Severe asthma: One disease and multiple definitions

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...

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Autores principales:	Diego Bagnasco, MD, PhD, Pierluigi Paggiaro, MD, Manuela Latorre, MD, Chiara Folli, BS, Elisa Testino, MD, Arianna Bassi, MD, Manlio Milanese, MD, Enrico Heffler, MD, Andrea Manfredi, Anna Maria Riccio, BS, Laura De Ferrari, BS, Francesco Blasi, Rikki Frank Canevari, MD, Giorgio Walter Canonica, MD, Giovanni Passalacqua, MD, 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, Giuseppe Spadaro, Caterina Detoraki, Francesco Menzella, Carla Galeone, Patrizia Ruggiero, Monna Rita Yacoub, Alvise 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, Nucera Eleonora, 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, 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
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Severe asthma Classification Definition Biological treatment Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/8bd465ece0db4a60b1326728338e4570
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id	oai:doaj.org-article:8bd465ece0db4a60b1326728338e4570
record_format	dspace
institution	DOAJ
collection	DOAJ
language	EN
topic	Severe asthma Classification Definition Biological treatment Immunologic diseases. Allergy RC581-607
spellingShingle	Severe asthma Classification Definition Biological treatment Immunologic diseases. Allergy RC581-607 Diego Bagnasco, MD, PhD Pierluigi Paggiaro, MD Manuela Latorre, MD Chiara Folli, BS Elisa Testino, MD Arianna Bassi, MD Manlio Milanese, MD Enrico Heffler, MD Andrea Manfredi Anna Maria Riccio, BS Laura De Ferrari, BS Francesco Blasi Rikki Frank Canevari, MD Giorgio Walter Canonica, MD Giovanni Passalacqua, MD 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 Giuseppe Spadaro Caterina Detoraki Francesco Menzella Carla Galeone Patrizia Ruggiero Monna Rita Yacoub Alvise 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 Nucera Eleonora 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 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 Severe asthma: One disease and multiple definitions
description	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.
format	article
author	Diego Bagnasco, MD, PhD Pierluigi Paggiaro, MD Manuela Latorre, MD Chiara Folli, BS Elisa Testino, MD Arianna Bassi, MD Manlio Milanese, MD Enrico Heffler, MD Andrea Manfredi Anna Maria Riccio, BS Laura De Ferrari, BS Francesco Blasi Rikki Frank Canevari, MD Giorgio Walter Canonica, MD Giovanni Passalacqua, MD 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 Giuseppe Spadaro Caterina Detoraki Francesco Menzella Carla Galeone Patrizia Ruggiero Monna Rita Yacoub Alvise 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 Nucera Eleonora 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 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
author_facet	Diego Bagnasco, MD, PhD Pierluigi Paggiaro, MD Manuela Latorre, MD Chiara Folli, BS Elisa Testino, MD Arianna Bassi, MD Manlio Milanese, MD Enrico Heffler, MD Andrea Manfredi Anna Maria Riccio, BS Laura De Ferrari, BS Francesco Blasi Rikki Frank Canevari, MD Giorgio Walter Canonica, MD Giovanni Passalacqua, MD 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 Giuseppe Spadaro Caterina Detoraki Francesco Menzella Carla Galeone Patrizia Ruggiero Monna Rita Yacoub Alvise 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 Nucera Eleonora 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 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
author_sort	Diego Bagnasco, MD, PhD
title	Severe asthma: One disease and multiple definitions
title_short	Severe asthma: One disease and multiple definitions
title_full	Severe asthma: One disease and multiple definitions
title_fullStr	Severe asthma: One disease and multiple definitions
title_full_unstemmed	Severe asthma: One disease and multiple definitions
title_sort	severe asthma: one disease and multiple definitions
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/8bd465ece0db4a60b1326728338e4570
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spelling	oai:doaj.org-article:8bd465ece0db4a60b1326728338e45702021-11-22T04:20:23ZSevere asthma: One disease and multiple definitions1939-455110.1016/j.waojou.2021.100606https://doaj.org/article/8bd465ece0db4a60b1326728338e45702021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1939455121001009https://doaj.org/toc/1939-4551Introduction: 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.Diego Bagnasco, MD, PhDPierluigi Paggiaro, MDManuela Latorre, MDChiara Folli, BSElisa Testino, MDArianna Bassi, MDManlio Milanese, MDEnrico Heffler, MDAndrea ManfrediAnna Maria Riccio, BSLaura De Ferrari, BSFrancesco BlasiRikki Frank Canevari, MDGiorgio Walter Canonica, MDGiovanni Passalacqua, MDGabriella GuarnieriVincenzo PatellaFoschino Barbaro Maria PiaGiovanna Elisiana CarpagnanoAnna del ColleGiulia SciosciaPelaia GerolamoFrancesca PuggioniFrancesca RaccaElisabetta FaveroSandra IannaconeEleonora SaviMarcello MontagniGianna CamiciottoliChiara AllegriniCarlo LombardiGiuseppe SpadaroCaterina DetorakiFrancesco MenzellaCarla GaleonePatrizia RuggieroMonna Rita YacoubAlvise BertiNicola ScichiloneCarmen DuranteMaria Teresa CostantinoChiara RoncalloMariachiara BraschiAlice D’AddaErminia RidoloMassimo TriggianiRoberta ParenteD’Amato MariaMaria Vittoria VerrilloGiovanni RollaLuisa BrussinoAgata Valentina FrazzettoZappa Maria CristinaMarianna LilliNunzio CrimiMarco BonaviaAngelo Guido CorsicoAmelia GrossoStefano Del GiaccoMargherita DeiddaLuisa RicciardiStefania IsolaFrancesca CiceroGiuliana AmatoFederica VitaAntonio SpanevelloPatrizia PignattiFrancesca CherubinoDina ViscaFabio Luigi Massimo RicciardoloVitina Maria Anna CarrieroFrancesca BertoliniPierachille SantusRoberta BarlassinaAndrea AiroldiGiuseppe GuidaNucera EleonoraArianna AruannoAngela RizziCristiano CarusoStefania ColantuonoGianenrico SennaMarco CaminatiAlessandra ArcolaciAndrea VianelloFulvia Chieco BianchiMaria Rita MarchiStefano CentanniSimone LuraschiSilvia RuggeriRocco RinaldoElena ParazziniCecilia CalabreseMartina FloraLorenzo CosmiLinda Di PietroEnrico MaggiLaura PiniLuigi MacchiaDanilo Di BonaLuca RicheldiCarola CondoluciLeonello FusoMatteo BoniniAlessandro FarsiGiulia CarliPaolo MontuschiGiuseppe SantiniMaria Elisabetta ConteElisa TurchetCarlo BarbettaFrancesco MazzaSimona D’AloStefano PucciMaria Filomena CaiaffaElena MinennaLuciana D'EliaCarlo PasculliVittorio VivianoPaolo TarsiaJoyce RoloMariacarmela Di ProiettoSalvatore Lo CiceroElsevierarticleSevere asthmaClassificationDefinitionBiological treatmentImmunologic diseases. AllergyRC581-607ENWorld Allergy Organization Journal, Vol 14, Iss 11, Pp 100606- (2021)

Severe asthma: One disease and multiple definitions

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