Characteristics of patients with severe asthma in our population
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Vicente Javier Albendiz, Francisco Javier de Castro, Irene Garcia Gutierrez, Jimena Crespo, Jose Manuel Zubeldia, MD, PhD
RATIONALE: Severe asthma accounts for approximately 5% of all asthmatics. Different studies have shown high morbidity, mortality and frequent exacerbations despite treatment.

METHODS: A retrospective study was carried out to determine the preliminary characteristics of this patients. We recruited data from patients who visited our outpatient unit for severe uncontrolled asthma during 2016.

RESULTS: Seventy two patients were attended with severe asthma. Mean (SD) of visits in 2016 per person were 3.73 (2.02). Most of them were women (87.5%) with an average age of 58 years. Most frequent comorbidities were rhinosinusitis (75.0%), gastroesophageal reflux disease (54.1%), anxiety/depressive syndrome (52.7%), obesity (27.7%), nasal polyposis (18%), fibromyalgia (9.7%) and sleep apnea/hypopnea syndrome (8.3%). Mean (SD) blood eosinophil count was 457.14 Eos/μL (536), with a median of 300 Eos/μL. About 80% tested positive for ≥1 allergen-specific IgE and 36.11% had moderate/severe airflow obstruction in spirometry. Almost two-thirds of patients (65.3%) reported poor control of symptoms throughout the year (Asthma Control Test questioner). Regarding to treatment: 100% used high doses of inhaled corticosteroids, 83.3% montelukast, 76.4% long acting muscarinic antagonist, 27.7% omalizumab, 20% continuous treatment with oral corticosteroids and 16.7% theophylline. Two patients underwent bronchial thermoplasty. Over 60% had exacerbations that required oral corticosteroids (122 episodes among 46 patients): 68% treated in primary care and 32% in hospital emergencies, of which 43.5% (17/39) needed hospitalization.

CONCLUSIONS: Despite standard care monitoring, adequate treatment and screening of comorbidities, a high percentage of patients have a poor control of their disease. Requirement of outpatient units for severe uncontrolled asthma is outlined.