Korn Stephanie, Milger Katrin, Skowasch Dirk, Timmermann Hartmut, Taube Christian, Idzko Marco, Voß Hans Werner, Holtdirk Annette, Hamelmann Eckard, Buhl Roland
IKF Pneumologie Mainz, Mainz, Germany.
Department of Medicine V, LMU University Hospital, Comprehensive Pneumology Center Munich, and Member of the German Center for Lung Research, Germany.
Respir Med. 2022 Feb 26;195:106793. doi: 10.1016/j.rmed.2022.106793.
The German Asthma Net Severe Asthma Registry is collecting long-term data from a large cohort of patients aged ≥6 years with severe asthma. This manuscript presents their baseline characteristics, and identifies relationships with exacerbations and/or poor asthma control.
The registry is collecting routine clinical parameters including: demographics and medical history; disease characteristics (Asthma Control Questionnaire [ACQ]-5, forced expiratory volume in 1 s [FEV]); exacerbations; and biomarkers (eosinophils, immunoglobulin E [IgE], fractional exhaled nitric oxide [FeNO]).
These analyses include data from 2011 patients at 72 sites (91.9% adult). Children (6-17 years) were more likely to be male, whereas more adults were female (males: children/adults 62%/41%). Most were receiving inhaled corticosteroid/long-acting β-agonist combinations (78%/81%); 38.0% of adults were receiving systemic steroids. Asthma control was suboptimal in both groups: 21.5%/13.3% were controlled; 10.4%/49.1% were symptomatic; 33.1%/37.2% received emergency asthma treatment in the previous year. Median blood eosinophil (400/238 cells/μL) and IgE levels (494/186 IU/mL) were higher in children; FeNO was lower (19/35 ppb). Patients with ≥2 exacerbations in the previous year had lower FEV (absolute and % predicted) and IgE, and higher ACQ-5, FeNO and blood eosinophil levels (all p < 0.05). There was a weak, negative correlation between ACQ-5 and FEV% predicted in adults (p < 0.001).
These analyses characterise the typical German patient with severe asthma, and provide information on their overall care. Their planned long-term follow-up will assess whether asthma control can be optimised, how best to do so, and most importantly how such optimisation can benefit patients.
德国哮喘网重症哮喘登记处正在收集大量年龄≥6岁的重症哮喘患者的长期数据。本手稿展示了他们的基线特征，并确定了与病情加重和/或哮喘控制不佳的关系。
该登记处正在收集常规临床参数，包括：人口统计学和病史；疾病特征（哮喘控制问卷[ACQ]-5、第1秒用力呼气量[FEV]）；病情加重情况；以及生物标志物（嗜酸性粒细胞、免疫球蛋白E[IgE]、呼出一氧化氮分数[FeNO]）。
这些分析包括来自72个地点的2011名患者的数据（91.9%为成年人）。儿童（6 - 17岁）男性居多，而成年人中女性更多（男性：儿童/成年人62%/41%）。大多数患者正在接受吸入性糖皮质激素/长效β受体激动剂联合治疗（78%/81%）；38.0%的成年人正在接受全身用类固醇治疗。两组的哮喘控制情况均不理想：21.5%/13.3%的患者病情得到控制；10.4%/49.1%的患者有症状；33.1%/37.2%的患者在上一年接受了哮喘急救治疗。儿童的嗜酸性粒细胞中位数（400/238个/μL）和IgE水平（494/186 IU/mL）较高；FeNO较低（19/35 ppb）。上一年病情加重≥2次的患者FEV（绝对值和预测值百分比）和IgE较低，而ACQ-5、FeNO和嗜酸性粒细胞水平较高（所有p < 0.05）。成年人中，ACQ-5与FEV预测值百分比之间存在微弱的负相关（p < 0.001）。
这些分析描述了典型的德国重症哮喘患者特征，并提供了有关其整体护理的信息。他们计划进行的长期随访将评估哮喘控制是否可以优化、如何最好地实现优化，以及最重要的是这种优化如何使患者受益。
