Skip to main content

Main menu

  • Home
  • Current issue
  • Early View
  • Archive
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • COVID-19 submission information
    • Institutional open access agreements
    • Peer reviewer login
  • Alerts
  • Subscriptions
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

User menu

  • Log in
  • Subscribe
  • Contact Us
  • My Cart

Search

  • Advanced search
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

Login

European Respiratory Society

Advanced Search

  • Home
  • Current issue
  • Early View
  • Archive
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • COVID-19 submission information
    • Institutional open access agreements
    • Peer reviewer login
  • Alerts
  • Subscriptions

FASE-CPHG study: a panoramic snapshot of difficult-to-treat, severe asthma in French nonacademic hospitals

Laurent Portel, Eric Parrat, Cécilia Nocent-Ejnaini, Gilles Mangiapan, Anne Prud'homme, Jean-Philippe Oster, Corinne Aperre de Vecchi, Cyril Maurer, Chantal Raherison, Didier Debieuvre
ERJ Open Research 2019 5: 00069-2019; DOI: 10.1183/23120541.00069-2019
Laurent Portel
1Centre Hospitalier de Libourne, Libourne, France
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: laurent.portel@ch-libourne.fr
Eric Parrat
2Centre Hospitalier de Polynésie Française, Hôpital du Taaone, Papeete, French Polynesia
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Cécilia Nocent-Ejnaini
3Centre Hospitalier de la Côte Basque, Bayonne, France
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Gilles Mangiapan
4Centre Hospitalier Intercommunal de Créteil, Service de Pneumologie, Créteil, France
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Anne Prud'homme
5Centre Hospitalier Intercommunal de Bigorre, Service de Pneumologie, Tarbes, France
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jean-Philippe Oster
6Centre Hospitalier Louis Pasteur, Service de Pneumologie, Colmar, France
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Corinne Aperre de Vecchi
7Centre Hospitalier d'Argenteuil, Argenteuil, France
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Cyril Maurer
8Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Montfermeil, France
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Chantal Raherison
9Groupe Hospitalier Sud, Hôpital du Haut-Lévêque, Pessac, France
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Didier Debieuvre
10Groupe Hospitalier de la Région Mulhouse Sud-Alsace, Hôpital Émile Muller, Service de Pneumologie, Mulhouse, France
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Didier Debieuvre
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

Figures

  • Tables
  • Supplementary Materials
  • FIGURE 1
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIGURE 1

    Study flow chart: pulmonologist participation and patient recruitment. CRF: case report form.

Tables

  • Figures
  • Supplementary Materials
  • TABLE 1

    Confirmation of severe asthma in the analysed population

    Confirmed severe asthmaNot confirmed severe asthmaMissing dataTotal
    Subjects137778101465
    GINA step
     Step 101 (1)1 (0)
     Step 2000
     Step 324 (2)8 (10)32 (2)
     Step 4565 (41)41 (53)606 (41)
     Step 5788 (57)28 (36)816 (56)
     Unknown1010 (1)
    Patient follow-up <6 months073 (94)73 (5)

    Data are presented as n or n (%). GINA: Global Initiative for Asthma.

    • TABLE 2

      Patient characteristics

      Subjects n1465
      Female921 (63)
      Age years54.4±16.1
       18–39281 (19)
       40–59586 (40)
       ≥60598 (41)
      BMI kg·m−227.6±6.2
       <1845 (3)
       18–24.99512 (35)
       25–29.99473 (32)
       ≥30435 (30)
      Physical activity level
       No activity440 (32)
       Occasional528 (38)
       Regular323(23)
       Common or at competition level99 (7)
       Missing data75
      Educational level
       Ongoing8 (1)
       No diploma420 (32)
       Certificate of general education (junior high school)413 (31)
       Baccalaureate (high school)200 (15)
       Post-baccalaureate diplomas (bachelor and graduate)285 (21)
       Missing data139
      Professional status
       Active596 (42)
       Inactive311 (22)
       Retired511 (36)
       Missing data47
      Smoking status
       Current smokers170 (12)
       Ex-smokers424 (29)
       Non-smokers871 (60)
      Smoking history pack·years−117.9±14.8
      History of atopy
       Personal atopy958 (65)
       Familial atopy566 (39)
      Animal exposure
       Domestic animals610 (42)
        Dogs385 (63)
        Cats341 (56)
        Others (rabbits, rodents, birds, …)64 (11)
       Nondomestic animals115 (8)
      Housing
       Urban697 (48)
       Rural391 (27)
       Semi-rural377 (26)
      Residence proximity to a pollution source148 (10)
      Residence proximity to a trunk road290 (20)

      Data are presented as n, n (%) or mean±sd. BMI: body mass index.

