FASE-CPHG study: a panoramic snapshot of difficult-to-treat, severe asthma in French nonacademic hospitals

Abstract

BackgroundReal-world data describing management of patients with severe asthma are limited. To address this issue, we conducted FASE-CPHG (France Asthme Sevère – Collège des Pneumologues des Hôpitaux Généraux), a descriptive, multicentric, and observational cross-sectional study.MethodsFrench pulmonologists from nonacademic hospitals completed questionnaires on patient characteristics and ongoing asthma treatment for severe asthmatic patients observed during the inclusion period. In addition, we collected data from patients via self-assessment questionnaires.Findings104 physicians recruited 1502 patients within 1 year. The mean age of the 1465 patients analysed was 54.4±16.1 years. Severe asthmatic patients were more frequently female (63%), with a history of atopy (65%). Most patients remained poorly controlled or uncontrolled, with an important difference between physicians' opinion and the Global Initiative for Asthma criteria (63% versus 96%). The most common comorbidities included ear, nose and throat diseases (59% of cases); anxiety (40%); and gastro-oesophageal reflux disease (39%). Allergic sensitisation tests and/or blood eosinophil count evaluation, and spirometry were performed in 92% and 98% of patients, respectively. The mean eosinophil count and total serum IgE were 437 cells·mm−3 and 546 UI·L−1, respectively. In addition to high doses of inhaled corticosteroids plus long-acting β2-agonists, patients were receiving leukotriene receptor antagonists (52%), anticholinergic drugs (34%), anti IgE (27%) and oral corticosteroids (17%); 65% adhered to their treatment.InterpretationThis study provides insight into the characteristics and management of severe asthma in France and may help improve knowledge on this pathology, which represents a high burden to healthcare.

Is overreliance on short-acting β2-agonists associated with health risks in the older asthma population?

“…In this study we adjusted for age, sex, controller use and comorbidities to identify SABA use as an independent risk factor. Our study results are consistent with the published findings (Table 4) on SABA use and health outcomes from Sweden, [7] Italy, [8] Germany, [19] France, [20,21] Poland, [22] and the UK. [9] For example, Nwaru et al used the Swedish national registries data from 2006-2014 in asthma patients aged 12-45 years and reported that increasing number of collected SABA canisters was associated with increased risk of asthma exacerbations.…”

“…In this study we adjusted for age, sex, controller use and comorbidities to identify SABA use as an independent risk factor. Our study results are consistent with the published findings ( table 4 ) on SABA use and health outcomes from Sweden [ 7 ], Italy [ 8 ], Germany [ 19 ], France [ 20 , 21 ], Poland [ 22 ] and the UK [ 9 ]. For example, N waru et al .…”

Characteristics of Severe Non-Eosinophilic Asthma: Analysis of Data from 1075 Patients Included in the FASE-CPHG Study

“…Its secondary objectives were to compare data from patients with severe eosinophilic and non-eosinophilic asthma and describe the profile of patients with severe non-eosinophilic asthma according to their allergic profile. 13–15 …”

“…Its secondary objectives were to compare data from patients with severe eosinophilic and non-eosinophilic asthma and describe the profile of patients with severe non-eosinophilic asthma according to their allergic profile. [13][14][15] Data from 1502 adult (>18 years) patients with severe asthma were collected from May 2016 to June 2017 in France by 104 respiratory physicians in non-academic hospitals. All patients received information about the study and gave their informed consent before being included in the FASE-CPHG study.…”

FASE-CPHG Study: Identification of asthma phenotypes in the French Severe Asthma Study using cluster analysis

“…One hundred and ten centers accepted to participate to the study. The methodology and descriptive analysis have been published elsewhere [12].…”