Swiss Severe Asthma Registry (SSAR)-Good asthma control and high number of exacerbations. How does this fit?

Background: Asthma is one of the most common chronic diseases and according to the SAPALDIA-study; the prevalence of asthma in adults in Switzerland is estimated to be around 2-8%. Despite optimized treatments and specific medication the prevalence of asthma is increasing worldwide. There are a variety of phenotypes and subtypes in asthma. Considering the range of manifestations, especially severe asthma, the special interest group obstructive lung diseases and allergy of the Swiss Pneumology Society (SGP) was building up a national registry for severe asthma to get a better understanding about the variety of the disease. The registry originally started in 2018 and the first patients were enrolled in 2019. Currently >150 patients are enrolled. Methods: This is a longitudinal prospective cohort study with a planned, annual follow up for up to 15 years in all regions of Switzerland. Results: Asthma control was assessed with the Asthma Control Test (ACT) and reported by physicians. The mean ACT was 19.91 (SD 4.48). Reported asthma control (according to GINA Guidelines) by physicians was controlled (61.6%), partially controlled (21.4%) and uncontrolled (17%). Number of exacerbation within the last year were reported as following none (32%), 1x/year (2%), >1 x/year (24 %), >1x /month (33%) and unknown(9%). Most of the patient that were included in the registry are treated according to current guidelines. Reported maintenance therapy were monoclonal antibody (90%), ICS/LABA (90%), LAMA (50%) and systemic corticosteroids (20%). Discussion: Despite rather good asthma control, the number of reported exacerbations is high, the findings evokes questions for further analyses.