The survey is available on thenextbreath.it, Sanofi portal dedicated to severe asthma

Circa three patients with severe asthma out of four show how the pathology has a strong impact on the quality of one's life: a significant fact that emerges from a research conducted by Doxa Pharma for Sanofi. This is the first specific investigation on patients with severe asthma, of which an excerpt on thenextbreath.it, the Italian portal of Sanofi dedicated to patients and doctors to inform about severe asthma with type 2 inflammation and its comorbidities.

Severe asthma presents a clinical picture that significantly affects normal activities of daily living: difficulty in breathing (62%), shortness of breath (60%), cough (55%), physical fatigue (49%) and respiratory crisis (47%) are the main symptoms, which alter and often prevent night rest, and impose renunciations in career, sports, travel and leisure.

Severe asthma has an even greater impact on patients' quality of life concomitant diseases or comorbidities, which impact a total of 79% of the patients interviewed. Of these, about 33% suffer from allergic rhinitis, 13% from atopic dermatitis (which reaches 22% in the 25-34 age group) and 17% from allergic conjunctivitis. Furthermore, respiratory allergies are extremely widespread: according to the Doxa Pharma research, about 64% of the patients with severe asthma interviewed are allergic to dust and mites, about 48% to plants and pollen. Not to mention concomitant pathologies such as nasal polyposis (13% of young people between 25 and 34 years of age suffer from it) or eosinophilic esophagitis, which aggravate the clinical picture of asthma.

To complicate the picture often occur comorbidities due tochronic use of systemic corticosteroids, which affect 60% of the patients interviewed. These include, for example, type 2 diabetes, osteoporosis, gastrointestinal disorders or cataracts. The management of these adverse events involves huge costs for health every year: a recent analysis has in fact estimated that the costs associated with the management of adverse events from oral cortisone is equal to 242,7 million euros borne by the National Health Service. The data is even more significant if we consider patients with severe asthma and nasal polyposis, as their use of corticosteroids is longer-term (40% more) and for twice as many days each year (79 compared to 161 ) compared to patients without nasal polyposis.

"Patients with severe asthma, if they do not receive a correct functional, clinical and immunological diagnosis and appropriate treatment, tend not to be able to lead a normal life because the typical symptoms of asthma (such as dyspnoea, asthenia and a feeling of suffocation) become disabling and very intense, making even the simplest daily activities difficult - Explains Dr. Francesca Puggioni, Head of the Immunocenter Organizational Clinical Section of the Humanitas Research Hospital in Milan - It is therefore a pathology that can take over the quality of life of patients, also due to the feelings of fragility and fear that it can generate. Today we have new biological therapies available which represent a significant step forward in the treatment of pathologies caused by type 2 inflammation: it is necessary that patients are increasingly treated through a multidisciplinary approach, which includes the skills of different specialists, so that the best therapeutic path may be indicated and the development of other comorbidities may be limited ".

But the quality of life also falls on time required for medical examinations and for the administration of biological therapy in the hospital: 1 patient out of 2 being treated with biological drugs (51%) renounces his commitments for this reason and on average spends about 2 hours in his specialist doctor's office, for one in 4 at least once a month. 

The limits sometimes imposed by the symptomatic manifestations of the pathology also guide the worries about the future: 54% of patients with severe asthma fear that their asthma could worsen further, while about 32% are worried that they will no longer be able to do even small routine activities, concerns that grow more when considering the range aged from 12 to 24 years, so the fear of a future deterioration is close to 70%.

To learn to live with the disease and learn to manage it, it is essential for patients to be able to get more information, especially considering that access to information is one of the most unsatisfied needs and the most problematic for about one in two respondents: being able to benefit from information on possible exemptions related to severe asthma is a wish for about 82% of patients; being able to use a free toll-free number to manage any emergencies deriving from the disease could be useful for 43% of patients.

"Living with severe asthma is not easy, today more than ever - he has declared Simona Barbaglia, President of Breathe Together Onlus - Often years can pass from the onset of the first symptoms to the diagnosis: a long waiting period in which the patient, not knowing the pathology and not knowing with which tools he will be able to deal with it, can fall into despair. Correct information regarding the pathology, symptoms, causes and risk factors is essential to allow patients to have all the possibilities at their disposal to be able to know and manage themselves. Our hope for the future is that patients with respiratory diseases can be less and less taken care of only by the general practitioner, but that there may be an ever-increasing coordination between the health professionals involved so that they can receive adequate care at home and the appropriate taking charge of specialized centers in which all the specialists of the case converge. "

Severe asthma

Severe asthma is a respiratory disease caused by chronic inflammation of the respiratory tract, with persistent symptoms that are difficult to control and which can impair daily activities, sleep and quality of life. 

Characterized by chest tightness, shortness of breath, lung function limitation, increased exacerbations and chronic use of systemic cortisone, severe asthma interests between 3,5% and 10% of the asthmatic population (about 300.000 people in Italy, according to an estimate), with symptoms that remain uncontrolled despite adherence to maximum optimized therapy.

Despite its impact, severe asthma is often not recognized: patients may not be aware of the true severity of their condition.

Causes of severe asthma

Over the years, advances in scientific research on asthma have made it possible to determine how, in 50-70% of cases, at the basis of severe forms of asthma there is atype 2 inflammation, due to the reaction of the immune system to triggers, such as allergens, viruses or bacteria and which determines the severity and persistence of asthma symptoms.

At the basis of type 2 inflammation there is the action of some cytokines, among which the most prevalent are interleukins 4 and 13 (IL-4 and IL-13). Acting on the signaling cascade of these two interleukins can therefore help reduce type 2 inflammation and, consequently, control thesevere asthma with allergic, eosinophilic and mixed phenotype, that is the frequent situation in which the two phenotypes are co-expressed in the same patient.6 It is estimated that thesevere asthma with uncontrolled type 2 inflammation regards in Italy about 20.000 people.

Dupilumab

Joint research by Sanofi and Regeneron Pharmaceuticals Inc. led to the development of dupilumab, an all-human monoclonal antibody that works by quenching type 2 inflammation through inhibition of the IL-4 and IL-13-mediated signaling pathway. 

Today dupilumab is the only biological treatment approved in the European Union which, by reducing type 2 inflammation, can help patients limit the impact of severe asthma in terms of reducing exacerbations, improving lung function and quality. of life. In addition, dupilumab is approved in Europe and Italy for the treatment of adults with moderate to severe atopic dermatitis, and in Europe for chronic rhinosinusitis with nasal polyposis, often co-present in patients with asthma. Finally, it is also being studied in other comorbidities of asthma and / or dermatitis, such as eosinophilic esophagitis, allergic rhinitis and allergies. The current guidelines of the Global Initiative for Asthma (GINA) recommend therapies that act on multiple related diseases as the best approach to improve the health outcomes of people living with severe asthma.

Severe asthma, Doxa Pharma survey: patients looking for more information and support in daily life

| NEWS ' |