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Characteristics of Adult Severe Refractory Asthma in Korea Analyzed From the Severe Asthma Registry

Allergy, Asthma & Immunology Research : AAIR 2019년 11권 1호 p.43 ~ 54
 ( Kim Min-Hye ) - Ewha Womans University College of Medicine Department of Internal Medicine

 ( Kim Sang-Heon ) - Hanyang University College of Medicine Department of Internal Medicine
 ( Park So-Young ) - Konkuk University Medical Center Department of Allergy and Respiratory Medicine
 ( Ban Ga-Young ) - Hallym University College of Medicine Kangdong Sacred Heart Hospital Department of Pulmonary, Allergy and Critical Care Medicine
 ( Kim Joo-Hee ) - Hallym University College of Medicine Department of Internal Medicine
 ( Jung Jae-Woo ) - Chung-Ang University College of Medicine Department of Internal Medicine
 ( Moon Ji-Yong ) - Hanyang University College of Medicine Department of Internal Medicine
 ( Song Woo-Jung ) - University of Ulsan College of Medicine Asan Medical Center Department of Internal Medicine
 ( Kwon Hyouk-Soo ) - University of Ulsan College of Medicine Asan Medical Center Department of Internal Medicine
 ( Kwon Jae-Woo ) - Kangwon National University School of Medicine Department of Internal Medicine
 ( Lee Jae-Hyun ) - Yonsei University College of Medicine Department of Internal Medicine
 ( Kang Hye-Ryun ) - Seoul National University College of Medicine Department of Internal Medicine
 ( Park Jong-Sook ) - Soonchunhyang University College of Medicine Department of Internal Medicine
 ( Kim Tae-Bum ) - University of Ulsan College of Medicine Asan Medical Center Department of Internal Medicine
 ( Park Heung-Woo ) - Seoul National University College of Medicine Department of Internal Medicine
 ( Yoo Kwang-Ha ) - Konkuk University Medical Center Department of Allergy and Respiratory Medicine
 ( Oh Yeon-Mok ) - University of Ulsan College of Medicine Asan Medical Center Department of Internal Medicine
 ( Koh Young-Il ) - Chonnam National University Medical School and Hospital Department of Internal Medicine
 ( Jang An-Soo ) - Soonchunhyang University College of Medicine Department of Internal Medicine
 ( Lee Byung-Jae ) - Sungkyunkwan University School of Medicine Department of Internal Medicine
 ( Cho Young-Joo ) - Ewha Womans University College of Medicine Department of Internal Medicine
 ( Cho Sang-Heon ) - Seoul National University College of Medicine Department of Internal Medicine
 ( Park Hae-Sim ) - Ajou University School of Medicine Department of Allergy and Clinical Immunology
 ( Park Choon-Sik ) - Soonchunhyang University College of Medicine Department of Internal Medicine
 ( Yoon Ho-Joo ) - Hanyang University College of Medicine Department of Internal Medicine
 ( Cho You-Sook ) - University of Ulsan College of Medicine Asan Medical Center Department of Internal Medicine

Abstract

Purpose: Although mild to moderate asthma is much more common, the morbidity and mortality of severe asthma are much higher. This study was performed to identify and analyze the clinical characteristics of severe asthma in Korea.

Methods: We registered patients with severe refractory asthma into the Severe Asthma Registry supported by the Severe Asthma Work Group of the Korean Academy of Asthma, Allergy and Clinical Immunology. Patients were enrolled since 2010 from the 15 university hospitals nationwide in Korea. Severe asthma was defined according to modified European Respiratory Society/American Thoracic Society criteria. Information on demographics, medical history, pulmonary function tests and skin prick tests was collected; the clinical characteristics of severe asthmatics were analyzed from the collected data.

Results: A total of 489 patients were enrolled with a mean age of 62.3; 45% are male. Sixty percent of patients received Global Initiative for Asthma step 4 treatment, and 30% received step 5 treatment. The most common comorbidities were allergic rhinitis (58.7%). Aspirin hypersensitivity was observed in 14.0%. Approximately half (53.9%) are non-smokers. Atopy was proven in 38.5% of the patients. Regarding asthma medications, inhaled corticosteroids and long-acting β-agonist combination inhalers were most commonly prescribed (96.5%), followed by leukotriene antagonists (71.0%). A recombinant anti-immunoglobulin E monoclonal antibody (omalizumab) has been used in 1.8% of the patients. The mean forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and FEV1/FVC were 78.7%, 67.5% and 67.9% of predicted values, respectively. The mean Asthma Control Test and quality of life questionnaire scores were 16.5 out of 25 and 59.5 out of 85, respectively.

Conclusions: The baseline characteristics of severe asthma patients in the Korea Severe Asthma Registry were analyzed and reported for the first time. With this cohort, further prospective studies should be performed to search for ways to improve management of severe refractory asthma.

키워드

Asthma; severe asthma; registry
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