PMID- 37462932 OWN - NLM STAT- MEDLINE DCOM- 20230905 LR - 20231012 IS - 1764-1489 (Print) IS - 1764-1489 (Linking) VI - 55 IP - 5 DP - 2023 Sep TI - Severe asthma: follow-up after one year from the Italian Registry on Severe Asthma (IRSA). PG - 199-211 LID - 10.23822/EurAnnACI.1764-1489.304 [doi] AB - Background. Asthma affects millions of people worldwide, with a subgroup suffering from severe asthma (SA). Biologics have revolutionized SA treatment, but challenges remain in managing different patient traits. This study analyzed data from the Italian Registry on Severe Asthma (IRSA) to investigate changes in SA characteristics and effectiveness of treatments after one year of follow-up, and to identify factors associated with response to treatments in a real-world setting. Methods. Data on SA patients with one year of follow-up were extracted from IRSA. Asthma control, exacerbations, lung function, and treatments, were assessed at follow-up and analyzed against baseline characteristics. Results. After one year of follow-up, notable improvements were observed in all the outcomes of SA of the included patients (n = 570). The effectiveness of biologic therapies was particularly evident, as they contributed significantly to these positive outcomes. Additionally, certain factors were found to be associated with improvement, namely T2 phenotype, baseline eosinophil count (BEC), and area of residence. On the other hand, comorbidities (obesity, gastro-esophageal reflux disease) and poor lung function were risk factors. Notably, poor-responders to biologics exhibited lower level of education, BEC, and exacerbations, and higher frequency of atopy and ACT score >/= 20. Conclusions. The findings demonstrate the effectiveness of biologics in asthma management, when implemented as part of a planned follow-up strategy aimed at optimizing and fine-tuning the therapy. Moreover, the study highlights the importance of considering key traits such as the T2 phenotype, BEC, education, and comorbidities when tailoring SA treatment. Overall, this study contributes to enhancing our understanding of SA management and guiding the development of personalized treatment approaches for patients with SA. FAU - Bilo, M B AU - Bilo MB AD - Allergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti, Ancona, Italy. AD - Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy. FAU - Martini, M AU - Martini M AD - Allergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti, Ancona, Italy. AD - Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy. FAU - Antonicelli, L AU - Antonicelli L AD - Allergy and Asthma Outpatient Clinic, Ancona, Italy. FAU - Aliani, M AU - Aliani M AD - Istituti Clinici Scientifici Maugeri IRCCS, Division of Pulmonary Disease and Respiratory Rehabilitation, Bari Institute, Bari, Italy. FAU - Carone, M AU - Carone M AD - Istituti Clinici Scientifici Maugeri IRCCS, Division of Pulmonary Disease and Respiratory Rehabilitation, Bari Institute, Bari, Italy. FAU - Cecchi, L AU - Cecchi L AD - SOS Allergy and Clinical Immunology, USL Toscana Centro, Prato, Italy. FAU - de Michele, F AU - de Michele F AD - Pulmonology and Respiratory Pathophysiology Unit, A. Cardarelli Hospital, Naples, Italy. FAU - Polese, G AU - Polese G AD - Pulmonology Unit, Ospedale di Bussolengo, ULSS 9 Scaligera, Villafranca, Verona, Italy. FAU - Vaghi, A AU - Vaghi A AD - Former Head of Pneumology and Chief of Department of Medicine and Rehabilitation, Guido Salvini Hospital-ASSTRhodense,Garbagnate Milanese, Milan, Italy. FAU - Musarra, A AU - Musarra A AD - Allergy Unit, Casa della Salute di Scilla, Scilla, Reggio Calabria, Italy. FAU - Micheletto, C AU - Micheletto C AD - Pulmonary Unit, Integrated University Hospital of Verona, Verona, Italy. CN - IRSA Follow-up Study Group LA - eng PT - Journal Article DEP - 20230717 PL - Italy TA - Eur Ann Allergy Clin Immunol JT - European annals of allergy and clinical immunology JID - 101466614 RN - 0 (Biological Products) RN - 0 (Anti-Asthmatic Agents) SB - IM MH - Humans MH - Child MH - Cost-Effectiveness Analysis MH - Portugal/epidemiology MH - Standard of Care MH - *Asthma/drug therapy MH - *Rhinitis, Allergic MH - Immunotherapy MH - *Biological Products/therapeutic use MH - Poaceae MH - *Anti-Asthmatic Agents/therapeutic use OTO - NOTNLM OT - Severe asthma OT - asthma management OT - biologics OT - phenotyping OT - real-world OT - registry FIR - Banfi, P IR - Banfi P FIR - Bettinzoli, M IR - Bettinzoli M FIR - Bini, F IR - Bini F FIR - Bonaiti, G IR - Bonaiti G FIR - Cilia, M IR - Cilia M FIR - Colangelo, C IR - Colangelo C FIR - Contini, P IR - Contini P FIR - Fasano, R IR - Fasano R FIR - Gabrielli, A R IR - Gabrielli AR FIR - Gargano, D IR - Gargano D FIR - Garritani, M S IR - Garritani MS FIR - Harari, S IR - Harari S FIR - Inciso, G IR - Inciso G FIR - Manganello, G IR - Manganello G FIR - Manzotti, G IR - Manzotti G FIR - Marchesani, F IR - Marchesani F FIR - Massaccesi, C IR - Massaccesi C FIR - Paolucci, E IR - Paolucci E FIR - Rivolta, F IR - Rivolta F FIR - Romano, A IR - Romano A FIR - Sabato, E IR - Sabato E FIR - Savoia, F IR - Savoia F FIR - Scartabellati, A IR - Scartabellati A FIR - Semenzato, U IR - Semenzato U FIR - Toraldo, D IR - Toraldo D FIR - Tripodi, S IR - Tripodi S FIR - Valenti, G IR - Valenti G FIR - Zappa, M C IR - Zappa MC FIR - Zuccon, U IR - Zuccon U EDAT- 2023/07/18 13:08 MHDA- 2023/09/05 06:42 CRDT- 2023/07/18 11:23 PHST- 2023/09/05 06:42 [medline] PHST- 2023/07/18 13:08 [pubmed] PHST- 2023/07/18 11:23 [entrez] AID - 10.23822/EurAnnACI.1764-1489.304 [doi] PST - ppublish SO - Eur Ann Allergy Clin Immunol. 2023 Sep;55(5):199-211. doi: 10.23822/EurAnnACI.1764-1489.304. Epub 2023 Jul 17.