Severe asthma care trajectories: the French RAMSES cohort.
ERJ Open Res
; 10(2)2024 Mar.
Article
in En
| MEDLINE
| ID: mdl-38651091
ABSTRACT
Background:
The French RAMSES study is an observational prospective multicentre real-life cohort including severe asthmatic subjects. The objective of the study was to compare the characteristics of patients, in terms of phenotype and asthma care trajectories, between those managed by tertiary referral centres (TRCs) or secondary care centres (SCCs).Methods:
Patients were prospectively recruited and enrolled for a 5-year follow-up. Patients' characteristics were analysed at inclusion and compared between TRCs and SCCs.Results:
52 centres (24 TRCs and 28 SCCs) included 2046 patients 1502 (73.4%) were included by a TRC and 544 (26.6%) by a SCC. Patients were mainly women (62%), 53±15â years old, 67% with Asthma Control Test <20; at inclusion, 14% received oral corticosteroids (OCS) and 66% biologics. Compared with the SCC group, the TRC group had more frequent comorbidities and lower blood eosinophil counts (262 versus 340â mm-3; p=0.0036). OCS and biologics use did not differ between groups, but patients in the TRC group benefited more frequently from an educational programme (26% versus 18%; p=0.0008) and received more frequently two or more sequential lines of biologics (33% versus 24%; p=0.0105). In-depth investigations were more frequently performed in the TRC group (allergy tests 74% versus 62%; p<0.0001; exhaled nitric oxide fraction 56% versus 21%; p<0.0001; induced sputum 6% versus 3%; p=0.0390).Conclusions:
Phenotypes and care trajectories differed in the RAMSES cohort between SCCs and TRCs, probably related to different levels of asthma severity and differences in medical resources and practices among centres. This highlights the need for standardisation of severe asthma care.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
ERJ Open Res
/
ERJ open res
/
ERJ open research
Year:
2024
Document type:
Article
Affiliation country:
Francia
Country of publication:
Reino Unido