The Italian severe/uncontrolled asthma registry (RItA): A 12-month clinical follow-up. (December 2022)

• Record Type: Journal Article
• Authors: Maio, Sara; Murgia, Nicola; Tagliaferro, Sofia; Angino, Anna; Sarno, Giuseppe; Carrozzi, Laura; Pistelli, Francesco; Bacci, Elena; Paggiaro, Pier Luigi; Latorre, Manuela; Baldacci, Sandra; Viegi, Giovanni
• Is Part Of: Respiratory medicine. Volume 205(2022)
• Publication Date: 2022-12
• Subjects: anti-IgE treatment -- Longitudinal patterns -- Phenotypes -- Registry -- Asthma control; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2022.107030
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Background: follow-up studies on registries of severe/uncontrolled asthma (SUA) patients are scanty. Objective: to analyze baseline and follow-up characteristics of SUA patients and their longitudinal patterns. Methods: 180 adult patients (age ≥15 yrs) were investigated at baseline and 12-month follow-up through the Italian SUA registry (RItA). Latent transition analysis (LTA) was performed to detect cross-sectional SUA phenotypes and longitudinal patterns. Risk factors for longitudinal patterns were assessed through logistic regression. Results: a significant/borderline improvement of asthma control outcomes in the last 2–4 weeks emerged at follow-up with respect to baseline for: daily activities limitations (Δ −16%), frequent diurnal symptoms (Δ −25%), uncontrolled asthma symptoms according to ACT (Δ −26%). Last 12-month use of oral corticosteroids was less frequent at follow-up than at baseline (Δ −25%). Health status improvement was confirmed by lung function test results. Through LTA, two longitudinal patterns were detected considering last 12-month control outcomes: "persistence/worsening" (53.9%), "under control/improvement" (46.1%). A lower likelihood of having "persistence/worsening" SUA was exhibited by patients under anti-IgE (OR 0.38, 95% CI 0.17–0.84) and inhaled corticosteroids-bronchodilator association treatment (OR 0.13, 95% CI 0.01–1.26, borderline value), while a higher likelihood was shown by older age at first asthma diagnosis (OR 1.04, 95% CI 1.01–1.07). Conclusion: the implementation of a SUA registry, the availability of patient-level data and the application of an innovative longitudinal analysis allowed to observe a general improvement in asthma control, one year after baseline, and a lower risk of SUA "persistence/worsening" in patients under anti-IgE and regular ICS-bronchodilator association use. Highlights: Registries collect information for preventive, diagnostic, therapeutic strategies. Patient-level longitudinal data allowed to identify predictors of clinical patterns. Regular review allows for thorough patients' clinical characterization and management.