Asthma control in Europe: A real-world evaluation based on an international population-based study

Lucia Cazzoletti, Alessandro Marcon, Christer Janson, Angelo Corsico, Deborah Jarvis, Isabelle Pin, Simone Accordini, Enrique Almar, Massimiliano Bugiani, Adriana Carolei, Isa Cerveri, Enric Duran-Tauleria, David Gislason, Amund Gulsvik, Rain Jõgi, Alessandra Marinoni, Jesús Martínez-Moratalla, Paul Vermeire, Roberto de Marco

Research output: Contribution to journalArticlepeer-review


Background: Epidemiologic evidence related to asthma control in patients from the general population is scanty. Objectives: We sought to assess asthma control in several European centers according to the Global Initiative for Asthma (GINA) guidelines and to investigate its determinants. Methods: In the European Community Respiratory Health Survey II (1999-2002), 1241 adults with asthma were identified and classified into inhaled corticosteroid (ICS) users and non-ICS users in the last year. Control was assessed in both groups by using the GINA proposal (controlled, partly controlled, and uncontrolled asthma), and it was related to potential determinants. Results: Only 15% (95% CI, 12% to 19%) of subjects who had used ICSs in the last year and 45% (95% CI, 41% to 50%) of non-ICS users had their asthma under control; individuals with uncontrolled asthma accounted for 49% (95% CI, 44% to 53%) and 18% (95% CI, 15% to 21%), respectively. Among ICS users, the prevalence of uncontrolled asthma showed great variability across Europe, ranging from 20% (95% CI, 7% to 41%; Iceland) to 67% (95% CI, 35% to 90%; Italy). Overweight status, chronic cough and phlegm, and sensitization to Cladosporium species were associated with poor control in ICS users. About 65% and 87% of ICS users with uncontrolled and partly controlled asthma, respectively, were on a medication regimen that was less than recommended by the GINA guidelines. Conclusion: Six of 7 European asthmatic adults using ICSs in the last year did not achieve good disease control. The large majority of subjects with poorly controlled asthma were using antiasthma drugs in a suboptimal way. A wide variability in asthma control emerged across Europe. Clinical implications: Greater attention should be paid to asthma management and to the implementation of the GINA guidelines.

Original languageEnglish
Pages (from-to)1360-1367
Number of pages8
JournalJournal of Allergy and Clinical Immunology
Issue number6
Publication statusPublished - Dec 2007


  • Asthma control
  • body mass index
  • Cladosporium species
  • cross-sectional study
  • European Community Respiratory Health Survey
  • Global Initiative for Asthma
  • inhaled corticosteroids
  • population-based study
  • predictors of uncontrolled asthma
  • total IgE

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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