The Italian registry for severe/uncontrolled asthma

Abstract

In 2014, the Italian severe/uncontrolled asthma (SUA) registry was released to improve asthma care, awareness, knowledge on natural history, phenotypes. Aim: to characterize Italian SUA patients. Methods: The web-based registry, containing demographic, clinical, functional, inflammatory data, included 492 SUA patients (by GINA guidelines) from 3 Italian centres (Pisa, Perugia, Ancona). Results: SUA patients were more frequently females (60.9%), obese/overweight (64.7%), with a mean age of 53.8 yrs. 36.9% had asthma familiarity, 83.1% allergic asthma, 77.2% perennial symptoms. A late-onset of asthma symptoms (30yr) and a late first diagnosis (34yr) were observed. Other than the combination bronchodilator/corticosteroid, 51.6% of patients received antileukotrienes, 19.5% anticholinergics, 15.8% oral corticosteroids, 69.4% anti-IgE. In the last 12 months, SUA patients had 1.5±2.4 mean number of exacerbations, 9.7% had an emergency department visit and 7.3% hospitalization, 57.5% took oral steroids for exacerbations. The median blood eosinophil count was 300/mm 3 . The median FENO was 22 ppb. 65 patients performed induced sputum: 64.6% had an eosinophilic asthma phenotype (sputum Eos ≥ 3%), 13.8% neutrophilic (sputum Neu ≥ 76%), 16.9% paucigranulocytic. Comorbidities included allergic rhinitis (62.4%), gastro-oesophageal reflux (42.1%), nasal polyposis (30.2%), allergic conjunctivitis (30.2%), aspirin hyper-sensitivity (22%). Conclusion: Italian SUA patients are characterized by late symptoms onset and diagnosis, indices of eosinophilic inflammation, high burden in terms of health care costs and comorbidity. Supported by: the Italian Medicines Agency; an unrestricted grant of Roche.