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1. Persistence of both reversible airway obstruction and higher blood eosinophils may predict lung function decline in severe asthma

Author

Sposato B., Scalese M., Ricci A., Rogliani P., Paggiaro P., Migliorini M. G., Di Tomassi M., Olivieri C., Perrella A., Camiciottoli G., Maselli R., Pelaia G., Busceti M. T., Sabato E., Cagnazzo M. G., Colombo F., Palumbo L., Ravazzi A., Bucca C., Caiaffa M. F., Berra A., Calabrese C., Stanziola A. A., Schino P., Di Gioacchino M., Cazzola M., Segreti A., Pastorello E. A., Scibilia G., Vianello A., Marchi M. R., Paladini L., Baglioni S., Abbritti M., Almerigogna F., Matucci A., Vultaggio A., Maggi E., Maestrelli P., Guarnieri G., Steinhilber G., Bonavia M., Rottoli P., Bargagli E., Senna G., Caminati M., Macchia L., Bellia V., Scichilone N., Novelli F., Latorre M., Vergura L., Masieri S., Rosati Y., Milanese M., Folletti I., Pio R., Pio A., Maccari U., Maggiorelli C., Scala R., Vignale L., Pulera N., Carpagnano G. E., Foschino Barbaro M. P., Sposato B., Scalese M., Ricci A., Rogliani P., Paggiaro P., Migliorini M.G., Di Tomassi M., Olivieri C., Perrella A., Camiciottoli G., Maselli R., Pelaia G., Busceti M.T., Sabato E., Cagnazzo M.G., Colombo F., Palumbo L., Ravazzi A., Bucca C., Caiaffa M.F., Berra A., Calabrese C., Stanziola A.A., Schino P., Di Gioacchino M., Cazzola M., Segreti A., Pastorello E.A., Scibilia G., Vianello A., Marchi M.R., Paladini L., Baglioni S., Abbritti M., Almerigogna F., Matucci A., Vultaggio A., Maggi E., Maestrelli P., Guarnieri G., Steinhilber G., Bonavia M., Rottoli P., Bargagli E., Senna G., Caminati M., Macchia L., Bellia V., Scichilone N., Novelli F., Latorre M., Vergura L., Masieri S., Rosati Y., Milanese M., Folletti I., Pio R., Pio A., Maccari U., Maggiorelli C., Scala R., Vignale L., Pulera N., Carpagnano G.E., Foschino Barbaro M.P., Sposato, B., Scalese, M., Ricci, A., Rogliani, P., Paggiaro, P., Migliorini, M. G., Di Tomassi, M., Olivieri, C., Perrella, A., Camiciottoli, G., Maselli, R., Pelaia, G., Busceti, M. T., Sabato, E., Cagnazzo, M. G., Colombo, F., Palumbo, L., Ravazzi, A., Bucca, C., Caiaffa, M. F., Berra, A., Calabrese, C., Stanziola, A. A., Schino, P., Di Gioacchino, M., Cazzola, M., Segreti, A., Pastorello, E. A., Scibilia, G., Vianello, A., Marchi, M. R., Paladini, L., Baglioni, S., Abbritti, M., Almerigogna, F., Matucci, A., Vultaggio, A., Maggi, E., Maestrelli, P., Guarnieri, G., Steinhilber, G., Bonavia, M., Rottoli, P., Bargagli, E., Senna, G., Caminati, M., Macchia, L., Bellia, V., Scichilone, N., Novelli, F., Latorre, M., Vergura, L., Masieri, S., Rosati, Y., Milanese, M., Folletti, I., Pio, R., Pio, A., Maccari, U., Maggiorelli, C., Scala, R., Vignale, L., Pulera, N., Carpagnano, G. E., Foschino Barbaro, M. P., and Et, Al

Subjects
Pulmonary and Respiratory Medicine, severe asthma, medicine.medical_specialty, medicine.drug_class, Severe asthma, Eosinophil, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Gastroenterology, Persistence (computer science), 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Bronchodilator, allergic asthma, blood eosinophil, bronchodilator reversibility, lung function decline, severe asthma, salbutamol, Forced Expiratory Volume, medicine, Settore MED/10, Immunology and Allergy, Humans, 030212 general & internal medicine, Blood eosinophil, Lung, Genetics (clinical), Lung function, Bronchodilator Agent, allergic asthma, blood eosinophil, bronchodilator reversibility, lung function decline, salbutamol, bronchodilator agents, eosinophils, forced expiratory volume, humans, lung, airway obstruction, asthma, business.industry, Airway obstruction, medicine.disease, Asthma, Bronchodilator Agents, Airway Obstruction, Eosinophils, 030228 respiratory system, Salbutamol, Blood eosinophils, business, medicine.drug, Human
Abstract

