The Italian severe/uncontrolled asthma registry (RItA): A 12-month clinical follow-up.

Autor: Maio S; Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy. Electronic address: saramaio@ifc.cnr.it., Murgia N; Section of Occupational Medicine, Respiratory Diseases and Toxicology, Medicine, Dept., Perugia University, Italy., Tagliaferro S; Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy., Angino A; Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy., Sarno G; Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy., Carrozzi L; Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Italy; Cardio-Thoracic and Vascular Department, Pisa University Hospital, Pisa, Italy., Pistelli F; Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Italy; Cardio-Thoracic and Vascular Department, Pisa University Hospital, Pisa, Italy., Bacci E; Cardio-Thoracic and Vascular Department, Pisa University Hospital, Pisa, Italy., Paggiaro PL; Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Italy., Latorre M; Pulmonary Unit, Department of Medical Specialties, Nuovo Ospedale Apuano, Massa, Italy., Baldacci S; Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy., Viegi G; Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy.
Jazyk: angličtina
Zdroj: Respiratory medicine [Respir Med] 2022 Dec; Vol. 205, pp. 107030. Date of Electronic Publication: 2022 Oct 29.
DOI: 10.1016/j.rmed.2022.107030
Abstrakt: Background: follow-up studies on registries of severe/uncontrolled asthma (SUA) patients are scanty.
Objective: to analyze baseline and follow-up characteristics of SUA patients and their longitudinal patterns.
Methods: 180 adult patients (age ≥15 yrs) were investigated at baseline and 12-month follow-up through the Italian SUA registry (RItA). Latent transition analysis (LTA) was performed to detect cross-sectional SUA phenotypes and longitudinal patterns. Risk factors for longitudinal patterns were assessed through logistic regression.
Results: a significant/borderline improvement of asthma control outcomes in the last 2-4 weeks emerged at follow-up with respect to baseline for: daily activities limitations (Δ -16%), frequent diurnal symptoms (Δ -25%), uncontrolled asthma symptoms according to ACT (Δ -26%). Last 12-month use of oral corticosteroids was less frequent at follow-up than at baseline (Δ -25%). Health status improvement was confirmed by lung function test results. Through LTA, two longitudinal patterns were detected considering last 12-month control outcomes: "persistence/worsening" (53.9%), "under control/improvement" (46.1%). A lower likelihood of having "persistence/worsening" SUA was exhibited by patients under anti-IgE (OR 0.38, 95% CI 0.17-0.84) and inhaled corticosteroids-bronchodilator association treatment (OR 0.13, 95% CI 0.01-1.26, borderline value), while a higher likelihood was shown by older age at first asthma diagnosis (OR 1.04, 95% CI 1.01-1.07).
Conclusion: the implementation of a SUA registry, the availability of patient-level data and the application of an innovative longitudinal analysis allowed to observe a general improvement in asthma control, one year after baseline, and a lower risk of SUA "persistence/worsening" in patients under anti-IgE and regular ICS-bronchodilator association use.
Competing Interests: Declaration of competing interest Nicola Murgia, grants from GSK, personal fees from AstraZeneca, grants and personal fees from Chiesi, and personal fees from Menarini, outside the submitted work; Laura Carrozzi, grants for educational activities and a randomised clinical trial from GSK, Guidotti, F.I.R.M.A., Sanofi, and Chiesi, outside the submitted work; Elena Bacci, personal grants for educational activities from GSK, Sanofi, and AstraZeneca, outside the submitted work; Pier Luigi Paggiaro, personal grants for educational activities from Chiesi, GSK, Guidotti, Lusofarmaco, and Sanofi, outside the submitted work. The other authors have no conflict of interest to declare.
(Copyright © 2022 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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