RESUMO
BACKGROUND: Biological therapies have revolutionized the treatment of severe asthma with type 2 inflammation. Although such treatments are very effective in reducing exacerbation and the dose of oral steroids, little is known about the persistence of symptoms in severe asthma patients treated with biologics. PURPOSE: We aim to describe asthma control and healthcare consumption of severe asthma patients treated with biologics. DESIGN: The Second Souffle study is a real-life prospective observational study endorsed by the Clinical Research Initiative in Severe Asthma: a Lever for Innovation & Science Network. METHODS: Adults with a confirmed diagnosis of severe asthma for at least 12 months' duration were enrolled in the study. A self-administered questionnaire including the Asthma Control Questionnaire (ACQ), Asthma Quality of Life Questionnaire (AQLQ) and a compliance evaluation test was given to the patients. Healthcare consumption within 12 months prior to enrolment was documented. In patients receiving biologics, doctors indicated whether the patients were biologic responders or non-responders. RESULTS: The characteristics of 431 patients with severe asthma were analysed. Among them, 409 patients (94.9%) presented asthma with type 2 inflammation (T2 high) profile, and 297 (72.6%) patients with a T2 high phenotype were treated with a biologic. Physicians estimated that 88.2% of patients receiving biologics were responders. However, asthma control was only achieved in 25.3% of those patients (ACQ > 0.75). A high proportion of patients (77.8%) identified as responders to biologics were not controlled according to the ACQ score. About 50% of patients continue to use oral corticosteroids either daily (25.2%) or more than three times a year for at least three consecutive days (25.6%). Gastro-oesophageal Reflux Disease (GERD) and Obstructive Sleep Apnoea syndrome (OSA) were identified as independent factors associated with uncontrolled asthma. CONCLUSION: Although a high proportion of severe asthma patients respond to biologics, only 25.3% have controlled asthma. GERD and OSA are independent factors of uncontrolled asthma.
Assuntos
Antiasmáticos , Asma , Produtos Biológicos , Refluxo Gastroesofágico , Apneia Obstrutiva do Sono , Adulto , Humanos , Antiasmáticos/efeitos adversos , Qualidade de Vida , Asma/diagnóstico , Asma/tratamento farmacológico , Produtos Biológicos/efeitos adversos , Refluxo Gastroesofágico/induzido quimicamente , Refluxo Gastroesofágico/tratamento farmacológico , Inflamação/tratamento farmacológicoAssuntos
Dispneia/etiologia , Melanoma/diagnóstico , Mesotelioma/diagnóstico , Neoplasias Pleurais/diagnóstico , Biópsia , Tubos Torácicos , Diagnóstico Diferencial , Humanos , Masculino , Melanoma/patologia , Mesotelioma/patologia , Pessoa de Meia-Idade , Pleura/patologia , Neoplasias Pleurais/patologia , Toracoscopia , Tomografia Computadorizada por Raios XRESUMO
We identified an unusual strain of mycobacteria from two patients with pulmonary tuberculosis by its smooth, glossy morphotype and, primarily, its genotypic characteristics. Spoligotyping and restriction fragment length polymorphism typing were carried out with the insertion sequence IS6110 patterns. All known cases of tuberculosis caused by Mycobacterium canetti have been contracted in the Horn of Africa.