      • TABLE 3

        Asthma control

        Control according to GINA criteriaTotalp-value
        Well controlledPartially controlledUncontrolledMissing data
        Control assessed by the physician
         Well controlled50 (10.1)229 (46.1)217 (43.8)11507 (37.4)<0.0001
         Partially controlled2 (0.3)98 (17)479 (82.7)19598 (44.1)
         Uncontrolled1 (0.4)7 (2,9)236 (96.7)6250 (18.5)
         Missing data005712
        Total53 (4)334 (25.2)937 (70.8)431367 (100)

        Data are presented as n (%) or n, unless otherwise stated. GINA: Global Initiative for Asthma.

        • TABLE 4

          Asthma history

          Subjects1465
          Age at asthma onset years26.9±20.4
           ≤12496 (34)
           13–39544 (37)
           ≥40417 (29)
           Missing data8
          Asthma duration years27.4±17.9
          Pulmonology follow-up duration years13.5±12.7
          History of acute severe asthma757 (52)
          >2 exacerbations in the past year949 (65)
          Exacerbation history in the past year
           Medical consultations2.6±3.1
           Hospitalisations for asthma0.5±1.3
           Visits to emergency room0.6±1.7
           Severe exacerbation2.5±3.1
          Absenteeism from work/school due to asthma in the past year days35.3±68.1

          Data are presented as n, mean±sd or n (%).

          • TABLE 5

            Medical history and comorbidities

            Subjects1465
            Medical history
             Aspirin intolerance160 (10.9)
             Widal syndrome101 (6.9)
             Food allergy153 (10.5)
             Drug allergy207 (14.1)
             Atopic dermatitis225 (15.4)
             Allergic bronchopulmonary aspergillosis40 (2.7)
             Churg–Strauss syndrome15 (1)
             ENT disease862 (58.9)
              Chronic rhinitis655 (44.7)
              Chronic rhinosinusitis358 (24.5)
              Polyposis265 (18.1)
            Comorbidities (ENT disease excluded)
             No comorbidity387 (26.5)
             1 comorbidity435 (29.8)
             2 comorbidities290 (19.8)
             ≥3 comorbidities350 (23.9)
             Missing data3
            Gastro-oesophageal reflux disease573 (39.1)
            Arterial hypertension372 (25.5)
            Diabetes149 (10.2)
            Ischaemic cardiopathy72 (5)
            Sleep apnoea161 (11)
            Osteoporosis156 (10.7)
            Anxiety579 (39.5)
            Depression208 (14.2)
            Other mental disorder32 (2.2)
            Anxiety and depression determined with self-assessment questionnaires1367
            Anxiety level (HADS-A)7.4±4.4
             Presence of anxiety (score >7)583 (43.3)
             Absence of anxiety (score ≤7)763 (56.7)
             Missing data21
            Depression level (HADS-D)5.1±3.8
             Presence of depression (score >7)320 (23.6)
             Absence of depression (score ≤7)1038 (76.4)
             Missing data9

            Data are presented as n, n (%) or mean±sd. ENT: ear, nose and throat; HADS: Hospital Anxiety and Depression Scale; A: anxiety; D: depression.

            • TABLE 6

              Allergy-related asthma assessment

              Subjects1465
              Allergic sensitisation#
               No allergic sensitisation353 (24.2)
               At least one allergic sensitisation823 (56.4)
               No allergological exploration282 (19.3)
               Missing data7
              Positive allergic sensitisation tests
               Dust mite638 (77.5)
               Pollens469 (57)
               Domestics animals363 (44.1)
               Moulds/Alternaria alternate161 (19.6)
               Cockroach55 (6.77)
               Others (including flour and dust)68 (8.3)
              Cutaneous test1038 (71.2)
               Positive736 (71.2)
               Negative297 (28.8)
               Missing data5
              Total serum IgE test907 (62.2)
               Total serum IgE UI·L−1546.1±1013.2
              Specific serum IgE test544 (37.3)
               Positive310 (57.6)
               Negative228 (42.4)
               Missing data6
              Blood eosinophils count1092 (74.9)
               Blood eosinophils cells·mm−3436.8±466.4
               <300509 (46.7)
               300–499255 (23.4)
               ≥500327 (30.0)
              Aspergillus serology659 (45.2)
               Positive69 (10.5)
               Negative589 (89.5)
               Missing data1
              Multiallergic serum testing124 (9.3)
               Positive55 (44.7)
               Negative68 (55.3)
               Missing data1

              Data are presented as n, n (%) or mean±sd. Ig: immunoglobulin. #: defined by positive cutaneous test or positive specific serum IgE test.

