Severe asthma: One disease and multiple definitions

Diego Bagnasco; Pierluigi Paggiaro; Manuela Latorre; Chiara Folli; Elisa Testino; Arianna Bassi; Manlio Milanese; Enrico Heffler; Andrea Manfredi; Anna Maria Riccio; Laura De Ferrari; Francesco Blasi; Rikki Frank Canevari; Giorgio Walter Canonica; Giovanni Passalacqua; Gabriella Guarnieri; Vincenzo Patella; Foschino Barbaro Maria Pia; Giovanna Elisiana Carpagnano; Anna Del Colle; Giulia Scioscia; Pelaia Gerolamo; Francesca Puggioni; Francesca Racca; Elisabetta Favero; Sandra Iannacone; Eleonora Savi; Marcello Montagni; Gianna Camiciottoli; Chiara Allegrini; Carlo Lombardi; Celestino Pio Lombardi; Giuseppe Spadaro; Caterina Detoraki; Francesco Menzella; Carla Galeone; Patrizia Ruggiero; Monna Rita Yacoub; Alvise Berti; Andrea Berti; Nicola Scichilone; Carmen Durante; Maria Teresa Costantino; Chiara Roncallo; Mariachiara Braschi; Alice D'Adda; Erminia Ridolo; Massimo Triggiani; Roberta Parente; D'Amato Maria; Maria Vittoria Verrillo; Giovanni Rolla; Luisa Brussino; Agata Valentina Frazzetto; Zappa Maria Cristina; Marianna Lilli; Nunzio Crimi; Marco Bonavia; Angelo Guido Corsico; Amelia Grosso; Stefano Del Giacco; Margherita Deidda; Luisa Ricciardi; Stefania Isola; Francesca Cicero; Giuliana Amato; Federica Vita; Antonio Spanevello; Patrizia Pignatti; Francesca Cherubino; Dina Visca; Fabio Luigi Massimo Ricciardolo; Vitina Maria Anna Carriero; Francesca Bertolini; Pierachille Santus; Roberta Barlassina; Andrea Airoldi; Giuseppe Guida; Maria Grazia Guida; Nucera Eleonora; Eleonora Nucera; Arianna Aruanno; Angela Rizzi; Cristiano Caruso; Stefania Colantuono; Gianenrico Senna; Marco Caminati; Alessandra Arcolaci; Andrea Vianello; Fulvia Chieco Bianchi; Maria Rita Marchi; Stefano Centanni; Simone Luraschi; Silvia Ruggeri; Rocco Rinaldo; Elena Parazzini; Cecilia Calabrese; Anna Chiara Calabrese; Martina Flora; Lorenzo Cosmi; Linda Di Pietro; Enrico Maggi; Laura Pini; Luigi Macchia; Danilo Di Bona; Luca Richeldi; Carola Condoluci; Leonello Fuso; Matteo Bonini; Alessandro Farsi; Giulia Carli; Paolo Montuschi; Giuseppe Santini; Maria Elisabetta Conte; Elisa Turchet; Carlo Barbetta; Francesco Mazza; Simona D'Alo; Stefano Pucci; Maria Filomena Caiaffa; Elena Minenna; Luciana D'Elia; Carlo Pasculli; Vittorio Viviano; Paolo Tarsia; Joyce Rolo; Mariacarmela Di Proietto; Salvatore Lo Cicero; Stefano Lo Cicero