Objective: This study analysed whether the persistence of both reversible airway obstruction (RAO) and elevated BE counts was associated to reduced asthma control and accelerated lung function decline in treated severe asthmatics. Methods: About 202 severe asthmatics were studied after 12–120months of step-5 treatment associated to anti-IgE therapy. Following treatments, reversibility tests, after inhaling 400 mcg of Salbutamol, were performed. FEV1>12% or ≤12% changes differentiated RAO+ from RAO− subjects. Blood eosinophil (BE) counts after treatment were considered. Results: Pre-/post-treatment bronchodilator FEV1% and ACT were lower (61% [50–71], 74.4% [62.5–83.7] and 20[18–22]), whereas BE were higher (380 cells/µl [170–590]) in RAO+ compared to RAO− subjects (77% [64–88], p=0.0001, 81.8% [66.1–94.3], p=0.0001, 21[18–23], p=0.045 and 230 cells/µl [80–360], p=0.003). A negative relationship between SABA-induced FEV1% changes and pre-bronchodilator FEV1% (β=−0.551%; p=0.0001) and ACT (β=−0.059; p=0.038) was found. Conversely, post-treatment BE levels were positively related (β=145.565 cells/µl; p=0.003) to FEV1>12% increases. A rising trend of pre-/post-bronchodilator FEV1% in time was observed in RAO− subjects with BE300 cells/µl reaching lower values after more than 36months of step-5 treatment (59.6% [39.9–72.1] vs 74[66.5–89.2] of RAO+ individuals with BE300 cells/µl [p=0.009]). Conclusion: Persistent SABA-induced FEV1>12%, especially when associated to BE>300 cells/ml, may be a marker of accelerated lung function decline in severe asthmatics despite maximal step-5 treatment. The highest bronchodilation associated to the lowest BE levels should be the main goal of asthma treatment to prevent such decline.

Published
2020

2. Clinical features associated with a doctor-diagnosis of bronchiectasis in the Severe Asthma Network in Italy (SANI) registry

Author

Malipiero, G., Paoletti, G., Blasi, F., Paggiaro, P., Senna, G., Latorre, M., Caminati, M., Carpagnano, G. E., Crimi, N., Spanevello, A., Aliberti, S., Canonica, G. W., Heffler, E., Bonavia, M., Bucca, C., Caiaffa, M. F., Calabrese, C., Camiciottoli, G, Caruso, C., Centanni, S., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., D'Alo, S., D'Amato, M., Del Giacco, S., Farsi, A., Favero, E., Foschino, B. M. P., Guarnieri, G., Guida, G., Lo Cicero, S., Lombardi, C., Macchia, L., Mazza, F., Menzella, F., Milanese, M., Montuschi, P., Montagni, M., Nucera, E., Parente, R., Passalacqua, G., Patella, V., Pelaia, G., Pini, L., Ricciardi, L., Ricciardolo, F. L. M., Richeldi, L., Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Solidoro, P., Spadaro, G., Vianello, A., Viviano, V., Yacoub, M. R., and Zappa, M. C.

Subjects
Pulmonary and Respiratory Medicine, Severe asthma, Pediatrics, medicine.medical_specialty, bronchiectasis, macromolecular substances, registry, phenotypes, real-life, 03 medical and health sciences, 0302 clinical medicine, immune system diseases, Humans, Immunology and Allergy, Medicine, Registries, 030212 general & internal medicine, Bronchiectasis, business.industry, musculoskeletal, neural, and ocular physiology, Public Health, Environmental and Occupational Health, medicine.disease, Asthma, respiratory tract diseases, Italy, nervous system, 030228 respiratory system, Quality of Life, business
Abstract

Several severe asthma comorbidities have been identified: an emerging one is bronchiectasis. We evaluated the frequency of bronchiectasis on severe asthma in a real-life setting, through the 'Severe Asthma Network Italy' (SANI) registry.SANI registry encompasses demographic, clinical, functional and inflammatory data of Italian severe asthmatics. Data obtained by the enrolled patients were analyzed, focusing the attention on those patients with concomitant clinically relevant bronchiectasis.About 15.5% patients have bronchiectasis. Bronchiectasis diagnosis was associated with a higher prevalence of chronic rhinosinusitis with nasal polyps (54.6% vs. 38%, p = 0.001) and higher serum IgE levels (673.4 vs. 412.1 kUI/L, p = 0.013). Patients with bronchiectasis had worse asthma control (ACT: 16.7 vs 18.2, p = 0.013), worse quality of life (AQLQ: 4.08 vs. 4.60, p = 0.02) and lower lung function (FEVsevere asthma associated with bronchiectasis represents a particularly severe asthma variant, possibly driven by an eosinophilic endotype. We, therefore, suggest that bronchiectasis should necessarily be assessed in severe asthmatic patients.

