Asthma control in severe asthmatics under treatment with omalizumab: A cross-sectional observational study in Italy

• DOI: 10.1016/j.pupt.2014.09.007
• Publication Date: 2014-09-30T20:42:37Z
• Authors: Federica Novelli; Manuela Latorre; Letizia Vergura; Maria Filomena Ca...; Gianna Camiciottoli; Gabriella Guarnieri; Andrea Matucci; Luigi Macchia; Andrea Vianello; Alessandra Vultaggio; Alessandro Celi; Mario Cazzola; Pierluigi Paggiaro
• Keywords: Pulmonary and Respiratory Medicine; Adult; Male; Settore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO; Comorbidity; Omalizumab; Asthma; Comorbidities; Control; Exacerbations; Exhaled nitric oxide; Omalizumab; Adult; Aged; Anti-Asthmatic Agents; Asthma; Comorbidity; Cross-Sectional Studies; Female; Humans; Inflammation Mediators; Italy; Male; Middle Aged; Omalizumab; Respiratory Function Tests; Severity of Illness Index; Exhaled nitric oxide; Exacerbations; Comorbidities; Asthma; Omalizumab; Control; Severity of Illness Index; Asthma; Comorbidities; Control; Exacerbations; Exhaled nitric oxide; Omalizumab; Pulmonary and Respiratory Medicine; Pharmacology (medical); Biochemistry (medical); Comorbidities; Exacerbations; Exhaled nitric oxide; 03 medical and health sciences; 0302 clinical medicine; Control; Anti-Asthmatic Agent; Humans; Pharmacology (medical); Anti-Asthmatic Agents; Inflammation Mediator; Respiratory Function Test; Aged; Cross-Sectional Studie; 2. Zero hunger; Biochemistry (medical); Exacerbation; Middle Aged; Asthma; Respiratory Function Tests; 3. Good health; Cross-Sectional Studies; Italy; Asthma; Comorbidities; Control; Exacerbations; Exhaled nitric oxide; Omalizumab; Adult; Aged; Anti-Asthmatic Agents; Asthma; Comorbidity; Cross-Sectional Studies; Female; Humans; Inflammation Mediators; Italy; Male; Middle Aged; Omalizumab; Respiratory Function Tests; Severity of Illness Index; Pulmonary and Respiratory Medicine; Biochemistry (medical); Pharmacology (medical); Female; Comorbiditie; Inflammation Mediators; Human

Few data are available on the proportion of asthmatics achieving a good asthma control (according GINA guidelines) and on the level of airway inflammation during omalizumab treatment. The aim of this cross-sectional national observational study was to assess the level of control (according to GINA guidelines) achieved in a group of asthmatics on omalizumab treatment, and to characterize the factors that influence the lack of control. We studied 306 asthmatics under omalizumab treatment for a median of 32 months (range 4-120). The level of control according to GINA was good in 25.2%, partial in 47.1% and poor in 24.5% of patients (data were missing for the remaining 3.2%). Comparison between poorly controlled and partially or well controlled asthmatics showed a statistically significant higher prevalence of some comorbidities in the first group, namely obesity, gastro-oesophageal reflux disease (GORD), aspirin intolerance and mental disorders (all p < 0.001). Similarly, asthmatics with at least one exacerbation in the last year showed a significantly higher prevalence of obesity, chronic rhinosinusitis, nasal polyps, GORD, and aspirin intolerance (all p < 0.05) than patients without exacerbations. When we selected patients without relevant comorbidities (upper airways disease, GORD, obesity, aspirin intolerance) and not currently smoking (N = 73), the percentage of well or partially controlled asthmatics was significantly higher than in patients with comorbidities (84.9% vs 71.1%, p = 0.02); the rate of asthmatics without exacerbations in the last year was also higher (73.6% vs 51.1%, p = 0.001). During omalizumab treatment, a high percentage of asthmatics obtain a good or partial control of asthma. Comorbidities are associated with the lack of asthma control and persistence of exacerbations.