Analysis of comorbidities and multimorbidity in adult patients in the International Severe Asthma Registry

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • João De Almeida Lopes Da Fonseca

    Autor

Participantes de fora da FMUP

  • Scelo, Ghislaine
  • Torres-Duque, Carlos A.
  • Maspero, Jorge
  • Tran, Trung N.
  • Murray, Ruth
  • Martin, Neil
  • Menzies-Gow, Andrew N.
  • Hew, Mark
  • Peters, Matthew J.
  • Gibson, Peter G.
  • Christoff, George C.
  • Popov, Todor A.
  • Cote, Andreanne
  • Bergeron, Celine
  • Dorscheid, Delbert
  • FitzGerald, J. Mark
  • Chapman, Kenneth R.
  • Boulet, Louis Philippe
  • Bhutani, Mohit
  • Sadatsafavi, Mohsen
  • Jimenez-Maldonado, Libardo
  • Duran-Silva, Mauricio
  • Rodriguez, Bellanid
  • Celis-Preciado, Carlos Andres
  • Cano-Rosales, Diana Jimena
  • Solarte, Ivan
  • Fernandez-Sanchez, Maria Jose
  • Parada-Tovar, Patricia
  • von Bulow, Anna
  • Bjerrum, Anne Sofie
  • Ulrik, Charlotte S.
  • Assing, Karin Dahl
  • Rasmussen, Linda Makowska
  • Hansen, Susanne
  • Altraja, Alan
  • Bourdin, Arnaud
  • Taille, Camille
  • Charriot, Jeremy
  • Roche, Nicolas
  • Papaioannou, I, Andriana
  • Kostikas, Konstantinos
  • Papadopoulos, Nikolaos G.
  • Salvi, Sundeep
  • Long, Deirdre
  • Mitchell, Patrick D.
  • Costello, Richard
  • Sirena, Concetta
  • Cardini, Cristina
  • Heffler, Enrico
  • Puggioni, Francesca
  • Canonica, Giorgio Walter
  • Guida, Giuseppe
  • Iwanaga, Takashi
  • Al-Ahmad, Mona
  • Linnemann, Desiree Larenas
  • Garcia, Ulises
  • Kuna, Piotr
  • Al-Lehebi, Riyad
  • Koh, Mariko Siyue
  • Rhee, Chin Kook
  • Cosio, Borja G.
  • de Llano, Luis Perez
  • Steve, Diahn-Warng Perng
  • Huang, Erick Wan-Chun
  • Wang, Hao-Chien
  • Tsai, Ming-Ju
  • Mahboub, Bassam
  • Salameh, Laila Ibraheem Jaber
  • Jackson, David
  • Busby, John
  • Heaney, Liam G.
  • Pfeffer, Paul
  • Goddard, Amanda Grippen
  • Wang, Eileen
  • Hoyte, Flavia
  • Wechsler, Michael E.
  • Chapman, Nicholas
  • Katial, Rohit
  • Carter, Victoria
  • Bulathsinhala, Lakmini
  • Eleangovan, Neva
  • Ariti, Con
  • Lyu, Juntao
  • Price, David B.
  • Porsbjerg, Celeste

