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- W3088473604 abstract "Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by impaired health-related quality-of-life (HRQoL), remarkable symptom burden, frequent recurrence/relapse. The Treatable Traits concept, firstly introduced in defining Respiratory Diseases, understanding and treating patients with COPD and/or Asthma, has been also introduced in the CRSwNP context. The Registries are instrumental in providing structured data. In Italy, SANI (Severe Asthma Network in Italy), an Italian National observatory supported by GINA Italy—SIAAIC (Italian Society of Allergy, Asthma and Clinical Immunology), SIP/IRS (Italian Respiratory Society) and Federasma (an asthma patients’ association), has been recently promoted and set up [ Senna et al CMA 2016]. In the current report the CRSwNP comorbidity, the clinical and laboratory features of 695 Severe Asthma- (SA) patients recruited by the SANI Centers by May 2019 were evaluated. Severe Asthma Network in Italy (SANI) and data collection: The Italian asthma network SANI is a web-based observatory collecting demographic, clinical, functional, and inflammatory data of SA patients, recruited in Italian reference centers for severe asthma, according to the ERS/ATS classification [Senna et al. CMA 2016]. The prevalence of CRSwNP in the 695 SANI Severe Asthma analyzed patients (mean age: 54.9 +/- 16.6 years; 60.6% females; 2.5% smokers; 75.9% atopics; mean BMI: 26.6 +/- 16.7; 42% with late-onset asthma) was 40.6 %. We then analyzed biomarkers, comorbidities and OCS use: Atopic Dermatitis & Bronchiectasis were significantly more present in patients with CRSwNP than in subjects without CRSwNP whereas no difference was detected about GERD. FeNO is significantly higher in subject with S.A. and CRSwNP respect the ones without CRSwNP. Whereas the circulating total IgE levels are higher in the absence of CRSwNP, circulating eosinophils were >300 in both the groups and no statistical difference was demonstrated (CRSwNP: 513,6 +/- 607,2 cells/mcl vs non-CRSwNP: 471,9 +/- 618,2 cells/mcl; p=0.466.) Patients with CRSwNP had a significant higher number of asthma exacerbation per year (mean annual exacerbations requiring OCS treatment: 3,69 vs 2,46, p=0.014); OCS use in the different populations and the number of OCS Long Term Users (defined as maintenance OCS use or ≥3 courses of OCS in the last 12 months) is significantly higher (P> 0.001) in CRSwNP SA patients. SA patients with CRSwNP are assuming OCS the double of the days/ year (79 vs 161; P>0.02) compared the ones without CRSwNP. The key message is the need of OCS sparing in SA patients, and in the light of the data herein reported, mainly in subjects with CRSwNP. Strategies to reach the previous statement contemplate two major approaches: Adherence to treatment with inhaled therapy for SA accordingly to the GINA recommendations 2019 and the use biologics due to their OCS sparing effects. A multidisciplinary approach in Severe Asthma diagnosis and management is becoming an important tool to better treat the patients." @default.
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- W3088473604 date "2020-08-01" @default.
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- W3088473604 title "Nasal polyps impact in severe asthma patients: evidences from the SANI" @default.
- W3088473604 doi "https://doi.org/10.1016/j.waojou.2020.100379" @default.
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