Characterization of Severe Asthma Worldwide: Data From the International Severe Asthma Registry.


Journal

Chest
ISSN: 1931-3543
Titre abrégé: Chest
Pays: United States
ID NLM: 0231335

Informations de publication

Date de publication:
04 2020
Historique:
received: 11 06 2019
revised: 01 10 2019
accepted: 14 10 2019
pubmed: 1 12 2019
medline: 10 2 2021
entrez: 1 12 2019
Statut: ppublish

Résumé

Clinical characteristics of the international population with severe asthma are unknown. Intercountry comparisons are hindered by variable data collection within regional and national severe asthma registries. We aimed to describe demographic and clinical characteristics of patients treated in severe asthma services in the United States, Europe, and the Asia-Pacific region. The International Severe Asthma Registry retrospectively and prospectively collected data in patients with severe asthma (≥ 18 years old), receiving Global Initiative for Asthma (GINA) Step 5 treatment or with severe asthma remaining uncontrolled at GINA Step 4. Baseline demographic and clinical data were collected from the United States, United Kingdom, South Korea, Italy, and the Severe Asthma Web-based Database registry (including Australia, Singapore, and New Zealand) from December 2014 to December 2017. We included 4,990 patients. Mean (SD) age was 55.0 (15.9) years, and mean (SD) age at asthma onset was 30.7 (17.7) years. Patients were predominantly female (59.3%) and white (72.6%), had never smoked (60.5%), and were overweight or obese (70.4%); 34.9% were at GINA Step 5; and 57.2% had poorly controlled disease. A total of 51.1% of patients were receiving regular intermittent oral corticosteroids, and 25.4% were receiving biologics (72.6% for those at GINA Step 5). Mean (SD) exacerbation rate was 1.7 (2.7) per year. Intercountry variation was observed in clinical characteristics, prescribed treatments, and biomarker profiles. Using a common data set and definitions, this study describes severe asthma characteristics of a large patient cohort included in multiple severe asthma registries and identifies country differences. Whether these are related to underlying epidemiological factors, environmental factors, phenotypes, asthma management systems, treatment access, and/or cultural factors requires further study.

Sections du résumé

BACKGROUND
Clinical characteristics of the international population with severe asthma are unknown. Intercountry comparisons are hindered by variable data collection within regional and national severe asthma registries. We aimed to describe demographic and clinical characteristics of patients treated in severe asthma services in the United States, Europe, and the Asia-Pacific region.
METHODS
The International Severe Asthma Registry retrospectively and prospectively collected data in patients with severe asthma (≥ 18 years old), receiving Global Initiative for Asthma (GINA) Step 5 treatment or with severe asthma remaining uncontrolled at GINA Step 4. Baseline demographic and clinical data were collected from the United States, United Kingdom, South Korea, Italy, and the Severe Asthma Web-based Database registry (including Australia, Singapore, and New Zealand) from December 2014 to December 2017.
RESULTS
We included 4,990 patients. Mean (SD) age was 55.0 (15.9) years, and mean (SD) age at asthma onset was 30.7 (17.7) years. Patients were predominantly female (59.3%) and white (72.6%), had never smoked (60.5%), and were overweight or obese (70.4%); 34.9% were at GINA Step 5; and 57.2% had poorly controlled disease. A total of 51.1% of patients were receiving regular intermittent oral corticosteroids, and 25.4% were receiving biologics (72.6% for those at GINA Step 5). Mean (SD) exacerbation rate was 1.7 (2.7) per year. Intercountry variation was observed in clinical characteristics, prescribed treatments, and biomarker profiles.
CONCLUSIONS
Using a common data set and definitions, this study describes severe asthma characteristics of a large patient cohort included in multiple severe asthma registries and identifies country differences. Whether these are related to underlying epidemiological factors, environmental factors, phenotypes, asthma management systems, treatment access, and/or cultural factors requires further study.

Identifiants

pubmed: 31785254
pii: S0012-3692(19)34295-3
doi: 10.1016/j.chest.2019.10.053
pii:
doi:

Substances chimiques

Glucocorticoids 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

790-804

Commentaires et corrections

Type : ErratumIn

Informations de copyright

Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

Auteurs

Eileen Wang (E)

Division of Allergy & Clinical Immunology, Department of Medicine, National Jewish Health, Denver, CO, and Division of Allergy & Clinical Immunology, Department of Internal Medicine, University of Colorado Hospital, Aurora, CO.

Michael E Wechsler (ME)

NJH Cohen Family Asthma Institute, Department of Medicine, National Jewish Health, Denver, CO.

Trung N Tran (TN)

AstraZeneca, Gaithersburg, MD.

Liam G Heaney (LG)

UK Severe Asthma Network and National Registry, Queen's University Belfast, Belfast, Northern Ireland.

Rupert C Jones (RC)

Faculty of Medicine and Dentistry, University of Plymouth, Plymouth, United Kingdom.

Andrew N Menzies-Gow (AN)

UK Severe Asthma Network and National Registry, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom.

John Busby (J)

UK Severe Asthma Network and National Registry, Queen's University Belfast, Belfast, Northern Ireland.

David J Jackson (DJ)

UK Severe Asthma Network and National Registry, Guy's and St Thomas' NHS Trust and Division of Asthma, Allergy & Lung Biology, King's College London, London, United Kingdom.

Paul E Pfeffer (PE)

UK Severe Asthma Network, Barts Health NHS Trust and Queen Mary University of London, London, United Kingdom.

Chin Kook Rhee (CK)

Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

You Sook Cho (YS)

Department of Internal Medicine, Division of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

G Walter Canonica (GW)

Personalized Medicine Asthma & Allergy Clinic, Humanitas University & Research Hospital, Milan, Italy and SANI-Severe Asthma Network Italy, Italy.

Enrico Heffler (E)

Personalized Medicine Asthma & Allergy Clinic, Humanitas University & Research Hospital, Milan, Italy and SANI-Severe Asthma Network Italy, Italy.

Peter G Gibson (PG)

Australian Severe Asthma Network, Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, NSW, Australia.

Mark Hew (M)

Allergy, Asthma & Clinical Immunology Service, Alfred Health, Melbourne, VIC, Australia; Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.

Matthew Peters (M)

Department of Thoracic Medicine, Concord Hospital, Sydney, NSW, Australia.

Erin S Harvey (ES)

Australian Severe Asthma Network, Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, NSW, Australia.

Marianna Alacqua (M)

AstraZeneca plc, Cambridge, United Kingdom.

James Zangrilli (J)

AstraZeneca, Gaithersburg, MD.

Lakmini Bulathsinhala (L)

Optimum Patient Care Global Ltd, Cambridge, England.

Victoria A Carter (VA)

Optimum Patient Care Global Ltd, Cambridge, England.

Isha Chaudhry (I)

Optimum Patient Care Global Ltd, Cambridge, England.

Neva Eleangovan (N)

Optimum Patient Care Global Ltd, Cambridge, England.

Naeimeh Hosseini (N)

Optimum Patient Care Global Ltd, Cambridge, England.

Ruth B Murray (RB)

Optimum Patient Care Global Ltd, Cambridge, England.

David B Price (DB)

Optimum Patient Care Global Ltd, Cambridge, England; Observational and Pragmatic Research Institute, Singapore, Republic of Singapore; Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom. Electronic address: dprice@opri.sg.

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