Published
2020
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3. Chronic rhinosinusitis with nasal polyps impact in severe asthma patients: Evidences from the Severe Asthma Network Italy (SANI) registry

Author

Canonica, Gw, Blasi, F., Paggiaro, PL. Senna G. E., Passalacqua, G., Spanevello, A., Aliberti, S., Bagnasco, D., Bonavia, M. Bonini M., Bucca, C., Brussino, L., Caiaffa, M. F., Calabrese, C., Camiciottoli, G., Caminati, M., Carpagnano, G. E., Caruso, C., Centanni, S., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., Crimi, N., D’Alo, S., D’Amato, M., Del Giacco, S., Farsi, A., Favero, E., Foschino Barbaro, M. P., Guarnieri, G., Guida, G., Latorre, M., Lo Cicero, S., Lombardi, C., Macchia, L., Mazza, F., Menzella, F., Milanese, M., Montagn, i. M., Montuschi, P., Nucera, E., Parente, R., Patella, V., Pelaia, G., Pini, L., Puggioni, F., Ricciardi, L., Ricciardolo, F. L. M., Richeldi, L., Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Spadaro, G., Yacoub, Mr., Vianello, A., Viviano, V., Zappa, M. C., Heffler, E., Canonica, G. W., Malvezzi, L., Blasi, F., Paggiaro, P., Mantero, M., Senna, G., Heffler, E., Bonavia, M., Caiaffa, P., Calabrese, C., Camiciottoli, G., Caruso, C., Centanni, S., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., Crimi, N., D'Alo, S., D'Amato, M., Del Giacco, S., Favero, E., Farsi, A., Foschino, B. P. M., Guarnieri, G., Latorre, M., Lombardi, C., Macchia, L., Menzella, F., Milanese, M., Montuschi, P., Nucera, E., Parente, R., Passalacqua, G., Patella, V., Pelaia, G., Pini, L., Ricciardolo, F. L. M., Ricciardi, L., Richeldi, L., Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Solidoro, P., Spadaro, G., Spanevello, A., Vianello, A., Yacoub, M. R., Zappa, M. C., Canonica G.W., Malvezzi L., Blasi F., Paggiaro P., Mantero M., Senna G., Heffler E., Bonavia M., Caiaffa P., Calabrese C., Camiciottoli G., Caruso C., Centanni S., Conte M.E., Corsico A.G., Cosmi L., Costantino M.T., Crimi N., D'Alo S., D'Amato M., Del Giacco S., Favero E., Farsi A., Foschino B.P.M., Guarnieri G., Guida G., Latorre M., Lombardi C., Macchia L., Menzella F., Milanese M., Montuschi P., Nucera E., Parente R., Passalacqua G., Patella V., Pelaia G., Pini L., Ricciardolo F.L.M., Ricciardi L., Richeldi L., Ridolo E., Rolla G., Santus P., Scichilone N., Solidoro P., Spadaro G., Spanevello A., Vianello A., Yacoub M.R., and Zappa M.C.

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, Severe asthma, Databases, Factual, Administration, Oral, Comorbidity, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Nitric Oxide, Severity of Illness Index, Comorbidities, Oral corticosteroid, Adrenal Cortex Hormones, Internal medicine, Severity of illness, Oral corticosteroids, medicine, Prevalence, Nasal polyps, Humans, Registries, Sinusitis, Asthma, Aged, Rhinitis, Internet, Bronchiectasis, business.industry, Nasal polyp, Settore MED/09 - MEDICINA INTERNA, Atopic dermatitis, Middle Aged, medicine.disease, Comorbidities, Nasal polyps, Oral corticosteroids, Severe asthma, Italy, Concomitant, Chronic Disease, Disease Progression, Female, Comorbiditie, business
Abstract

