Characterization of Severe Asthma Worldwide Data From the International Severe Asthma Registry
Characterization of Severe Asthma Worldwide Data From the International Severe Asthma Registry
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DOI：
10.1016/j.chest.2019.10.053
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发表时间：
2020-04-01
期刊：
影响因子：
9.6
通讯作者：
Price, David B.
中科院分区：
文献类型：
--
作者：
Wang, Eileen;Wechsler, Michael E.;Price, David B.
严重哮喘的国际人群的临床特征尚不清楚。区域和国家严重哮喘登记处的可变数据收集阻碍了国家间的比较。我们的目的是描述人口统计学和严重哮喘服务在美国，欧洲和亚太region.METHODS治疗的患者的临床特征，国际严重哮喘登记处回顾性和前瞻性收集数据的严重哮喘患者>= 18岁），接受全球哮喘倡议（GINA）第5步治疗或严重哮喘保持不受控制的GINA第4步。基线人口统计学和临床数据收集自2014年12月至2017年12月的美国、英国、韩国、意大利和严重哮喘网络数据库登记处（包括澳大利亚、新加坡和新西兰）。平均（SD）年龄为55.0（15.9）岁，哮喘发作时的平均（SD）年龄为30.7（17.7）岁。患者主要为女性（59.3%）和白色（72.6%），从不吸烟（60.5%），超重或肥胖（70.4%）; 34.9%处于GINA第5级; 57.2%的疾病控制不良。共有51.1%的患者接受定期间歇性口服皮质类固醇，25.4%接受生物制剂（GINA第5步的患者为72.6%）。平均（SD）急性加重率为1.7（2.7）/年。国家间的变化，观察到在临床特征，规定的治疗，和生物标志物profiles.CONCLUSION使用一个共同的数据集和定义，本研究描述了严重哮喘的特点，包括在多个严重哮喘登记的大型患者队列，并确定国家差异。这些是否与潜在的流行病学因素、环境因素、表型、哮喘管理系统、治疗途径和/或文化因素有关，需要进一步研究。
BACKGROUND Clinical characteristics of the international population with severe asthma are unknown. Intercountry comparisons are hindered by variable data collection within regional and national severe asthma registries. We aimed to describe demographic and clinical characteristics of patients treated in severe asthma services in the United States, Europe, and the Asia-Pacific region.METHODS The International Severe Asthma Registry retrospectively and prospectively collected data in patients with severe asthma >= 18 years old), receiving Global Initiative for Asthma (GINA) Step 5 treatment or with severe asthma remaining uncontrolled at GINA Step 4. Baseline demographic and clinical data were collected from the United States, United Kingdom, South Korea, Italy, and the Severe Asthma Web-based Database registry (including Australia, Singapore, and New Zealand) from December 2014 to December 2017.RESULT We included 4,990 patients. Mean (SD) age was 55.0 (15.9) years, and mean (SD) age at asthma onset was 30.7 (17.7) years. Patients were predominantly female (59.3%) and white (72.6%), had never smoked (60.5%), and were overweight or obese (70.4%); 34.9% were at GINA Step 5; and 57.2% had poorly controlled disease. A total of 51.1% of patients were receiving regular intermittent oral corticosteroids, and 25.4% were receiving biologics (72.6% for those at GINA Step 5). Mean (SD) exacerbation rate was 1.7 (2.7) per year. Intercountry variation was observed in clinical characteristics, prescribed treatments, and biomarker profiles.CONCLUSION Using a common data set and definitions, this study describes severe asthma characteristics of a large patient cohort included in multiple severe asthma registries and identifies country differences. Whether these are related to underlying epidemiological factors, environmental factors, phenotypes, asthma management systems, treatment access, and/ or cultural factors requires further study.