Worldwide registry study identifies demographics of severe asthma

The International Severe Asthma Registry evaluated patients with asthma worldwide to describe demographic and clinical characteristics of these patients and the severity of the disease, according to a registry study published in CHEST.

The registry collected data on adults with severe asthma who received Global Initiative for Asthma (GINA) Step 5 treatment or who had uncontrolled asthma at GINA Step 4. Baseline demographic and clinical data were collected from asthma centers in the United States, United Kingdom, South Korea, Italy and the Australasian Severe Asthma Network’s Severe Asthma Web-based Database (SAWD) from December 2014 to December 2017.

“Most patients had uncontrolled asthma on GINA Step 4,” Eileen Wang, MD, MPH, assistant professor at the division of allergy and clinical immunology in the department of medicine at the University of Colorado Hospital, and colleagues wrote. “Patients from the U.K. and Italy tended to have more severe disease and those from the U.S. and South Korea, the least severe compared to other countries.”

A total of 4,990 patients were included in this study (aged 55-77 years) with 3,286 U.S. patients, 696 U.K. patients, 439 South Korean patients, 310 Italian patients and 259 patients from the SAWD registry. The patients had a mean age of 30.7 years at asthma onset (77.5% developed asthma after age 12 years; 34.4% after age 40 years).

Patients were mostly women (59.3%), white (72.6%), neversmokers (60.5%) and had overweight/obesity (70.4%). An evaluation of asthma control in these patients was conducted, showing that 57.2% of patients had poorly controlled asthma. The mean exacerbation rate was 1.7 per year.

Asthma treatment was severity-specific, showing that 30% of patients were on regular oral corticosteroid therapy, more than 50% were taking oral corticosteroids intermittently and three-quarters of patients with the most severe asthma disease were on biologics.

“This study provides the first description of an international managed severe asthma population and facilitated a comparison of demographic and clinical characteristics across-country and health care systems,” the researchers wrote. “This will ensure better standardization of data fields, facilitating more accurate cross-country comparisons and reducing any data incongruence in upcoming International Severe Asthma Registry data sets.” – by Erin T. Welsh

Disclosures: Wang reports she received advisory board fees from AstraZeneca and has been an investigator on clinical trials sponsored by AstraZeneca, GlaxoSmithKline, Novartis and Teva. Please see the study for all other authors’ relevant financial disclosures.