Severe asthma management in the era of biologics: insights of the Italian Registry on Severe Asthma (IRSA)M. B. Bil˛ firstname.lastname@example.org,2, L. Antonicelli2, M. Carone3, F. De Michele4, F. Menzella5, A. Musarra6,
S. Tognella7, A. Vaghi8, C. Micheletto9Show more: Authors information and Publication history
Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Italy2
Allergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti di Ancona, Italy3
Division of Pulmonary Disease, Istituti Clinici Scientifici Maugeri Spa SB, Pavia, and IRCCS of Bari, Bari, Italy4
Pneumology I and Respiratory Pathophysiology Unit, A. Cardarelli Hospital, Naples, Italy5
Pneumology Unit, Department of Medical Specialties, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia-IRCCS, Reggio Emilia, Italy6
Department of Allergology, Casa della Salute di Scilla, Scilla, Reggio Calabria, Italy7
Respiratory Unit, Mater Salutis Hospital, AULSS 9 Scaligera, Legnago, Verona, Italy8
Respiratory Unit, ASST-Rhodense, Garbagnate Milanese, Milan, Italy9
Pulmonary Unit, Integrated University Hospital of Verona, Verona, ItalyHistory
Published online: 26 April 2021
Accepted: 17 February 2021
Received: February 2021
The Italian Registry on Severe Asthma (IRSA) is the most recent and largest registry in Italy. Objective.
To improve the knowledge on the clinical and biological features of severe asthma (SA), and to monitor its treatments. Methods.
To analyze clinical, functional, inflammatory, and treatment characteristics of severe asthmatics from the IRSA registry. Results.
851 subjects were enrolled. 31.8% and 64.5% of patients were submitted to oral corticosteroids (OCS), and monoclonal antibodies (MABs), respectively. At least two comorbidities affected 77.4% patients. Asthma was uncontrolled in 62.2% patients. Uncontrolled patients had a higher frequency of exacerbations, and hospitalization, showing a higher eosinophilic phenotype, a greater use of OCS, and being treated with MAB less frequently. However, uncontrolled patients treated with MAB had a lower use of OCS and a lower rate of hospitalization. Comparing SA patients with atopy and without atopy, the latter showed a greater use of OCS, and more frequent nasal polyposis and osteoporosis. Among SA patients with atopy treated with MAB, 36% were on a treatment targeting the IL-5 pathway. Conclusions and clinical relevance.
This study shows the features of the greatest Italian registry of SA patients, revealing at the time of enrollment a poor disease control, and the use of OCS and MABs in about one third and two thirds of patients, respectively. SA is a complex disease that requires a more precise phenotyping and a greater disease control.Key words
Asthma; biologics; eosinophils; IgE;registry.
Cite this article as:
Bilò MB, Antonicelli L, Carone M, De Michele F, Menzella F, Musarra A, Tognella S, Vaghi A, Micheletto C, Severe asthma management in the era of biologics:insights of the Italian Registry on Severe Asthma(IRSA), Eur Ann Allergy Clin Immunol 2021;53(3):103-114. doi:10.23822/EurAnnACI.1764-1489.196.