- Poster presentation
- Open Access
Severe asthma: a great clinical challenge
© Grzetic-Romcevic et al; licensee BioMed Central Ltd. 2015
- Published: 23 March 2015
- Obstructive Sleep Apnea
- Sleep Apnea
- Severe Asthma
- Skin Prick Test
Patients with severe asthma represent a significant unmet clinical need. At present, the underlying mechanisms of severe asthma have not been established yet but it is likely they reflect a heterogenous pattern rather than a single unifying process. The aim of this study is to assess the prevalence of severe asthma as well as the clinical and physiologic characteristics of patients and to establish a pattern occuring in comorbid diseases.
Between the January and December of 2013, a total of 324 consecutive asthmatic adult patients (67% females) attended to at an out - patients clinic (Sezana) were involved in the study. The mean age in these patients was 57.3 +- 2.4 years. The diagnosis of severe asthma was assessed according to the International ERS/ATS guidelines. The demographic criteria, body mass index BMI (kg/m2), skin prick tests (Allergopharma, Germany), smoking habits and comorbidities were analysed.
Severe asthma was present in 10% of patients. The mean age in patients was 67.3+- 1.7 years (59%females). Of them, 14% were active smokers and 24% were former smokers. Sixty- five percent patients had a positive family history of asthma. The average mean time of asthma duration was 14+- 3.2 years. The late onset of asthma (patients above 50 years of age) was observed in 60% of all cases. Atopy, which was estimated on the basis of at least one positive skin prick test, was observed in 66% of patients. In patients showing early onset, severe asthma involved significantly more allergen sensitivity (skin test positivity, 92% vs 26% p<0.01) than in patients with late- onset asthma. The average body mass index was 32.1+- 4.7 kg/m2. The obese patients were more frequently females (60% vs 40%). The comorbid diseases were present in 70% of patients. The most frequent were the comorbid conditions of the upper airways - nasal sinus diseases (54% of patients), mostly in females (44%). Next, there were aspirin sensitivity in females (10%) and OSA (obstructive sleep apnea) in males (10%). Both females and males suffered from GERD (gastroesophageal reflux disease) (15% males vs 10% females), and psychological dysfunction (82% females vs 61% males).
The above results suggest than an adult asthmatic with severe asthma has a positive family history of asthma as well as a late onset of disease with less atopy by skin test and is also more obese (especially females). The prevalence of comorbidites is very high.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.