              • TABLE 7

                Biology and lung function tests

                Subjects1465
                α1-antitrypsin test157 (10.8)
                 <0.8 g·L−16 (3.8)
                 0.8–0.99 g·L−14 (2.6)
                 ≥1 g·L−1145 (93.5)
                 Mean result g·L−11.3±0.4
                Pulmonary function tests1321 (98.2)
                 Time since last spirometry months2.1±8
                 Last spirometry assessed during the visit862 (65.6)
                 ≤6 months329 (25)
                 6–12 months64 (4.9)
                 >12 months59 (4.5)
                 Missing data7
                 Pre-bronchodilator FEV1 % pred72.1±20.6
                 Post-bronchodilator FEV1 % pred77.1±20.5
                 Pre-bronchodilator FEV1/FVC % pred70.2±14.4
                 FEV1/FVC <70% pred20%
                FEV1 evolution after β2-agonists %
                 No evolution243 (18.5)
                 Increase <10%363 (27.1)
                 Increase ≥10%304 (33.4)
                 Missing data411
                Exhaled nitric oxide measurements64 (4.4)
                 Results ppb37.5±26.2
                Chest CT scan754 (51.8)
                 Bronchiectasis156 (22)
                 Bronchial wall thickening307 (44)
                 Emphysema108 (15,5)
                ENT CT scan466 (16)
                 Absence of clinical signs135 (30.7)
                 Polyps119 (27)
                 Chronic sinusitis186 (42.3)
                 Missing data26

                Data are presented as n, n (%) or mean±sd. FEV1: forced expiratory volume in 1 s; FVC: forced vital capacity; CT: computed tomography; ENT: ear, nose and throat.

                • TABLE 8

                  Medications

                  Subjects1465
                  No LABA/ICS22 (1.5)
                  Inhaled corticosteroids only#136 (9.3)
                   <500 μg·day−121 (15.4)
                   500–1000 μg·day−141 (30.1)
                   1000–2000 μg·day−157 (41.9)
                   >2000 μg·day−115 (11)
                  LABAs only106 (7.2)
                  ICS/LABA combination#1326 (90.5)
                   <500 μg·day−162 (4.7)
                   500–1000 μg·day−1419 (31.6)
                   1000–2000 μg·day−1590 (44.5)
                   >2000 μg·day−1253 (19.1)
                  Anticholinergic treatment498 (34)
                  Antileukotriene (montelukast)759 (52.2)
                  Long-term oral corticosteroid therapy245 (16.8)
                   Mean daily dose¶ mg19.4±34.2
                  Anti-IgE (omalizumab)390 (26.8)
                   Dose mg347±155.3
                   Frequency of treatment
                    Every 2 weeks180 (46.9)
                    Every 4 weeks204 (53.1)
                    Missing data6
                   Duration of treatment years3.1±2.6
                  Theophylline97 (6.7)
                  Other therapies
                   Long-term azithromycin84 (5.6)
                   Antihistamine655 (45)
                   Antidepressants121 (8.3)
                   β-blocker26 (1.8)
                   Anti-GORD483 (33.2)
                   Postmenopausal hormone therapy14 (1.5)
                   Desensitisation in the previous 5 years54 (3.7)
                   Alternative medicine84 (5.8)
                  Patient adherence level according to physician
                   High1063 (78.5)
                   Medium245 (18.1)
                   Low47 (3.5)
                  Adherence level MMAS-4 score3.4±1
                   Adherent patient (score=4)835 (64.8)
                   Non-adherent patients (score <4)454 (35.2)
                   Missing data78

                  Data are presented as n, n (%) or mean±sd. LABA: long-acting β2-agonist; ICS: inhaled corticosteroid; Ig: immunoglobulin; GORD: gastro-oesophageal reflux disease; MMAS-4: four-item Morisky Medication Adherence Assessment Scale. #: doses are presented as equivalent beclomethasone dipropionate; ¶: doses are presented as equivalent prednisolone.

