Severe Asthma Network Italy Definition of Clinical Remission in Severe Asthma: A Delphi Consensus

被引：50

作者：

Canonica, Giorgio Walter ^{[1
,2
,54
]}

Blasi, Francesco ^{[3
,4
]}

Carpagnano, Giovanna Elisiana ^{[5
,6
]}

Guida, Giuseppe ^{[7
,8
]}

Heffler, Enrico ^{[1
,2
]}

Paggiaro, Pierluigi ^{[9
]}

Allegrini, Chiara ^{[10
]}

Antonelli, Andrea ^{[11
]}

Aruanno, Arianna ^{[12
]}

Bacci, Elena ^{[13
]}

Bagnasco, Diego ^{[14
]}

Beghe, Bianca ^{[15
]}

Bonavia, Marco ^{[16
]}

Bonini, Matteo ^{[17
]}

Brussino, Luisa ^{[18
]}

Caiaffa, Maria Filomena ^{[19
]}

Calabrese, Cecilia ^{[20
]}

Camiciottoli, Gianna ^{[10
]}

Caminati, Marco ^{[21
]}

Caruso, Cristiano ^{[22
]}

Cavallini, Mirta ^{[23
]}

Bianchi, Fulvia Chieco ^{[24
]}

Conte, Maria Elisabetta ^{[25
]}

Corsico, Angelo Guido ^{[26
]}

Cosmi, Lorenzo ^{[27
]}

Costantino, Mariateresa ^{[28
]}

Costanzo, Giulia ^{[29
]}

Crivellaro, Mariaangiola ^{[24
]}

D'Alo, Simona ^{[30
]}

D'Amato, Mariella ^{[31
]}

Detoraki, Aikaterini ^{[32
]}

Proietto, Maria Carmela Di ^{[33
]}

Facciolongo, Nicola Cosimo ^{[34
]}

Ferri, Sebastian ^{[1
]}

Fierro, Vincenzo ^{[35
]}

Foschino, Maria Pia ^{[36
]}

Latorre, Manuela ^{[37
]}

Lombardi, Carlo ^{[38
]}

Macchia, Luigi ^{[39
]}

Milanese, Manlio ^{[40
]}

Montagni, Marcello ^{[41
]}

Parazzini, Elena Maria ^{[42
]}

Parente, Roberta ^{[43
]}

Passalacqua, Giovanni ^{[44
]}

Patella, Vincenzo ^{[45
]}

Pelaia, Girolamo ^{[46
]}

Pini, Laura ^{[47
]}

Puggioni, Francesca ^{[1
]}

Ricciardi, Luisa ^{[48
]}

Ridolo, Erminia ^{[49
]}

机构：

[1] IRCCS Humanitas Res Hosp, Personalized Med Asthma & Allergy, Milan, Italy

[2] Humanitas Univ, Dept Biomed Sci, Milan, Italy

[3] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Cyst Fibrosis Adult Ctr, Resp Unit, Milan, Italy

[4] Univ Milan, Dept Pathophysiol & Transplantat, Milan, Italy

[5] Univ Bari Aldo Moro, Dept Translat Biomed & Neurosci DiBraiN, Bari, Italy

[6] Hosp Pharm Policlin Bari, Bari, Italy

[7] Univ Turin, Dept Clin & Biol Sci, Turin, Italy

[8] San Luigi Gonzaga Univ Hosp, Severe Asthma & Rare Lung Dis Unit, Orbassano, Italy

[9] Univ Pisa, Dept Surg Med Mol Biol & Crit Care, Pisa, Italy

[10] Azienda Ospedaliera Univ Careggi, Radiotherapy Unit, Florence, Italy

[11] Azienda Osped S Croce & Carle, Dept Pathol, I-12100 Cuneo, Italy

[12] Sapienza Univ Roma, Reumatol, Dipartimento Med Interna & Specialita Med, Rome, Italy

[13] Azienda Ospedaliero Univ Pisana AOUP, I-56100 Pisa, Italy

[14] IRCCS AOU San Martino IST, UO Clin Ematol, Genoa, Italy

[15] Univ Modena & Reggio Emilia, Endocrinol Gynecol Ctr, Dept Maternal Infant & Adult Med & Surg Sci, Gynecol & Obstetr Clin, Modena, Italy

[16] Osped La Colletta, Dept Internal Med, UO Nefrol & Dialisi, Via Giappone 5, I-16011 Genoa, Italy

[17] Fdn Policlin Univ A Gemelli IRCCS, UOC Pneumol, Rome, Italy

[18] AO Mauriziano Radiol Interventist, Turin, Italy

[19] Azienda Osped Univ Ospedali Riuniti, Struttura Semplice Neurofisiopatol, Foggia, Italy

