[Effectiveness and safety of biological therapy in patients with severe asthma in a real clinical practice].

AIM: To assess effectiveness and safety of biological therapy in patients with severe asthma during 5 yr follow-up. MATERIALS AND METHODS: We recruited 129 adult outpatients (29% males) aged 18-81 yrs with severe asthma were followed up during 5 yrs and were examined for every 3-6 months. Eighty five patients were treated by conventional therapy (ICS/LABA ± tiotropium, montelukast, OCS) only and 44 pts additionally received biologicals (оmalizumab - 9 pts, мepolizumab - 8 pts, benralizumab - 11 pts, dupilumab - 16 pts). Pulmonary function tests were measured by dry spirometer (2120, Vitalograph Ltd., UK). Eosinophil count in blood was assessed by automatic haemoanalyser. Fraction of exhaled nitric oxide was measured by a chemiluminescence analyzer (LR4100; Logan Research, UK). Asthma control and quality of life were assessed by using Russian versions of ACQ-5 and SGRQ. RESULTS: The use of biologicals led to a more significant reduction of exacerbations and OCS use, improvement of lung function, asthma control and quality of life, decrease of eosinophil and fraction of exhaled nitric oxide than conventional therapy of severe asthma (p<0.05). Systemic side effects were not registered, frequency of local adverse reactions (edema, hyperemia and itching at injection site) was 14%. CONCLUSION: Long-term use of biologicals added to conventional therapy in patients with severe asthma is characterized by high effectiveness and favorable safety profile.

[Severe asthma: Characteristics of patients in clinical practice].

AIM: To provide clinical characteristics of severe asthma (SA) patients encountered in clinical practice. SUBJECTS AND METHODS: A cross-sectional cohort study was performed to cover 119 outpatients aged 22-82 years. SA was diagnosed according to the ERS/ATS criteria (2014). Spirometry and bronchodilator reversibility testing were carried out; fractional exhaled nitric oxide (FeNO) was measured; inhalant allergen hypersensitivity (skin prick and blood specific IgE testing) and peripheral blood eosinophil counts were estimated. Asthma control and asthma-related quality of life were assessed. RESULTS: 77% of the patients were found to have allergic asthma; in this case, house dust mites were leading allergens in the spectrum of sensitization. 82% of the patients were observed to have uncontrolled asthma and 76% had incompletely reversible bronchial obstruction. The airway eosinophilic inflammation markers (FeNO more than 25 ppb and eosinophil counts of more than 150 cells/µ) were elevated in 63% of the patients. Good compliance was noted in 61% of the patients. There were 27% of active smokers who had lower lung function and FeNO levels. The smokers showed a low compliance with inhaled glucocorticosteroid treatment. SA was concurrent with chronic obstructive pulmonary disease in 37% of the cases. CONCLUSION: SA is a heterogeneous disease. Traditional treatment is not always effective, as many patients, despite their treatment, have uncontrolled SA and continuously increased markers of airways eosinophilic inflammation. Monoclonal antibody therapy may promote success in treating this cohort of patients.

[Prevalence of bronchial asthma and allergic rhinitis in the adult population of St. Petersburg]. / Rasprostranennost' bronkhial'noi asatmy i allergicheskogo rinita sredi vzroslogo naseleniia Sankt-Peterburga.

AIM: To evaluate prevalence of bronchial asthma (BA) and allergic rhinitis (AR) among adult population of St-Petersburg. MATERIAL AND METHODS: Responders to ECRHS and B. Sibbald & E. Rink questionnaires who gave at least one positive answer were examined clinically, functionally and allergologically. A total of 3634 responders aged 16 to 98 years participated in the study. RESULTS: By the answers of the responders prevalence of BA was 7.2%, of AR--9.9%. Such figures were much higher than official statistics. Atopic BA was most frequent among other types--64%. CONCLUSION: It became evident that BA and AR in many cases are diagnosed late or are not recognized at all. This leads to growing number of patients with moderate and severe course of these diseases and deteriorates effectiveness of BA and AR treatment.

[Effectiveness of detection of bronchial asthma with two international questionnaires]. / Effektivnost' vyiavleniia bronkhial'noi astmy pri ispol'zovanii dvukh mezhdunarodnykh oprosnikov.

AIM: Assessment of two questionnaires (ECRHS and IUATLD) for efficiency in bronchial asthma (BA) detection. MATERIAL AND METHODS: 196 patients aged 16-59 years seeking advice of a doctor for pulmonary or extrapulmonary complaints. All of them have not been previously examined for BA. At first stage of the study the patients filled in ECRHS and IUATLD questionnaires. At the second stage patients who had answered positively as least one question of the above questionnaires underwent clinical, functional and allergological examinations. RESULTS: BA was more frequently detected in patients with chronic bronchopulmonary and allergic diseases. New cases with mild disease predominated. CONCLUSION: Both questionnaires were effective for BA diagnosis but ECRHS showed a number of advantages which make it preferable for epidemiological surveys.