniNucera EleonoraGiovanna Elisiana CarpagnanoLinda Di PietroStefano CentanniMaria Elisabetta ConteVincenzo PatellaMona-rita YacoubDiego BagnascoNunzio CrimiAnna Maria RiccioStefania IsolaMargherita DeiddaGabriella GuarnieriGiuseppe GuidaElena MinennaManuela LatorreGianna CamiciottoliMaria Vittoria VerrilloLuca RicheldiMarcello MontagniFrancesca CiceroMaria Filomena CaiaffaAntonio SpanevelloCecilia CalabreseCarlo BarbettaElisabetta FaveroGianenrico SennaGiuliana AmatoAmelia GrossoFederica VitaFrancesco BlasiFrancesco BlasiLuisa RicciardiCarola CondoluciMassimo TriggianiEnrico MaggiMariacarmela Di ProiettoGiulia CarliRoberta ParenteEleonora SaviChiara RoncalloPaolo MontuschiLuciana D'eliaFrancesco MazzaSimona D’aloPatrizia RuggieroFrancesca PuggioniMatteo BoniniSimone LuraschiFrancesco MenzellaLeonello FusoMarco CaminatiMartina FloraMariachiara BraschiCristiano CarusoAngela RizziSandra IannaconeFrank Rikki CanevariAndrea VianelloD’amato MariaManlio MilaneseStefania ColantuonoGiorgio Walter CanonicaGiulia SciosciaLaura PiniElisa TestinoErminia RidoloJoyce RoloElisa TurchetPelaia GerolamoDanilo Di BonaLaura De FerrariFrancesca CherubinoAlice D’addaMarianna LilliGiuseppe SpadaroStefano PucciCaterina DetorakiChiara Allegrinisubject
Pulmonary and Respiratory Medicinemedicine.medical_specialtySevere asthmaSevere asthmaImmunologyNiceDiseaseSettore MED/10 - Malattie Dell'Apparato RespiratorioArticlePulmonary function testingInternal medicineBiological treatment; Classification; Definition; Severe asthmamedicineImmunology and AllergyRespiratory functioncomputer.programming_languageSevere asthma; Classification; Definition; Biological treatmentBiological therapiesbusiness.industrySettore MED/09 - MEDICINA INTERNADefinitionRC581-607ClassificationSevere asthma Classification Definition Biological treatmentBiological treatment Classification Definition Severe asthmaImmunologic diseases. AllergybusinessBiological treatmentcomputerdescription
Abstract Introduction There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used. Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERS-GINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-11-01 |