doi:10.1016/j.waojou.2021.100606

Severe asthma: One disease and multiple definitions

Diego Bagnasco, Pierluigi Paggiaro, Manuela Latorre, Chiara Folli, Elisa Testino, Arianna Bassi, Manlio Milanese, Enrico Heffler, Andrea Manfredi, Anna Maria Riccio, Laura De Ferrari, Francesco Blasi, Rikki Frank Canevari, Giorgio Walter Canonica, Giovanni Passalacqua, Gabriella Guarnieri, Vincenzo Patella, Foschino Barbaro Maria Pia, Giovanna Elisiana Carpagnano, Anna Del ColleGiulia Scioscia, Pelaia Gerolamo, Francesca Puggioni, Francesca Racca, Elisabetta Favero, Sandra Iannacone, Eleonora Savi, Marcello Montagni, Gianna Camiciottoli, Chiara Allegrini, Carlo Lombardi, Celestino Pio Lombardi, Giuseppe Spadaro, Caterina Detoraki, Francesco Menzella, Carla Galeone, Patrizia Ruggiero, Monna Rita Yacoub, Alvise Berti, Andrea Berti, Nicola Scichilone, Carmen Durante, Maria Teresa Costantino, Chiara Roncallo, Mariachiara Braschi, Alice D'Adda, Erminia Ridolo, Massimo Triggiani, Roberta Parente, D'Amato Maria, Maria Vittoria Verrillo, Giovanni Rolla, Luisa Brussino, Agata Valentina Frazzetto, Zappa Maria Cristina, Marianna Lilli, Nunzio Crimi, Marco Bonavia, Angelo Guido Corsico, Amelia Grosso, Stefano Del Giacco, Margherita Deidda, Luisa Ricciardi, Stefania Isola, Francesca Cicero, Giuliana Amato, Federica Vita, Antonio Spanevello, Patrizia Pignatti, Francesca Cherubino, Dina Visca, Fabio Luigi Massimo Ricciardolo, Vitina Maria Anna Carriero, Francesca Bertolini, Pierachille Santus, Roberta Barlassina, Andrea Airoldi, Giuseppe Guida, Maria Grazia Guida, Nucera Eleonora, Eleonora Nucera, Arianna Aruanno, Angela Rizzi, Cristiano Caruso, Stefania Colantuono, Gianenrico Senna, Marco Caminati, Alessandra Arcolaci, Andrea Vianello, Fulvia Chieco Bianchi, Maria Rita Marchi, Stefano Centanni, Simone Luraschi, Silvia Ruggeri, Rocco Rinaldo, Elena Parazzini, Cecilia Calabrese, Anna Chiara Calabrese, Martina Flora, Lorenzo Cosmi, Linda Di Pietro, Enrico Maggi, Laura Pini, Luigi Macchia, Danilo Di Bona, Luca Richeldi, Carola Condoluci, Leonello Fuso, Matteo Bonini, Alessandro Farsi, Giulia Carli, Paolo Montuschi, Giuseppe Santini, Maria Elisabetta Conte, Elisa Turchet, Carlo Barbetta, Francesco Mazza, Simona D'Alo, Stefano Pucci, Maria Filomena Caiaffa, Elena Minenna, Luciana D'Elia, Carlo Pasculli, Vittorio Viviano, Paolo Tarsia, Joyce Rolo, Mariacarmela Di Proietto, Salvatore Lo Cicero, Stefano Lo Cicero

Research output: Contribution to journal › Article

Abstract

Introduction: There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used. Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods: Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results: 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERS-GINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions: The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem.

Original language	English
Pages (from-to)	100606-N/A
Journal	THE WORLD ALLERGY ORGANIZATION JOURNAL
Volume	14
DOIs	https://doi.org/10.1016/j.waojou.2021.100606
Publication status	Published - 2021

Keywords

Biological treatment
Classification
Definition
Severe asthma

Access to Document

10.1016/j.waojou.2021.100606

Cite this

Bagnasco, D., Paggiaro, P., Latorre, M., Folli, C., Testino, E., Bassi, A., Milanese, M., Heffler, E., Manfredi, A., Riccio, A. M., De Ferrari, L., Blasi, F., Canevari, R. F., Canonica, G. W., Passalacqua, G., Guarnieri, G., Patella, V., Maria Pia, F. B., Carpagnano, G. E., ... Lo Cicero, S. (2021). Severe asthma: One disease and multiple definitions. THE WORLD ALLERGY ORGANIZATION JOURNAL, 14, 100606-N/A. https://doi.org/10.1016/j.waojou.2021.100606

