Giorgio Walter Canonica1, Luca Malvezzi2, Francesco Blasi3, Pierluigi Paggiaro4, Marco Mantero3, Gianenrico Senna5, Enrico Heffler6. 1. Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Via Manzoni 56, 20089, Rozzano, MI, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy. Electronic address: giorgio_walter.canonica@hunimed.eu. 2. Otolaryngology, Humanitas Clinical and Research Center IRCCS, Via Manzoni 56, 20089, Rozzano, MI, Italy. 3. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy. 4. Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Italy. 5. Asthma Center and Allergy Unit, Verona University Hospital, Verona, Italy. 6. Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Via Manzoni 56, 20089, Rozzano, MI, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.
Abstract
BACKGROUND: The clinical and laboratory features of patients enrolled in the Severe Asthma Network in Italy (SANI) registry, a web-based observatory collecting demographic, clinical, functional and inflammatory data of patients with severe asthma were evaluated, with a special emphasis to chronic rhinosinusitis with nasal polyposis (CRSwNP). METHODS: For each eligible patients the following information has been collected: demographic data, clinical features, asthma control in the previous month according to the GINA (Global INitiative for Asthma) Guidelines and standardized questionnaires, concomitant regular and on demand treatments and inflammatory markers. RESULTS: 695 patients with severe asthma enrolled in 66 SANI centers were analyzed. The prevalence of chronic rhinosinusitis with nasal polyposis was 40.6%. Atopic dermatitis and bronchiectasis was significantly more frequent in patients with CRSwNP than in subjects without nasal polyposis; similarly, FeNO values are significantly higher in subject with CRSwNP than in patients without nasal polyposis. Finally, patients with CRSwNP had a significantly higher number of asthma exacerbations per year, more days on oral corticosteroids and were more likely to be OCS long term users. CONCLUSION: OCS sparing is needed in patients with severe asthma, mainly in subjects with CRSwNP, adopting adequate strategies such as a better adherence to the treatment with inhaled therapy according to the GINA recommendations, the use of biologic agents and a multidisciplinary approach of the patient.
BACKGROUND: The clinical and laboratory features of patients enrolled in the Severe Asthma Network in Italy (SANI) registry, a web-based observatory collecting demographic, clinical, functional and inflammatory data of patients with severe asthma were evaluated, with a special emphasis to chronic rhinosinusitis with nasal polyposis (CRSwNP). METHODS: For each eligible patients the following information has been collected: demographic data, clinical features, asthma control in the previous month according to the GINA (Global INitiative for Asthma) Guidelines and standardized questionnaires, concomitant regular and on demand treatments and inflammatory markers. RESULTS: 695 patients with severe asthma enrolled in 66 SANI centers were analyzed. The prevalence of chronic rhinosinusitis with nasal polyposis was 40.6%. Atopic dermatitis and bronchiectasis was significantly more frequent in patients with CRSwNP than in subjects without nasal polyposis; similarly, FeNO values are significantly higher in subject with CRSwNP than in patients without nasal polyposis. Finally, patients with CRSwNP had a significantly higher number of asthma exacerbations per year, more days on oral corticosteroids and were more likely to be OCS long term users. CONCLUSION: OCS sparing is needed in patients with severe asthma, mainly in subjects with CRSwNP, adopting adequate strategies such as a better adherence to the treatment with inhaled therapy according to the GINA recommendations, the use of biologic agents and a multidisciplinary approach of the patient.
Authors: Ian D Pavord; Elisabeth H Bel; Arnaud Bourdin; Robert Chan; Joseph K Han; Oliver N Keene; Mark C Liu; Neil Martin; Alberto Papi; Florence Roufosse; Jonathan Steinfeld; Michael E Wechsler; Steven W Yancey Journal: Allergy Date: 2021-09-16 Impact factor: 14.710
Authors: Cemal Cingi; Nuray Bayar Muluk; Dimitrios I Mitsias; Nikolaos G Papadopoulos; Ludger Klimek; Anu Laulajainen-Hongisto; Maija Hytönen; Sanna Katriina Toppila-Salmi; Glenis Kathleen Scadding Journal: Front Allergy Date: 2021-02-22
Authors: Christer Janson; Leif Bjermer; Lauri Lehtimäki; Hannu Kankaanranta; Jussi Karjalainen; Alan Altraja; Valentyna Yasinska; Bernt Aarli; Madeleine Rådinger; Johan Hellgren; Magnus Lofdahl; Peter H Howarth; Celeste Porsbjerg Journal: Eur Clin Respir J Date: 2022-03-02