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

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Date
2023-08-25Authors
Scelo, GhislaineTorres-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.
Côté, Andréanne
Bergeron, Celine
Dorscheid, Delbert
FitzGerald, J. Mark
Chapman, Kenneth R.
Boulet, Louis Philippe
Bhutani, Mohit
Sadatsafavi, Mohsen
Jiménez-Maldonado, Libardo
Duran-Silva, Mauricio
Rodriguez, Bellanid
Celis-Preciado, Carlos Andrés
Cano-Rosales, Diana Jimena
Solarte, Ivan
Fernández Sánchez, Maria José
Parada-Tovar, Patricia
von Bülow, Anna
Bjerrum, Anne Sofie
Ulrik, Charlotte S.
Assing, Karin Dahl
Makowska Rasmussen, Linda
Hansen, Susanne
Altraja, Alan
Bourdin, Arnaud
Taille, Camille
Charriot, Jeremy
Roche, Nicolas
Papaioannou, Andriana I.
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
Larenas Linnemann, Désirée
Larenas Linnemann, Désirée
García, Ulises
Kuna, Piotr
Fonseca, João A.
Al-Lehebi, Riyad
Koh Siyue, Mariko
Kook Rhee, Chin
Cosio, Borja G.
Perez de Llano, Luis
Perng (Steve), Diahn-Warng
Wan-Chun Huang, Erick
Wang, Hao-Chien
Tsai, Ming-Ju
Mahboub, Bassam
Jaber Salameh, Laila Ibraheem
Jackson, David
Busby, John
Heaney, Liam G.
Pfeffer, Paul
Grippen Goddard, Amanda
Wang, Eileen
Hoyte, Flavia
Wechsler, Michael E.
Chapman, Nicholas
Katial, Rohit
Carter, Victoria
Bulathsinhala, Lakmini
Eleangovan, Neva
Ariti, Con
Lyu, Juntao
Price, David
Porsbjerg, Celeste
Corporate Author(s)
Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Medicina Interna. Neumología
Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Ciencias Fisiológicas
Type
Artículo de revista
ISSN
1081-1206 / 1534-4436 (Electrónico)
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Abstract
Background:
Investigation for the presence of asthma comorbidities is recommended by GINA as 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. Thirty comorbidities were identified and categorized a priori as either (1) potentially T2-related, (2) potentially oral corticosteroid (OCS)-related or (3) mimicking/aggravating asthma. The association between comorbidities and asthma-related outcomes was investigated using multivariable models adjusted for country, age at enrollment, and sex.
Results:
Of 11,821 patients, 69%, 67%, and 55% had ≥1 potentially T2-related, potentially OCS-related, or mimicking/aggravating comorbidities, respectively; 57% had ≥3 comorbidities, and 33% had comorbidities in all three categories. Patients with allergic rhinitis (AR), nasal polyposis (NP), and chronic rhinosinusitis (CRS) experienced 1.12- (p=0.003), 1.16- (p<0.001) and 1.29-times (p<0.001) more exacerbations/year, respectively, than those without. Patients with NP and CRS were 40% and 46% more likely (p<0.001), respectively, to have received long-term (LT) OCS. All assessed potential OCS-related comorbidities (except obesity) were associated with greater likelihood of LTOCS use (ORs: 1.23-2.77) and, except for dyslipidemia, with greater likelihood of uncontrolled asthma (ORs: 1.29-1.68). All mimicking/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 COPD) with increased likelihood of LTOCS use (ORs: 1.37-1.57). Greater number of comorbidities was associated with worse outcome.
Conclusion:
In a global study, comorbidity or multimorbidity is reported in most adults with severe asthma and is associated with poorer asthma-related outcomes.
Keywords
Allergic rhinitisAnxiety/depression
Chronic obstructive pulmonary disease
Chronic rhinosinusitis
Diabetes, Dyslipidemia
Gastroesophageal reflux disease
Hypertension
Nasal polys
Obesity
Osteoporosis
Sleep apnea
Temporary coverage
2010-2022Community
Pacientes con Asma severaLink to the resource
https://www.annallergy.org/article/S1081-1206(23)00630-0/fulltext#%20Source
Annals of Allergy, Asthma & Immunology; , Páginas 1 - 98 (2023)
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