Byline: Mohamed. Abuzakouk, Omar. Ghorab, Bassam. Mahboub, Ashraf. Alzaabi, Mateen. Uzbeck, Mohsen. Nasir, Zaid. Zoumot, Deepa. Grandon, Yaser. El Sameed, Rajaie. Namas, Ali. Wahla, Jeffrey. Chapman, Khaled. Saleh, Fulvio. Salvo, Govinda. Bodi, Irfan. Shafiq
BACKGROUND: Severe asthma is a major burden on health-economic resources; hence, knoing the epidemiology of these patients is important in planning and provision of asthma care. In addition, identifying and managing the comorbidities helps improve symptoms and reduce associated morbidity and mortality. OBJECTIVES: Epidemiology of difficult asthma has not been ell studied in the Middle East, so in this study, e present the demographic and clinical characteristics of severe asthma in the United Arab Emirates (UAE). METHODS: We retrospectively revieed the notes of severe asthma patients attending three tertiary care hospitals beteen May 2015 and December 2019. Data on baseline demographics, asthma characteristics, treatment, and comorbidities ere collected. RESULTS: We revieed the notes of 458 patients (271 females and 187 males) that fulfilled the 2019 Global Initiative for Asthma guidelines for the diagnosis of severe asthma. The mean age as 47.7 (standard deviation 17.2) years. Males had significantly higher asthma control test scores (17.9 vs. 16, P = 0.01) and mean blood eosinophils (0.401 vs. 0.294, P <0.01) than females. The most common comorbidity observed as allergic rhinitis (52.2%) folloed by gastroesophageal reflux disease (27.1%). In total, 109 (23.8%) patients ere on biological therapies ith most patients being on omalizumab and dupilumab (29 and 18 patients, respectively). Most patients ere nonsmokers (97.2%), and majority ere of TH2-high phenotype (75.7%). CONCLUSIONS: In this first report of severe asthma characteristics in the UAE, e found a pattern of female preponderance and most patients having a Th2-high phenotype. The findings are likely to help optimize asthma care in the region in the era of biologic therapies.
Asthma is a chronic lung disease characterized by airay inflammation and hyper-responsiveness affecting almost 300 million people orldide. Asthma can be classified as mild, moderate, or severe, based on the intensity of treatment required to achieve asthma control. Severe asthma is defined as asthma that requires treatment ith high-dose inhaled corticosteroids (ICS) to maintain good control or as asthma that is poorly controlled despite the use of maximal optimized therapy and treatment of contributory factors. Severe asthma is reported to affect about 5%-10% of asthmatics. It is important to differentiate severe asthma from difficult-to-treat asthma, hich is defined as asthma that is poorly controlled due to correctable factors such as environmental allergens, comorbidities, poor medication compliance, and incorrect inhaler technique. While severe asthma is less prevalent than milder asthma severities, it remains a major cause of morbidity and mortality, orldide. In addition, it is associated ith a major socioeconomic, psychological, and treatment burden.
The clinical characteristics and phenotypes of severe asthma patients have been previously reported from various parts of the orld,,, and this knoledge has been particularly important for the development and application of novel biological therapies. In addition, severe asthma registries can be used for genetic profiling to help identify individuals...