Unidades de investigação

Abstract

Background: Investigation for the presence of asthma comorbidities is recommended by the Global Initiative for Asthma because their presence can complicate asthma management. Objective: To understand the prevalence and pattern of comorbidities and multimorbidity in adults with severe asthma and their association with asthma-related outcomes. Methods: This was a cross-sectional study using data from the International Severe Asthma Registry from 22 countries. A total of 30 comorbidities were identified and categorized a priori as any of the following: (1) poten-tially type 2-related comorbidities, (2) potentially oral corticosteroid (OCS)-related comorbidities, or (3) comor-bidities mimicking or aggravating asthma. The association between comorbidities and asthma-related outcomes was investigated using multivariable models adjusted for country, age at enrollment, and sex (ie male or female). Results: Of the 11,821 patients, 69%, 67%, and 55% had at least 1 potentially type 2-related, potentially OCS-related, or mimicking or aggravating comorbidities, respectively; 57% had 3 or more comorbidities, and 33% had comorbid-ities in all 3 categories. Patients with allergic rhinitis, nasal polyposis, and chronic rhinosinusitis experienced 1.12 (P = .003), 1.16 (P < .001), and 1.29 times (P < .001) more exacerbations per year, respectively, than those without. Patients with nasal polyposis and chronic rhinosinusitis were 40% and 46% more likely (P < .001), respectively, to have received long-term (LT) OCS. All assessed potential OCS-related comorbidities (except obesity) were associated with a greater likelihood of LTOCS use (odds ratios [ORs]: 1.23-2.77) and, except for dyslipidemia, with a greater like-lihood of uncontrolled asthma (ORs: 1.29-1.68). All mimicking or aggravating comorbidities assessed were associated with more exacerbations (1.24-1.68 times more), all (except bronchiectasis) with increased likelihood of uncontrolled asthma (ORs: 1.57-1.81), and all (except chronic obstructive pulmonary disease) with increased likelihood of LTOCS use (ORs: 1.37-1.57). A greater number of comorbidities was associated with worse outcomes. Conclusion: In a global study, comorbidity or multimorbidity is reported in most adults with severe asthma and is associated with poorer asthma-related outcomes. Clinical Trial Registration: The International Severe Asthma Registry database has ethical approval from the Anonymous Data Ethics Protocols and Transparency (ADEPT) committee (ADEPT0218) and is registered with the European Union Electronic Register of Post-Authorization Studies (European Network Centres for Pharmacoepi-demiology and Pharmacovigilance [ENCEPP]/DSPP/23720). The study was designed, implemented, and reported in compliance with the European Network Centres for Pharmacoepidemiology and Pharmacovigilance (ENCEPP) Code of Conduct (EMA 2014; EUPAS44024) and with all applicable local and international laws and regulations, and registered with ENCEPP (https://www.encepp.eu/encepp/viewResource.htm?id=48848). Governance was provided by ADEPT (registration number: ADEPT1121). (c) 2023 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. This is an open access arti-cle under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

Dados da publicação

ISSN/ISSNe:
1534-4436, 1081-1206

ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY  American College of Allergy, Asthma and Immunology

Tipo:
Article
Páginas:
42-53

Citações Recebidas na Web of Science: 10

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Keywords

  • CO-MORBIDITIES; REVERSIBILITY; PREVALENCE

Proyectos asociados

Prevalence and Characterisation of Asthma Patients According to Disease Severity in Portugal (EPI-ASTHMA) - NCT05169619

Investigador Principal: João de Almeida Lopes da Fonseca

Estudo Clínico Observacional (EPI-ASTHMA) . AstraZeneca . 2021

Effect of a Mobile App on Improving Asthma Control in Adolescents and Adults With Persistent Asthma: A Pilot Randomized Multicentre, Superiority Clinical Trial (mINSPIRERS) - NCT05129527

Investigador Principal: João de Almeida Lopes da Fonseca

Ensaio Clínico Académico (mINSPIRERS) . 2021

Utilização em estudos observacionais do Registo de Asma Grave Portugal.

Investigador Principal: João de Almeida Lopes da Fonseca

Estudo Observacional Académico (RAG) . 2020

Clinical Research Collaboration Severe Heterogenous Asthma Research collaboration, Patient-centered (CRC SHARP).

Investigador Principal: João de Almeida Lopes da Fonseca

Estudo Clínico Observacional (SHARP) . European Respiratory Society . 2021

Multidimensional phenotyping of severe asthma patients and its impact on disease control and therapeutic response - analysis from the Portuguese Severe Asthma Registry.

Investigador Principal: João de Almeida Lopes da Fonseca

Estudo Clínico Observacional (RAG-SPP-GSK) . SPPneumologia . 2022

BREATHE - An oBservational, pRimary data study to characterize severe AsThma pHenotypes and assEss disease burden across the EUCAN region.

Investigador Principal: João de Almeida Lopes da Fonseca

Estudo Clínico Observacional (RAG-AZ-BREATHE) . AstraZeneca . 2022

Efficiency in Spine Care ? Assessing outcomes and costs to inform healthcare improvement

Investigador Principal: João de Almeida Lopes da Fonseca

Estudo Clínico Académico . 2022

Use of secondary data, health technology assessment methods and economic modelling applied to penicillin allergy

Investigador Principal: João de Almeida Lopes da Fonseca

Estudo Clínico Académico . 2020

Using different data sources for the identification of asthma patients and those at high risk of adverse outcomes

Investigador Principal: João de Almeida Lopes da Fonseca

Estudo Clínico Académico . 2020

Phenotypes of Chronic Diseases of the Airways: Towards Multidimensional Data -Driven Profiling

Investigador Principal: João de Almeida Lopes da Fonseca

Estudo Clínico Académico . 2020

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