The Severe Asthma Network in Italy: Findings and Perspectives

SANI Network, Enrico Heffler, Francesco Blasi, Manuela Latorre, Francesco Menzella, Pierluigi Paggiaro, Girolamo Pelaia, Gianenrico Senna, Giorgio Walter Canonica

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Severe Asthma Network in Italy (SANI) is a registry of patients recruited by accredited centers on severe asthma. Objective: To analyze epidemiological, clinical, inflammatory, functional, and treatment characteristics of severe asthmatics from the SANI registry. Methods: All consecutive patients with severe asthma were included into the registry, without exclusion criteria to have real-life data on demographics, asthma control, treatments (including biologics), inflammatory biomarkers, and comorbidities. Results: A total of 437 patients (mean age: 54.1 years, 57.2% females, 70.7% atopics, 94.5% in Global Initiative for Asthma severity step V) were enrolled into the study. The mean annual exacerbation rate was 3.75. The mean blood eosinophil level was 536.7 cells/mcL, and the average serum total IgE was 470.3 kU/L. Approximately 64% of patients were on regular oral corticosteroid treatment, 57% with omalizumab and 11.2% with mepolizumab. Most common comorbidities were rhinitis, nasal polyposis, and bronchiectasis. Patients with nasal polyposis had higher age of disease onset, higher blood eosinophil count, and lower frequency of atopy and atopic eczema. Bronchiectasis was associated with more frequent severe exacerbations, higher blood eosinophils, and total IgE. Stratifying patients, those with late-onset asthma were less frequently atopic (with less frequent allergic rhinitis and food allergy), and more frequently with nasal polyposis and higher serum total IgE levels. Conclusions: This study revealed a high frequency of relevant comorbidities and that a substantial proportion of patients have late-onset asthma; all these features define specific different disease phenotypes. Severe asthma complexity and comorbidities require multidisciplinary approaches, led by specifically trained pulmonologists and allergists.

Original languageEnglish
Pages (from-to)1462-1468
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume7
Issue number5
DOIs
Publication statusPublished - 2019

Fingerprint

Italy
Asthma
Comorbidity
Nose
Eosinophils
Immunoglobulin E
Registries
Bronchiectasis
Food Hypersensitivity
Atopic Dermatitis
Rhinitis
Biological Products
Serum
Age of Onset
Adrenal Cortex Hormones
Therapeutics
Biomarkers
Demography
Phenotype

Keywords

  • Bronchiectasis
  • Comorbidities
  • Late-onset asthma
  • Nasal polyps
  • Registry
  • SANI
  • Severe asthma

ASJC Scopus subject areas

  • Immunology and Allergy

Cite this

The Severe Asthma Network in Italy : Findings and Perspectives. / SANI Network ; Heffler, Enrico; Blasi, Francesco; Latorre, Manuela; Menzella, Francesco; Paggiaro, Pierluigi; Pelaia, Girolamo; Senna, Gianenrico; Canonica, Giorgio Walter.

In: Journal of Allergy and Clinical Immunology: In Practice, Vol. 7, No. 5, 2019, p. 1462-1468.

Research output: Contribution to journalArticle

SANI Network ; Heffler, Enrico ; Blasi, Francesco ; Latorre, Manuela ; Menzella, Francesco ; Paggiaro, Pierluigi ; Pelaia, Girolamo ; Senna, Gianenrico ; Canonica, Giorgio Walter. / The Severe Asthma Network in Italy : Findings and Perspectives. In: Journal of Allergy and Clinical Immunology: In Practice. 2019 ; Vol. 7, No. 5. pp. 1462-1468.
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AU - Blasi, Francesco

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AU - Menzella, Francesco

AU - Paggiaro, Pierluigi

AU - Pelaia, Girolamo

AU - Senna, Gianenrico

AU - Canonica, Giorgio Walter

AU - Barbuto, Sarah

AU - Bradicich, Matteo

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AU - Crimi, Nunzio

AU - Crivellaro, Mariangiola

AU - D'Adda, Alice

AU - D'Amato, Mariella

AU - Favero, Elisabetta

AU - Foschino, Maria Pia

AU - Galeone, Carla

AU - Guarnieri, Gabriella

AU - Lombardi, Carlo

AU - Parente, Roberta

AU - Passalacqua, Giovanni

AU - Patella, Vincenzo

AU - Puggioni, Francesca

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N2 - Background: Severe Asthma Network in Italy (SANI) is a registry of patients recruited by accredited centers on severe asthma. Objective: To analyze epidemiological, clinical, inflammatory, functional, and treatment characteristics of severe asthmatics from the SANI registry. Methods: All consecutive patients with severe asthma were included into the registry, without exclusion criteria to have real-life data on demographics, asthma control, treatments (including biologics), inflammatory biomarkers, and comorbidities. Results: A total of 437 patients (mean age: 54.1 years, 57.2% females, 70.7% atopics, 94.5% in Global Initiative for Asthma severity step V) were enrolled into the study. The mean annual exacerbation rate was 3.75. The mean blood eosinophil level was 536.7 cells/mcL, and the average serum total IgE was 470.3 kU/L. Approximately 64% of patients were on regular oral corticosteroid treatment, 57% with omalizumab and 11.2% with mepolizumab. Most common comorbidities were rhinitis, nasal polyposis, and bronchiectasis. Patients with nasal polyposis had higher age of disease onset, higher blood eosinophil count, and lower frequency of atopy and atopic eczema. Bronchiectasis was associated with more frequent severe exacerbations, higher blood eosinophils, and total IgE. Stratifying patients, those with late-onset asthma were less frequently atopic (with less frequent allergic rhinitis and food allergy), and more frequently with nasal polyposis and higher serum total IgE levels. Conclusions: This study revealed a high frequency of relevant comorbidities and that a substantial proportion of patients have late-onset asthma; all these features define specific different disease phenotypes. Severe asthma complexity and comorbidities require multidisciplinary approaches, led by specifically trained pulmonologists and allergists.

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