Prevalence and characterization of severe asthma in Hungary

Abstract

Background: Severe asthma (SA) database was established in Hungary to estimate the prevalence of SA and to define and analyze clinical phenotypes of the patients. Methods: SA questionnaires were sent out to 143 public pulmonary dispensaries specialized for diagnosing and caring pulmonary patients. Data of 520 SA patients were evaluated. Results: The prevalence of SA within the asthmatic population in Hungary was 0.89%. The mean age of patients were 56.4 ± 13.4 years, SA were more frequent in females (64%), the prevalence of allergy was 56.6%, 72.1% of patients had persistent airflow limitation (FEV1 < 80%), 37.9% severe airway obstruction (FEV1 ≤ 60%), 33.6% required systemic corticosteroid maintenance therapy, 21.5% had salicylate intolerance and 43.2% rhinosinusitis. A Bayesian dependency network was calculated which revealed several interdependencies between the characteristics. E.g. there was a strong association between salicylate intolerance and rhinosinusitis, more patients received regular systemic corticosteroid treatment who had salicylate intolerance and the proportion of salicylate intolerance was significantly higher in females. Conclusion: The prevalence of SA was determined in Hungary which was lower than in other studies. Using a Bayesian-based network analysis several interdependencies were revealed between patient characteristics.

Severe Asthma in a General Population Study: Prevalence and Clinical Characteristics

“…In our sample, those with severe asthma had better lung function compared with existing studies which show a mean FEV 1 between 60-72% of predicted, 3,7,8,16,26,27,34 with some higher reports at 77-81% of predicted. 5,25 Most of these studies used clinical samples and generally a higher cut-off for ICS dose, which indicates a higher severity of symptoms.…”

“…Ever since the medication levels became the basis of the definition of severe asthma, studies reporting prevalence have used different cut-offs for ICS dose. 5,6,[12][13][14][15][16]25,26 Some studies have reported the prevalence of severe asthma defined as uncontrolled asthma despite high dose ICS (ie, refractory asthma). 12,25,26 Others have presented controlled and uncontrolled asthma together under the umbrella of severe asthma, 5,6,[13][14][15] or as a mix of the methods.…”

“…5,6,[12][13][14][15][16]25,26 Some studies have reported the prevalence of severe asthma defined as uncontrolled asthma despite high dose ICS (ie, refractory asthma). 12,25,26 Others have presented controlled and uncontrolled asthma together under the umbrella of severe asthma, 5,6,[13][14][15] or as a mix of the methods. 16 With these differences in mind, the prevalence of severe asthma among asthmatics, was estimated to be 4-8%, 6,12,13,15,16 ranging from 0.9% 26 to 8.1% 6 among studies based on registry data, and from 4% 14 to 6% 25 among studies with samples from clinics.…”

“…A British study that also included GINA step 4-users in their sample of potential severe asthma, showed only a marginally smaller prevalence than in our study, at 8% among asthmatics. 16 Prevalence of uncontrolled asthma varies among samples categorized as severe asthma, from 30-57% 5,6,[13][14][15]27 up to 90-100%, 7,8,12,25,26 and the variation is likely dependent on each study's design and the definition of asthma control. A previous study based on WSAS data, reported prevalence of signs of asthma severity (at 13-36% among asthmatics), but did not include a specific ICS dose in the definition of severity.…”

Investigation of circulating lncRNAs as potential biomarkers in chronic respiratory diseases

“…Chronic respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD) and allergic rhinitis cause an enormous burden on the societies and are considered as major non-communicable diseases [ 1 ]. Over 1 billion people in the world suffer from chronic respiratory diseases [ 2 , 3 ].…”