@article{5986f6bdadc94359810509018e7cb9a3,

title = "Severe asthma: One disease and multiple definitions",

abstract = "Introduction: There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used. Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods: Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results: 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERS-GINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions: The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem.",

keywords = "Biological treatment, Classification, Definition, Severe asthma, Biological treatment, Classification, Definition, Severe asthma",

author = "Diego Bagnasco and Pierluigi Paggiaro and Manuela Latorre and Chiara Folli and Elisa Testino and Arianna Bassi and Manlio Milanese and Enrico Heffler and Andrea Manfredi and Riccio, {Anna Maria} and {De Ferrari}, Laura and Francesco Blasi and Canevari, {Rikki Frank} and Canonica, {Giorgio Walter} and Giovanni Passalacqua and Gabriella Guarnieri and Vincenzo Patella and {Maria Pia}, {Foschino Barbaro} and Carpagnano, {Giovanna Elisiana} and Colle, {Anna Del} and Giulia Scioscia and Pelaia Gerolamo and Francesca Puggioni and Francesca Racca and Elisabetta Favero and Sandra Iannacone and Eleonora Savi and Marcello Montagni and Gianna Camiciottoli and Chiara Allegrini and Carlo Lombardi and Lombardi, {Celestino Pio} and Giuseppe Spadaro and Caterina Detoraki and Francesco Menzella and Carla Galeone and Patrizia Ruggiero and Yacoub, {Monna Rita} and Alvise Berti and Andrea Berti and Nicola Scichilone and Carmen Durante and Costantino, {Maria Teresa} and Chiara Roncallo and Mariachiara Braschi and Alice D'Adda and Erminia Ridolo and Massimo Triggiani and Roberta Parente and D'Amato Maria and Verrillo, {Maria Vittoria} and Giovanni Rolla and Luisa Brussino and Frazzetto, {Agata Valentina} and Cristina, {Zappa Maria} and Marianna Lilli and Nunzio Crimi and Marco Bonavia and Corsico, {Angelo Guido} and Amelia Grosso and {Del Giacco}, Stefano and Margherita Deidda and Luisa Ricciardi and Stefania Isola and Francesca Cicero and Giuliana Amato and Federica Vita and Antonio Spanevello and Patrizia Pignatti and Francesca Cherubino and Dina Visca and {Massimo Ricciardolo}, {Fabio Luigi} and {Anna Carriero}, {Vitina Maria} and Francesca Bertolini and Pierachille Santus and Roberta Barlassina and Andrea Airoldi and Giuseppe Guida and Guida, {Maria Grazia} and Nucera Eleonora and Eleonora Nucera and Arianna Aruanno and Angela Rizzi and Cristiano Caruso and Stefania Colantuono and Gianenrico Senna and Marco Caminati and Alessandra Arcolaci and Andrea Vianello and Bianchi, {Fulvia Chieco} and Marchi, {Maria Rita} and Stefano Centanni and Simone Luraschi and Silvia Ruggeri and Rocco Rinaldo and Elena Parazzini and Cecilia Calabrese and Calabrese, {Anna Chiara} and Martina Flora and Lorenzo Cosmi and {Di Pietro}, Linda and Enrico Maggi and Laura Pini and Luigi Macchia and {Di Bona}, Danilo and Luca Richeldi and Carola Condoluci and Leonello Fuso and Matteo Bonini and Alessandro Farsi and Giulia Carli and Paolo Montuschi and Giuseppe Santini and Conte, {Maria Elisabetta} and Elisa Turchet and Carlo Barbetta and Francesco Mazza and Simona D'Alo and Stefano Pucci and Caiaffa, {Maria Filomena} and Elena Minenna and Luciana D'Elia and Carlo Pasculli and Vittorio Viviano and Paolo Tarsia and Joyce Rolo and {Di Proietto}, Mariacarmela and {Lo Cicero}, Salvatore and {Lo Cicero}, Stefano",