                  Supplementary Materials

                  • Figures
                  • Tables
                  • Supplementary Material

                    Please note: supplementary material is not edited by the Editorial Office, and is uploaded as it has been supplied by the author.

                    Supplementary figure 00069-2019.supplementary_figure

                    Supplementary material 00069-2019.supplementary_table

                  PreviousNext
                  Back to top
                  Vol 5 Issue 4 Table of Contents
                  ERJ Open Research: 5 (4)
                  • Table of Contents
                  • Index by author
                  Email

                  Thank you for your interest in spreading the word on European Respiratory Society .

                  NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

                  Enter multiple addresses on separate lines or separate them with commas.
                  FASE-CPHG study: a panoramic snapshot of difficult-to-treat, severe asthma in French nonacademic hospitals
                  (Your Name) has sent you a message from European Respiratory Society
                  (Your Name) thought you would like to see the European Respiratory Society web site.
                  CAPTCHA
                  This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
                  Print
                  Citation Tools
                  FASE-CPHG study: a panoramic snapshot of difficult-to-treat, severe asthma in French nonacademic hospitals
                  Laurent Portel, Eric Parrat, Cécilia Nocent-Ejnaini, Gilles Mangiapan, Anne Prud'homme, Jean-Philippe Oster, Corinne Aperre de Vecchi, Cyril Maurer, Chantal Raherison, Didier Debieuvre
                  ERJ Open Research Oct 2019, 5 (4) 00069-2019; DOI: 10.1183/23120541.00069-2019

                  Citation Manager Formats

                  • BibTeX
                  • Bookends
                  • EasyBib
                  • EndNote (tagged)
                  • EndNote 8 (xml)
                  • Medlars
                  • Mendeley
                  • Papers
                  • RefWorks Tagged
                  • Ref Manager
                  • RIS
                  • Zotero
                  Share
                  FASE-CPHG study: a panoramic snapshot of difficult-to-treat, severe asthma in French nonacademic hospitals
                  Laurent Portel, Eric Parrat, Cécilia Nocent-Ejnaini, Gilles Mangiapan, Anne Prud'homme, Jean-Philippe Oster, Corinne Aperre de Vecchi, Cyril Maurer, Chantal Raherison, Didier Debieuvre
                  ERJ Open Research Oct 2019, 5 (4) 00069-2019; DOI: 10.1183/23120541.00069-2019
                  del.icio.us logo Digg logo Reddit logo Technorati logo Twitter logo CiteULike logo Connotea logo Facebook logo Google logo Mendeley logo
                  Full Text (PDF)

                  Jump To

                  • Article
                    • Abstract
                    • Abstract
                    • Introduction
                    • Methods
                    • Results
                    • Discussion
                    • Supplementary material
                    • Acknowledgements
                    • Footnotes
                    • References
                  • Figures & Data
                  • Info & Metrics
                  • PDF

                  Subjects

                  • Asthma and allergy
                  • Tweet Widget
                  • Facebook Like
                  • Google Plus One

                  More in this TOC Section

                  Original articles

                  • Endobronchial autologous BM-MSCs in IPF patients
                  • Effect of β-blockers on the risk of COPD exacerbations
                  • Recurrence of symptoms after childhood LRTI
                  Show more Original articles

                  Asthma

                  • Specialist assessments in OCS-treated asthma in young adults
                  • Clinical response to biologicals for severe asthma
                  • Lung function in young adulthood
                  Show more Asthma

                  Related Articles

                  Navigate

                  • Home
                  • Current issue
                  • Archive

                  About ERJ Open Research

                  • Editorial board
                  • Journal information
                  • Press
                  • Permissions and reprints
                  • Advertising

                  The European Respiratory Society

                  • Society home
                  • myERS
                  • Privacy policy
                  • Accessibility

                  ERS publications

                  • European Respiratory Journal
                  • ERJ Open Research
                  • European Respiratory Review
                  • Breathe
                  • ERS books online
                  • ERS Bookshop

                  Help

                  • Feedback

                  For authors

                  • Instructions for authors
                  • Publication ethics and malpractice
                  • Submit a manuscript

                  For readers

                  • Alerts
                  • Subjects
                  • RSS

                  Subscriptions

                  • Accessing the ERS publications

                  Contact us

                  European Respiratory Society
                  442 Glossop Road
                  Sheffield S10 2PX
                  United Kingdom
                  Tel: +44 114 2672860
                  Email: journals@ersnet.org

                  ISSN

                  Online ISSN: 2312-0541

                  Copyright © 2022 by the European Respiratory Society