Background The clinical and laboratory features of patients enrolled in the Severe Asthma Network in Italy (SANI) registry, a web-based observatory collecting demographic, clinical, functional and inflammatory data of patients with severe asthma were evaluated, with a special emphasis to chronic rhinosinusitis with nasal polyposis (CRSwNP). Methods For each eligible patients the following information has been collected: demographic data, clinical features, asthma control in the previous month according to the GINA (Global INitiative for Asthma) Guidelines and standardized questionnaires, concomitant regular and on demand treatments and inflammatory markers. Results 695 patients with severe asthma enrolled in 66 SANI centers were analyzed. The prevalence of chronic rhinosinusitis with nasal polyposis was 40.6%. Atopic dermatitis and bronchiectasis was significantly more frequent in patients with CRSwNP than in subjects without nasal polyposis; similarly, FeNO values are significantly higher in subject with CRSwNP than in patients without nasal polyposis. Finally, patients with CRSwNP had a significantly higher number of asthma exacerbations per year, more days on oral corticosteroids and were more likely to be OCS long term users. Conclusion OCS sparing is needed in patients with severe asthma, mainly in subjects with CRSwNP, adopting adequate strategies such as a better adherence to the treatment with inhaled therapy according to the GINA recommendations, the use of biologic agents and a multidisciplinary approach of the patient.

Published
2020

4. Higher blood eosinophil levels after omalizumab treatment may be associated with poorer asthma outcomes

Author

Sposato, B, Scalese, M, Milanese, M, Masieri, S, Cavaliere, C, Latorre, M, Scichilone, N, Ricci, A, Cresti, A, Santus, P, Olivieri, C, Perrella, A, Rogliani, P, Paggiaro, P, Migliorini, M. G, Di Tomassi, M, Camiciottoli, G, Maselli, R, Pelaia, G, Busceti, M. T, Sabato, E, Cagnazzo, M. G, Colombo, F, Palumbo, L, Ravazzi, A, Bucca, C, Caiaffa, M. F, Berra, A, Calabrese, C, Stanziola, A. A, Schino, P, Di Gioacchino, M, Cazzola, M, Segreti, A, Pastorello, E. A, Scibilia, G, Vianello, A, Marchi, M. R, Paladini, L, Baglioni, S, Abbritti, M, Almerigogna, F, Matucci, A, Vultaggio, A, Maggi, E, Maestrelli, P, Guarnieri, G, Steinhilber, G, Bonavia, M, Rottoli, P, Bargagli, E, Senna, G, Caminati, M, Macchia, L, Bellia, V, Novelli, F, Vergura, L, Rosati, Y, Folletti, I, Pio, R, Pio, A, Maccari, U, Maggiorelli, C, Scala, R, Vignale, L, Pulerà, N, Carpagnano, G. E, Foschino Barbaro, M. P, The Omalizumab Italian Study Group, Sposato, B, Scalese, M, Milanese, M, Masieri, S., Cavaliere, C, Latorre, M., Scichilone, N., Ricci, A., Cresti, A., Santus, P., Olivieri, C., Perrella, A., Rogliani, P., Paggiaro, P., Sposato, B., Migliorini, M. G., Di Tomassi, M., Camiciottoli, G., Maselli, R., Pelaia, G., Busceti, M. T., Sabato, E., Cagnazzo, M. G., Colombo, F., Palumbo, L., Ravazzi, A., Bucca, C., Caiaffa, M. F., Berra, A., Calabrese, C., Stanziola, A. A., Schino, P., Di Gioacchino, M., Cazzola, M., Segreti, A., Pastorello, E. A., Scibilia, G., Vianello, A., Marchi, M. R., Paladini, L., Baglioni, S., Abbritti, M., Almerigogna, F., Matucci, A., Vultaggio, A., Maggi, E., Maestrelli, P., Guarnieri, G., Steinhilber, G., Bonavia, M., Rottoli, P., Bargagli, E., Senna, G., Caminati, M., Macchia, L., Bellia, V., Novelli, F., Vergura, L., Scalese, M., Rosati, Y., Milanese, M., Folletti, I., Pio, R., Pio, A., Maccari, U., Maggiorelli, C., Scala, R., Vignale, L., Pulera, N., Carpagnano, G. E., Foschino Barbaro, M. P., Cavaliere, C., Sposato B., Scalese M., Milanese M., Masieri S., Cavaliere C., Latorre M., Scichilone N., Ricci A., Cresti A., Santus P., Olivieri C., Perrella A., Rogliani P., Paggiaro P., Migliorini M.G., Di Tomassi M., Camiciottoli G., Maselli R., Pelaia G., Busceti M.T., Sabato E., Cagnazzo M.G., Colombo F., Palumbo L., Ravazzi A., Bucca C., Caiaffa M.F., Berra A., Calabrese C., Stanziola A.A., Schino P., Di Gioacchino M., Cazzola M., Segreti A., Pastorello E.A., Scibilia G., Vianello A., Marchi M.R., Paladini L., Baglioni S., Abbritti M., Almerigogna F., Matucci A., Vultaggio A., Maggi E., Maestrelli P., Guarnieri G., Steinhilber G., Bonavia M., Rottoli P., Bargagli E., Senna G., Caminati M., Macchia L., Bellia V., Novelli F., Vergura L., Rosati Y., Folletti I., Pio R., Pio A., Maccari U., Maggiorelli C., Scala R., Vignale L., Pulera N., Carpagnano G.E., and Foschino Barbaro M.P.

