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.