Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Italy.
Allergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti di Ancona, Italy.
Eur Ann Allergy Clin Immunol. 2021 May;53(3):103-114. doi: 10.23822/EurAnnACI.1764-1489.196. Epub 2021 Mar 16.
The Italian Registry on Severe Asthma (IRSA) is the most recent and largestregistry in Italy. To improve the knowledge on the clinical and biological features of severe asthma (SA), and to monitor its treatments. To analyze clinical,functional, inflammatory, and treatment characteristics of severe asthmatics from the IRSA registry. 851 subjects were enrolled. 31.8% and 64.5% of patients were submitted to oral corticosteroids (OCS), and monoclonal antibodies (MABs), respectively. At least tw ocomorbidities affected 77.4% patients. Asthma was uncontrolled in 62.2% patients. Uncontrolled patients had a higher frequency of exacerbations, and hospitalization, showing a highere osinophilic phenotype, a greater use of OCS, and being treated with MAB less frequently. However, uncontrolled patients treated with MAB had a lower use of OCS and a lower rateof hospitalization. Comparing SA patients with atopy and without atopy, the latter showeda greater use of OCS, and more frequent nasal polyposis and osteoporosis. Among SA patients with atopy treated with MAB, 36% were on a treatment targeting the IL-5 pathway. This study shows the features of the greatest Italian registryof SA patients, revealing at the time of enrollment a poor disease control, and the use of OCSand MABs in about one third and two thirds of patients, respectively. SA is a complex diseasethat requires a more precise phenotyping and a greater disease control.
意大利严重哮喘登记研究（IRSA）是意大利最新和最大的哮喘登记研究。为了提高对严重哮喘（SA）的临床和生物学特征的认识，并监测其治疗效果。分析来自 IRSA 登记研究的严重哮喘患者的临床、功能、炎症和治疗特征。共纳入 851 例患者。31.8%和 64.5%的患者分别接受了口服皮质类固醇（OCS）和单克隆抗体（MAB）治疗。77.4%的患者至少合并两种疾病。62.2%的患者哮喘未得到控制。未控制的患者发生加重和住院的频率更高，表现出更高的嗜酸性粒细胞表型，更频繁地使用 OCS，较少使用 MAB。然而，接受 MAB 治疗的未控制患者使用 OCS 较少，住院率较低。比较有和无特应性的 SA 患者，后者表现出更高的 OCS 使用频率，更频繁的鼻息肉和骨质疏松。在接受 MAB 治疗的有特应性的 SA 患者中，36%的患者接受了针对 IL-5 通路的治疗。这项研究展示了意大利最大的 SA 患者登记研究的特征，在登记时发现疾病控制不佳，OCS 和 MAB 的使用率分别约为三分之一和三分之二。SA 是一种复杂的疾病，需要更精确的表型分析和更好的疾病控制。
