The German severe asthma patient: Baseline characteristics of patients in the German Severe Asthma Registry, and relationship with exacerbations and control

Stephanie Korn; Katrin Milger; Dirk Skowasch; Hartmut Timmermann; Christian Taube; Marco Idzko; Hans Werner Voß; Annette Holtdirk; Eckard Hamelmann; Roland Buhl

doi:10.1016/j.rmed.2022.106793

The German severe asthma patient: Baseline characteristics of patients in the German Severe Asthma Registry, and relationship with exacerbations and control

Respir Med. 2022 Feb 26:195:106793. doi: 10.1016/j.rmed.2022.106793. Online ahead of print.

Authors

Affiliations

¹ IKF Pneumologie Mainz, Mainz, Germany. Electronic address: korn@ikf-pneumologie.de.
² Department of Medicine V, LMU University Hospital, Comprehensive Pneumology Center Munich, and Member of the German Center for Lung Research, Germany.
³ Department of Internal Med. II - Pneumology, University Hospital Bonn, Bonn, Germany.
⁴ Hamburger Institut für Therapieforschung und Schwerpunktpraxis Colonnaden, Hamburg, Germany.
⁵ Department of Pulmonary Medicine, University Hospital Essen - Ruhrlandklinik, Essen, Germany.
⁶ Department of Pneumology, University Hospital Vienna, Austria.
⁷ Dr. med. Kottmann GmbH & Co KG, Hamm, Germany.
⁸ Department of Pediatrics. University Hospital OWL, University Bielefeld, Bielefeld, Germany.
⁹ Pulmonary Department, Mainz University Hospital, 55131, Mainz, Germany.

PMID: 35248804
DOI: 10.1016/j.rmed.2022.106793

Abstract

Introduction: The German Asthma Net Severe Asthma Registry is collecting long-term data from a large cohort of patients aged ≥6 years with severe asthma. This manuscript presents their baseline characteristics, and identifies relationships with exacerbations and/or poor asthma control.

Methods: The registry is collecting routine clinical parameters including: demographics and medical history; disease characteristics (Asthma Control Questionnaire [ACQ]-5, forced expiratory volume in 1 s [FEV₁]); exacerbations; and biomarkers (eosinophils, immunoglobulin E [IgE], fractional exhaled nitric oxide [FeNO]).

Results: These analyses include data from 2011 patients at 72 sites (91.9% adult). Children (6-17 years) were more likely to be male, whereas more adults were female (males: children/adults 62%/41%). Most were receiving inhaled corticosteroid/long-acting β₂-agonist combinations (78%/81%); 38.0% of adults were receiving systemic steroids. Asthma control was suboptimal in both groups: 21.5%/13.3% were controlled; 10.4%/49.1% were symptomatic; 33.1%/37.2% received emergency asthma treatment in the previous year. Median blood eosinophil (400/238 cells/μL) and IgE levels (494/186 IU/mL) were higher in children; FeNO was lower (19/35 ppb). Patients with ≥2 exacerbations in the previous year had lower FEV₁ (absolute and % predicted) and IgE, and higher ACQ-5, FeNO and blood eosinophil levels (all p < 0.05). There was a weak, negative correlation between ACQ-5 and FEV₁% predicted in adults (p < 0.001).

Conclusions: These analyses characterise the typical German patient with severe asthma, and provide information on their overall care. Their planned long-term follow-up will assess whether asthma control can be optimised, how best to do so, and most importantly how such optimisation can benefit patients.

Keywords: Disease control; Exacerbations; Observational; Registry; Severe asthma.