year = "2021",

doi = "10.1016/j.waojou.2021.100606",

language = "English",

volume = "14",

pages = "100606--N/A",

journal = "THE WORLD ALLERGY ORGANIZATION JOURNAL",

issn = "1939-4551",

publisher = "Philadelphia, PA : Lippincott Williams & Wilkins",

}

Bagnasco, D, Paggiaro, P, Latorre, M, Folli, C, Testino, E, Bassi, A, Milanese, M, Heffler, E, Manfredi, A, Riccio, AM, De Ferrari, L, Blasi, F, Canevari, RF, Canonica, GW, Passalacqua, G, Guarnieri, G, Patella, V, Maria Pia, FB, Carpagnano, GE, Colle, AD, Scioscia, G, Gerolamo, P, Puggioni, F, Racca, F, Favero, E, Iannacone, S, Savi, E, Montagni, M, Camiciottoli, G, Allegrini, C, Lombardi, C, Lombardi, CP, Spadaro, G, Detoraki, C, Menzella, F, Galeone, C, Ruggiero, P, Yacoub, MR, Berti, A, Berti, A, Scichilone, N, Durante, C, Costantino, MT, Roncallo, C, Braschi, M, D'Adda, A, Ridolo, E, Triggiani, M, Parente, R, Maria, DA, Verrillo, MV, Rolla, G, Brussino, L, Frazzetto, AV, Cristina, ZM, Lilli, M, Crimi, N, Bonavia, M, Corsico, AG, Grosso, A, Del Giacco, S, Deidda, M, Ricciardi, L, Isola, S, Cicero, F, Amato, G, Vita, F, Spanevello, A, Pignatti, P, Cherubino, F, Visca, D, Massimo Ricciardolo, FL, Anna Carriero, VM, Bertolini, F, Santus, P, Barlassina, R, Airoldi, A, Guida, G, Guida, MG, Eleonora, N, Nucera, E, Aruanno, A, Rizzi, A, Caruso, C, Colantuono, S, Senna, G, Caminati, M, Arcolaci, A, Vianello, A, Bianchi, FC, Marchi, MR, Centanni, S, Luraschi, S, Ruggeri, S, Rinaldo, R, Parazzini, E, Calabrese, C, Calabrese, AC, Flora, M, Cosmi, L, Di Pietro, L, Maggi, E, Pini, L, Macchia, L, Di Bona, D, Richeldi, L, Condoluci, C, Fuso, L, Bonini, M, Farsi, A, Carli, G, Montuschi, P, Santini, G, Conte, ME, Turchet, E, Barbetta, C, Mazza, F, D'Alo, S, Pucci, S, Caiaffa, MF, Minenna, E, D'Elia, L, Pasculli, C, Viviano, V, Tarsia, P, Rolo, J, Di Proietto, M, Lo Cicero, S & Lo Cicero, S 2021, 'Severe asthma: One disease and multiple definitions', THE WORLD ALLERGY ORGANIZATION JOURNAL, vol. 14, pp. 100606-N/A. https://doi.org/10.1016/j.waojou.2021.100606

