PT  - JOURNAL ARTICLE
AU  - Florence Schleich
AU  - Guy Brusselle
AU  - Renaud Louis
AU  - Olivier Vandenplas
AU  - Charles Pilette
AU  - Rudi Peche
AU  - Guy Joos
TI  - Cross-sectional analysis of the Belgian Severe Asthma Registry
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - P2292
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/P2292.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/P2292.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - The Belgian severe asthma registry (BSAR) is a secured web-based registry encompassing demographic, clinical, functional and inflammatory data of severe adult asthmatics as defined by the ATS, aiming at raising awareness on severe asthma, studying its natural history, identifying phenotypes, and offering tools to optimize care.MethodsThe cross-sectional analyses of the BSAR included 229 refractory asthmatics from 7 Belgian centers, followed up by respiratory physicians for at least one year prior to inclusion.ResultsSevere asthma was more frequent in women (56%), was associated with atopy (69%) and started early (71% before age 40). 10% were current smokers and 32% ex-smokers. In addition to high doses of ICS+LABA, 48% of patients received LTRA, 21% anti-IgE and 21% oral corticosteroids. Despite impaired flow rates (mean FEV1=70% pred; FEV1/FVC=63%), KCO was well preserved (98% pred).Eosinophilic asthma (sputum Eos≥3%) was the predominant phenotype (60%, n=45) while neutrophilic (sputum Neu≥76%) and paucigranulocytic asthma were 22% and 13% respectively. The median FENO was 22ppb (4-250ppb) and the fraction of patients with FENO≥50ppb was 17% (n=155). Comorbidities included chronic rhinosinusitis (58%), nasal polyposis (21%), oesophageal reflux (36%), obesity (48%) and depression (18%). Asthma control assessed by ACT and ACQ was impaired (85% had ACT<20 and 87% had ACQ>0.75) and average AQLQ was 4.39.ConclusionIn the BSAR, severe asthmatics are characterized by airflow limitation, frequent comorbidities, poor asthma control and quality of life. Paucigranulocytic asthma represents a rare phenotype while a high proportion of severe asthmatics have uncontrolled eosinophilic airway inflammation.