Cretan Severe Asthma Registry

Introduction: The process of a severe asthma diagnosis remains a challenging task, including tackling of differential diagnosis, comorbidities, and environmental triggers, family history, evaluating adherence and providing patient education. Methods: 261 patients referred by pulmonologists due to uncontrolled asthma to our expert center between 2008 and 2019 and attended a systematic evaluation during a 1-day visit. Retrospective medical records were used, and patients distributed into 3 groups according to the medical decisions made during the initial assessment at asthma clinic. Group 1 (N=63): patients with mild-moderate asthma Group 2 (N=112): patients with difficult-to-treat asthma on high dose ICS and/or LAMA Group 3 (N=16): patients with severe asthma already receiving biologic agent. Results: The median age of the total population was 54, with female predominance (67%), whereas 51 (19.8%) patients were current smokers. All had already received inhaled corticosteroid and the vast majority had been on a second controller. Most of them were on step 4 or 5 asthma treatment. Late onset asthma was more frequent in groups 2 and 3. Median number of exacerbations during the previous year before the referral was 1 and median ACQ-7 score was 1.1 while 3.5% patients were on OCS. Median total IgE for the whole population was 122.5 and median current blood eosinophil count was 200. Conclusion: Detailed assessment in expert asthma centers and phenotypic characterization becomes more clinically useful so that targeted therapy can be initiated when needed.