TY - JOUR

T1 - Severe asthma: One disease and multiple definitions

AU - Bagnasco, Diego

AU - Paggiaro, Pierluigi

AU - Latorre, Manuela

AU - Folli, Chiara

AU - Testino, Elisa

AU - Bassi, Arianna

AU - Milanese, Manlio

AU - Heffler, Enrico

AU - Manfredi, Andrea

AU - Riccio, Anna Maria

AU - De Ferrari, Laura

AU - Blasi, Francesco

AU - Canevari, Rikki Frank

AU - Canonica, Giorgio Walter

AU - Passalacqua, Giovanni

AU - Guarnieri, Gabriella

AU - Patella, Vincenzo

AU - Maria Pia, Foschino Barbaro

AU - Carpagnano, Giovanna Elisiana

AU - Colle, Anna Del

AU - Scioscia, Giulia

AU - Gerolamo, Pelaia

AU - Puggioni, Francesca

AU - Racca, Francesca

AU - Favero, Elisabetta

AU - Iannacone, Sandra

AU - Savi, Eleonora

AU - Montagni, Marcello

AU - Camiciottoli, Gianna

AU - Allegrini, Chiara

AU - Lombardi, Carlo

AU - Lombardi, Celestino Pio

AU - Spadaro, Giuseppe

AU - Detoraki, Caterina

AU - Menzella, Francesco

AU - Galeone, Carla

AU - Ruggiero, Patrizia

AU - Yacoub, Monna Rita

AU - Berti, Alvise

AU - Berti, Andrea

AU - Scichilone, Nicola

AU - Durante, Carmen

AU - Costantino, Maria Teresa

AU - Roncallo, Chiara

AU - Braschi, Mariachiara

AU - D'Adda, Alice

AU - Ridolo, Erminia

AU - Triggiani, Massimo

AU - Parente, Roberta

AU - Maria, D'Amato

AU - Verrillo, Maria Vittoria

AU - Rolla, Giovanni

AU - Brussino, Luisa

AU - Frazzetto, Agata Valentina

AU - Cristina, Zappa Maria

AU - Lilli, Marianna

AU - Crimi, Nunzio

AU - Bonavia, Marco

AU - Corsico, Angelo Guido

AU - Grosso, Amelia

AU - Del Giacco, Stefano

AU - Deidda, Margherita

AU - Ricciardi, Luisa

AU - Isola, Stefania

AU - Cicero, Francesca

AU - Amato, Giuliana

AU - Vita, Federica

AU - Spanevello, Antonio

AU - Pignatti, Patrizia

AU - Cherubino, Francesca

AU - Visca, Dina

AU - Massimo Ricciardolo, Fabio Luigi

AU - Anna Carriero, Vitina Maria

AU - Bertolini, Francesca

AU - Santus, Pierachille

AU - Barlassina, Roberta

AU - Airoldi, Andrea

AU - Guida, Giuseppe

AU - Guida, Maria Grazia

AU - Eleonora, Nucera

AU - Nucera, Eleonora

AU - Aruanno, Arianna

AU - Rizzi, Angela

AU - Caruso, Cristiano

AU - Colantuono, Stefania

AU - Senna, Gianenrico

AU - Caminati, Marco

AU - Arcolaci, Alessandra

AU - Vianello, Andrea

AU - Bianchi, Fulvia Chieco

AU - Marchi, Maria Rita

AU - Centanni, Stefano

AU - Luraschi, Simone

AU - Ruggeri, Silvia

AU - Rinaldo, Rocco

AU - Parazzini, Elena

AU - Calabrese, Cecilia

AU - Calabrese, Anna Chiara

AU - Flora, Martina

AU - Cosmi, Lorenzo

AU - Di Pietro, Linda

AU - Maggi, Enrico

AU - Pini, Laura

AU - Macchia, Luigi

AU - Di Bona, Danilo

AU - Richeldi, Luca

AU - Condoluci, Carola

AU - Fuso, Leonello

AU - Bonini, Matteo

AU - Farsi, Alessandro

AU - Carli, Giulia

AU - Montuschi, Paolo

AU - Santini, Giuseppe

AU - Conte, Maria Elisabetta

AU - Turchet, Elisa

AU - Barbetta, Carlo

AU - Mazza, Francesco

AU - D'Alo, Simona

AU - Pucci, Stefano

AU - Caiaffa, Maria Filomena

AU - Minenna, Elena

AU - D'Elia, Luciana

AU - Pasculli, Carlo

AU - Viviano, Vittorio

AU - Tarsia, Paolo

AU - Rolo, Joyce

AU - Di Proietto, Mariacarmela

AU - Lo Cicero, Salvatore

AU - Lo Cicero, Stefano

PY - 2021

Y1 - 2021

N2 - Introduction: There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used. Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods: Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results: 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERS-GINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions: The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem.

AB - Introduction: There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used. Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods: Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results: 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERS-GINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions: The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem.

KW - Biological treatment

KW - Classification

KW - Definition

KW - Severe asthma

KW - Biological treatment

KW - Classification

KW - Definition

KW - Severe asthma

UR - http://hdl.handle.net/10807/200459

U2 - 10.1016/j.waojou.2021.100606

DO - 10.1016/j.waojou.2021.100606

M3 - Article

SN - 1939-4551

VL - 14

SP - 100606-N/A

JO - THE WORLD ALLERGY ORGANIZATION JOURNAL

JF - THE WORLD ALLERGY ORGANIZATION JOURNAL

ER -

Severe asthma: One disease and multiple definitions

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this