Introduction: There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used.Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods: Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results: 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/ mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERSGINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions: The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem.

Severe asthma: One disease and multiple definitions / Bagnasco, Diego; Paggiaro, Pierluigi; Latorre, Manuela; Folli, Chiara; Testino, Elisa; Bassi, Arianna; Milanese, Manlio; Heffler, Enrico; Manfredi, Andrea; Riccio, Anna Maria; De Ferrari, Laura; Blasi, Francesco; Canevari, Rikki Frank; Canonica, Giorgio Walter; Passalacqua, GiovanniBagnasco; Guarnieri, Gabriella;Patella, Vincenzo;Maria Pia, Foschino Barbaro;Carpagnano, Giovanna Elisiana;Colle, Anna del;Scioscia, Giulia;Gerolamo, Pelaia;Puggioni, Francesca;Racca, Francesca;Favero, Elisabetta;Iannacone, Sandra;Savi, Eleonora;Montagni, Marcello;Camiciottoli, Gianna;Allegrini, Chiara;Lombardi, Carlo;Spadaro, Giuseppe;Detoraki, Caterina;Menzella, Francesco;Galeone, Carla;Ruggiero, Patrizia;Yacoub, Monna Rita;Berti, Alvise;Scichilone, Nicola;Durante, Carmen;Costantino, Maria Teresa;Roncallo, Chiara;Braschi, Mariachiara;D'Adda, Alice;Ridolo, Erminia;Triggiani, Massimo;Parente, Roberta;Maria, D'Amato;Verrillo, Maria Vittoria;Rolla, Giovanni;Brussino, Luisa;Frazzetto, Agata Valentina;Cristina, Zappa Maria;Lilli, Marianna;Crimi, Nunzio;Bonavia, Marco;Corsico, Angelo Guido;Grosso, Amelia;Del Giacco, Stefano;Deidda, Margherita;. - In: THE WORLD ALLERGY ORGANIZATION JOURNAL. - ISSN 1939-4551. - ELETTRONICO. - 14:(2021), pp. 100606.0-100606.0. [10.1016/j.waojou.2021.100606]

Severe asthma: One disease and multiple definitions

Camiciottoli, Gianna;Allegrini, Chiara;
2021

Abstract

Introduction: There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used.Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods: Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results: 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/ mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERSGINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions: The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem.
14
0
0
Goal 3: Good health and well-being
Goal 10: Reduced inequalities
Bagnasco, Diego; Paggiaro, Pierluigi; Latorre, Manuela; Folli, Chiara; Testino, Elisa; Bassi, Arianna; Milanese, Manlio; Heffler, Enrico; Manfredi, Andrea; Riccio, Anna Maria; De Ferrari, Laura; Blasi, Francesco; Canevari, Rikki Frank; Canonica, Giorgio Walter; Passalacqua, GiovanniBagnasco; Guarnieri, Gabriella;Patella, Vincenzo;Maria Pia, Foschino Barbaro;Carpagnano, Giovanna Elisiana;Colle, Anna del;Scioscia, Giulia;Gerolamo, Pelaia;Puggioni, Francesca;Racca, Francesca;Favero, Elisabetta;Iannacone, Sandra;Savi, Eleonora;Montagni, Marcello;Camiciottoli, Gianna;Allegrini, Chiara;Lombardi, Carlo;Spadaro, Giuseppe;Detoraki, Caterina;Menzella, Francesco;Galeone, Carla;Ruggiero, Patrizia;Yacoub, Monna Rita;Berti, Alvise;Scichilone, Nicola;Durante, Carmen;Costantino, Maria Teresa;Roncallo, Chiara;Braschi, Mariachiara;D'Adda, Alice;Ridolo, Erminia;Triggiani, Massimo;Parente, Roberta;Maria, D'Amato;Verrillo, Maria Vittoria;Rolla, Giovanni;Brussino, Luisa;Frazzetto, Agata Valentina;Cristina, Zappa Maria;Lilli, Marianna;Crimi, Nunzio;Bonavia, Marco;Corsico, Angelo Guido;Grosso, Amelia;Del Giacco, Stefano;Deidda, Margherita;
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in FLORE sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2158/1284495
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 5
  • ???jsp.display-item.citation.isi??? 5
social impact