[20] AO Monaldi, Dipartimento Medico Chirurg Oncol & Patol Torac, Ia Clin Pneumol SUN, Naples, Italy

[21] Azienda Ospedaliera Univ Integrata Verona, Verona, Italy

[22] Fdn Policlin Univ A Gemelli, IRCCS, Internal Med & Gastroenterol, Rome, Italy

[23] Fdn IRCCS Ca Granda Osped Maggiore Policlin Milan, Unita Operat Broncopneumol, Milan, Italy

[24] Azienda Ospedaliera Padova, Padua, Italy

[25] Azienda Assistenza Sanit N 5 Friuli Occidentale, I-33170 Pordenone, Italy

[26] Fdn IRCCS Policlin San Matteo, UOC Pneumol, Pavia, Italy

[27] Azienda Osped Univ Careggi, Sod Immunol & Terapie Cellulari, Florence, Italy

[28] Azienda Osped Carlo Poma, Dept Hematol & Transfus Med, Mantua, Italy

[29] Policlin Univ Cagliari, Allergol & Immunol Clin, Cagliari, Italy

[30] ASUR Marche AV3, Osped Civitanova Marche, Urol, Civitanova Marche, Italy

[31] Azienda Ospedaliera Colli V Monaldi, Naples, Italy

[32] Federico II Univ Naples, Naples, Italy

[33] ASST Grande Osped Metropolitano Niguarda, Milan, Italy

[34] Azienda USL Reggio Emilia IRCCS, Arcispedale St Maria Nuova, S C Dermatol, Reggio Emilia, Italy

[35] Osped Pediatr Bambino Gesu, Neurol, Rome, Italy

[36] Policlin Foggia, UOC Malattie Apparat Resp, Foggia, Italy

[37] Nuovo Osped Apuano, Dipartimento Emergenza, Massa Carrara, Italy

[38] Fdn Poliambulanza Ist Ospedaliero, Geriatr Dept, Brescia, Italy

[39] Cardiol Osped Policlin Bari, Bari, Italy

[40] OSPEDALE S CORONA, DIV MED, PIETRA LIGURE, Italy

[41] Osped Guglielmo Saliceto, AUSL Piacenza, Piacenza, Italy

[42] St i Paolo & Carlo Hosp, Otolaryngol Unit, Milan, Italy

[43] AOU San Giovanni di Dio & Ruggi di Aragona, Salerno, Italy

[44] Aou San Martino Ist Ge, IRCCS, Dip Med Interna, Genoa, Italy

[45] UO Allergol Immunol Clin, Azienda Sanit, Florence, Italy

[46] AOU Mater Domini, Catanzaro, Italy

[47] ASST Spedali Civili Brescia, UOC, Med Gen 2, Brescia, Italy

[48] AOU Policlin G Martino Univ Messina, BIOMORF, Messina, Italy

[49] Azienda Ospedaliero Univ Parma, UO Diagnost Ematochim, Parma, Italy

[50] ARNAS Civ Palermo, UOC Pneumol, I-90100 Palermo, Sicily, Italy

来源：

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE | 2023年 / 11卷 / 12期

关键词：

Asthma; Asthma remission; Allergy; Inflammation; Delphi analysis; MANAGEMENT;

D O I：

10.1016/j.jaip.2023.07.041

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

Severe asthma affects about 10% of the population with asthma and is characterized by low lung function and a high count of blood leukocytes, mainly eosinophils. Various definitions are used in clinical practice and in the literature to identify asthma remission: clinical remission, inflammatory remission, and complete remission. This work highlights a consensus for asthma remission using a Delphi method. In the context of the Severe Asthma Network Italy, which accounts for 57 severe asthma centers and more than 2,200 patients, a board of six experts drafted a list of candidate statements in a questionnaire, which has been revised to minimize redundancies and ensure clear and consistent wording for the first round (R1) of the analysis. Thirty-two statements were included in the R1 questionnaire and then submitted to a panel of 80 experts, which used a 5-point Likert scale to measure agreement regarding each statement. Then, an interim analysis of R1 data was performed, and items were discussed and considered to produce a consistent questionnaire for round 2 (R2) of the analysis. Then, the board set the R2 questionnaire, which included only important topics. Panelists were asked to vote on the statements in the R2 questionnaire afterward. During R2, the criteria of complete clinical remission (the absence of the need for oral corticosteroids, symptoms, exacerbations or attacks, and pulmonary function stability) and those of partial clinical remission (the absence of the need for oral corticosteroids, and two of three criteria: the absence of symptoms, exacerbations or attacks, and pulmonary stability) were confirmed. This Severe Asthma Network Italy Delphi analysis defined a valuable and independent tool that is easy to use, to test the efficacy of different treatments in patients with severe asthma enrolled into the SANI registry. (c) 2023 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).

引用

页码：3629 / 3637

页数：9

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