Jaun Fabienne, Tröster Lydia Marie, Giezendanne Stéphanie, Bridevaux Pierre-Olivier, Charbonnier Florian, Clarenbach Christian, Gianella Pietro, Jochmann Anja, Kern Lukas, Miedinger David, Pavlov Nikolay, Rothe Thomas, Steurer-Stey Claudia, von Garnier Christophe, Leuppi Jorg D
University Center of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland,
Medical Faculty, University of Basel, Basel, Switzerland,
Respiration. 2023;102(10):863-878. doi: 10.1159/000533474. Epub 2023 Sep 28.
Asthma is a chronic airway disease, affecting over 300 million people worldwide. 5-10% of patients suffer from severe asthma and account for 50% of asthma-related financial burden. Availability of real-life data about the clinical course of severe asthma is insufficient.
The aims of this study were to characterize patients with severe asthma in Switzerland, enrolled in the Swiss Severe Asthma Registry (SSAR), and evaluate predictors for asthma control.
A descriptive characterisation of 278 patients was performed, who were prospectively enrolled in the registry until January 2022. Socio-demographic variables, comorbidities, diagnostic values, asthma treatment, and healthcare utilisation were evaluated. Groups of controlled and uncontrolled asthma according to the asthma control test were compared.
Forty-eight percent of patients were female and the mean age was 55.8 years (range 13-87). The mean body mass index (BMI) was 27.4 kg/m2 (±6). 10.8% of patients were current smokers. Allergic comorbidities occurred in 54.3% of patients, followed by chronic rhinosinusitis (46.4%) and nasal polyps (34.1%). According to the ACT score, 54.7% had well controlled, 16.2% partly controlled and 25.9% uncontrolled asthma. The most common inhalation therapy was combined inhaled corticosteroids/long-acting β2-agonists (78.8%). Biologics were administered to 81.7% of patients and 19.1% received oral steroids. The multivariable analysis indicated that treatment with biologics was positively associated with asthma control whereas higher BMI, oral steroids, exacerbations, and COPD were negative predictors for asthma control.
Biologics are associated with improved control in severe asthma. Further studies are required to complete the picture of severe asthma in order to provide improved care for those patients.
哮喘是一种慢性气道疾病，全球有超过3亿人受其影响。5%-10%的患者患有重度哮喘，占哮喘相关经济负担的50%。关于重度哮喘临床病程的真实数据不足。
本研究旨在对瑞士重度哮喘登记处（SSAR）登记的瑞士重度哮喘患者进行特征描述，并评估哮喘控制的预测因素。
对278例患者进行了描述性特征分析，这些患者前瞻性地登记入该登记处直至2022年1月。评估了社会人口统计学变量、合并症、诊断值、哮喘治疗和医疗保健利用情况。比较了根据哮喘控制测试划分的哮喘控制组和未控制组。
48%的患者为女性，平均年龄为55.8岁（范围13-87岁）。平均体重指数（BMI）为27.4kg/m²（±6）。10.8%的患者为当前吸烟者。54.3%的患者有过敏性合并症，其次是慢性鼻-鼻窦炎（46.4%）和鼻息肉（34.1%）。根据ACT评分，54.7%的患者哮喘控制良好，16.2%的患者部分控制，25.9%的患者哮喘未得到控制。最常见的吸入疗法是联合吸入糖皮质激素/长效β2受体激动剂（78.8%）。81.7%的患者使用了生物制剂，19.1%的患者接受了口服类固醇治疗。多变量分析表明，生物制剂治疗与哮喘控制呈正相关，而较高的BMI、口服类固醇、病情加重和慢性阻塞性肺疾病是哮喘控制的负性预测因素。
生物制剂与重度哮喘控制的改善相关。需要进一步研究以完善重度哮喘的全貌，以便为这些患者提供更好的护理。
