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

被引：36

作者：

Scelo, Ghislaine ^{[1
,2
]}

Torres-Duque, Carlos A. ^{[3
,4
]}

Maspero, Jorge ^{[5
]}

Tran, Trung N. ^{[6
]}

Murray, Ruth ^{[2
]}

Martin, Neil ^{[6
,7
]}

Menzies-Gow, Andrew N. ^{[8
,9
]}

Hew, Mark ^{[10
,11
]}

Peters, Matthew J. ^{[12
]}

Gibson, Peter G. ^{[13
,14
]}

Christoff, George C. ^{[15
]}

Popov, Todor A. ^{[16
]}

Cote, Andreanne ^{[17
]}

Bergeron, Celine ^{[18
,19
]}

Dorscheid, Delbert ^{[20
]}

FitzGerald, J. Mark ^{[21
]}

Chapman, Kenneth R. ^{[22
]}

Boulet, Louis Philippe ^{[23
]}

Bhutani, Mohit ^{[24
]}

Sadatsafavi, Mohsen ^{[25
]}

Jimenez-Maldonado, Libardo ^{[4
,26
]}

Duran-Silva, Mauricio ^{[26
]}

Rodriguez, Bellanid ^{[27
]}

Celis-Preciado, Carlos Andres ^{[28
,29
]}

Cano-Rosales, Diana Jimena ^{[27
]}

Solarte, Ivan ^{[28
,29
]}

Fernandez-Sanchez, Maria Jose ^{[28
,29
]}

Parada-Tovar, Patricia ^{[3
]}

von Bulow, Anna ^{[30
]}

Bjerrum, Anne Sofie ^{[31
]}

Ulrik, Charlotte S. ^{[32
]}

Assing, Karin Dahl ^{[33
]}

Rasmussen, Linda Makowska ^{[34
]}

Hansen, Susanne ^{[35
,36
]}

Altraja, Alan ^{[37
,38
]}

Bourdin, Arnaud ^{[39
]}

Taille, Camille ^{[40
]}

Charriot, Jeremy ^{[39
]}

Roche, Nicolas ^{[41
]}

Papaioannou, Andriana, I ^{[42
]}

Kostikas, Konstantinos ^{[43
]}

Papadopoulos, Nikolaos G. ^{[44
,45
]}

Salvi, Sundeep ^{[46
]}

Long, Deirdre ^{[47
]}

Mitchell, Patrick D. ^{[48
]}

Costello, Richard ^{[49
]}

Sirena, Concetta ^{[50
]}

Cardini, Cristina ^{[50
]}

Heffler, Enrico ^{[51
,52
]}

Puggioni, Francesca ^{[51
]}

机构：

[1] Observat & Pragmat Res Inst, Singapore, Singapore

[2] Optimum Patient Care Global, Cambridge, England

[3] Fdn Neumol Colombiana, Resp Res Ctr, CINEUMO, Bogota, Colombia

[4] Univ La Sabana, Chia, Colombia

[5] CIDEA Fdn, Clin Res Allergy & Resp Med, Buenos Aires, DF, Argentina

[6] AstraZeneca, BioPharmaceut Med, Gaithersburg, MD USA

[7] Univ Leicester, Leicester, Leics, England

[8] AstraZeneca, Cambridge, England

[9] Royal Brompton & Harefield Hosp, London, England

[10] Alfred Hlth, Allergy Asthma & Clin Immunol Serv, Melbourne, Vic, Australia

[11] Monash Univ, Publ Hlth & Prevent Med, Melbourne, Vic, Australia

[12] Concord Hosp, Dept Thorac Med, Sydney, NSW, Australia

[13] Univ Newcastle, Prior Res Ctr Hlth Lungs, Australian Severe Asthma Network, Newcastle, NSW, Australia

[14] John Hunter Hosp, Hunter Med Res Inst, Dept Resp & Sleep Med, New Lambton Hts, NSW, Australia

[15] Med Univ, Sofia, Bulgaria

[16] Univ Hosp Sv Ivan Rilski, Sofia, Bulgaria

[17] Laval Univ, Dept Med, Quebec City, PQ, Canada

[18] Vancouver Gen Hosp, Vancouver, BC, Canada

[19] Univ British Columbia, Vancouver, BC, Canada

[20] Univ British Columbia, Ctr Heart Lung Innovat, Vancouver, BC, Canada

[21] Univ British Columbia, Dept Med, Vancouver, BC, Canada

[22] Univ Toronto, Toronto, ON, Canada

[23] Univ Laval, Quebec Heart & Lung Inst, Quebec City, PQ, Canada

[24] Univ Alberta, Dept Med, Div Pulm Med, Edmonton, AB, Canada

[25] Univ British Columbia, Fac Pharmaceut Sci, Resp Evaluat Sci Program, Vancouver, BC, Canada

[26] Fdn Neumol Colombiana, ASMAIRE Program, Bogota, Colombia

[27] Inst Neumol Oriente, Bucaramanga, Colombia

[28] Hosp Univ San Ignacio, Pulm Unit, Bogota, Colombia

[29] Pontificia Univ Javeriana, Hosp Univ San Ignacio, Fac Med, Bogota, Colombia

[30] Bispebjerg Hosp, Dept Resp Med & Infect Dis, Resp Res Unit, Copenhagen, Denmark

[31] Aarhus Univ Hosp, Dept Resp Med & Allergy, Aarhus, Denmark

[32] Copenhagen Univ Hosp, Dept Resp Med, Hvidovre, Denmark

[33] Aalborg Univ Hosp, Dept Resp Med, Aalborg, Denmark

[34] Copenhagen Univ Hosp Gentofte, Allergy Clin, Hellerup, Denmark

[35] Bispebjerg Hosp, Resp Res Unit, Copenhagen, Denmark

[36] Bispebjerg & Frederiksberg Hosp, Ctr Clin Res & Prevent, Copenhagen, Denmark

[37] Univ Tartu, Dept Pulmonol, Tartu, Estonia

[38] Tartu Univ Hosp, Lung Clin, Tartu, Estonia

[39] Univ Montpellier, CHU Montpellier, INSERM, CNRS,PhyMedExp, Montpellier, France

[40] Univ Paris Cite, Dept Resp Dis, Bichat Hosp, AP HP Nord, Paris, France

[41] Univ Paris Cite, APHP Ctr, Dept Resp Med, Cochin Hosp & Inst UMR1016, Paris, France

[42] Natl & Kapodistrian Univ Athens, Attikon Univ Hosp, Med Sch, Resp Med Dept 2, Athens, Greece

[43] Univ Ioannina, Resp Med Dept, Ioannina, Greece

[44] Univ Manchester, Div Infect Immun & Resp Med, Manchester, Lancs, England

[45] Univ Athens, Allergy Dept, Pediat Clin 2, Athens, Greece

[46] Pulmocare Res & Educ Fdn, Pune, Maharashtra, India

[47] Beaumont Hosp, Dept Med, Dublin, Ireland

[48] Trinity Coll Dublin, Sch Med, Dublin, Ireland

[49] Smurfit Bldg Beaumont Hosp, Dept Resp Med, RCSI, Clin Res Ctr, Dublin, Ireland

[50] Severe Asthma Network Italy SANI, Milan, Italy

来源：

ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY | 2024年 / 132卷 / 01期

关键词：

CO-MORBIDITIES; REVERSIBILITY; PREVALENCE;

D O I：

10.1016/j.anai.2023.08.021

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

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/)

引用

页码：42 / 53

页数：12

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