Subjects
Adult, Male, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Treatment outcome, MEDLINE, Omalizumab, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Immunoglobulin E, eosinophil, Omalizumab, anti-IgE, asthma, Leukocyte Count, Text mining, Forced Expiratory Volume, Internal medicine, Eosinophilia, medicine, Humans, Immunology and Allergy, Anti-Asthmatic Agents, Blood eosinophil, Aged, Retrospective Studies, Asthma, biology, business.industry, Retrospective cohort study, Middle Aged, asthma, Prognosis, medicine.disease, Eosinophils, Treatment Outcome, inflammation, biology.protein, Female, business, medicine.drug
Published
2019

5. Effects of omalizumab in severe asthmatics across ages: A real life Italian experience

Author

Sposato, B., Scalese, M., Latorre, M., Scichilone, N., Matucci, A., Milanese, M., Masieri, Simonetta, Rolla, G., Steinhilber, G., Rosati, Y., Vultaggio, A., Folletti, I., Baglioni, S., Bargagli, E., Di Tomassi, M., Pio, R., Pio, A., Maccari, U., Maggiorelli, C., Migliorini, M. G., Vignale, L., PulerÃ&nbsp, Carpagnano, G. E., Foschino Barbaro, M. P., Perrella, A., Paggiaro, P. L., Sposato, B., Scalese, M., Latorre, M., Scichilone, N., Matucci, A., Milanese, M., Masieri, S., Rolla, G., Steinhilber, G., Rosati, Y., Vultaggio, A., Folletti, I., Baglioni, S., Bargagli, E., Di Tomassi, M., Pio, R., Pio, A., Maccari, U., Maggiorelli, C., Migliorini, M., Vignale, L., Pulerà, N., Carpagnano, G., Foschino Barbaro, M., Perrella, A., and Paggiaro, P.

Subjects
Male, Severe asthma, Pediatrics, Comorbidity, Omalizumab, Overweight, Immunoglobulin E, Severity of Illness Index, Elderly, 0302 clinical medicine, Adrenal Cortex Hormones, Forced Expiratory Volume, Age effect, Anti-Asthmatic Agents, asthma, allergy, elderly, omalizumab, 030212 general & internal medicine, Young adult, biology, Real-life, Adrenergic beta-Agonists, Middle Aged, Treatment Outcome, Italy, Female, medicine.symptom, medicine.drug, Adult, Pulmonary and Respiratory Medicine, age effect, elderly, omalizumab, real-life, severe asthma, medicine.medical_specialty, Adolescent, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Antibodies, Monoclonal, Humanized, Young Adult, 03 medical and health sciences, Administration, Inhalation, Severity of illness, medicine, Humans, Aged, Retrospective Studies, Asthma, business.industry, Retrospective cohort study, asthma, allergy, medicine.disease, 030228 respiratory system, biology.protein, business
Abstract

Background This retrospective study aimed at evaluating long-term effects of Omalizumab in elderly asthmatics in a real-life setting. Methods 105 consecutive severe asthmatics (GINA step 4–5; mean FEV1% predicted:66 ± 15.7) treated with Omalizumab for at least 1 year (treatment mean duration 35.1 ± 21.7 months) were divided into 3 groups according to their age at Omalizumab treatment onset: 18–39, 40–64 and ≥ 65 years. Results Comorbidities, number of overweight/obese subjects and patients with late-onset asthma were more frequent among older people. A similar reduction of inhaled corticosteroids dosage and SABA on-demand therapy was observed in all groups during Omalizumab treatment; a similar FEV1 increased was also observed. Asthma Control Test (ACT) improved significantly (p

Published
2016
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6. RItA: The Italian severe/uncontrolled asthma registry

Author

Maio, S., Baldacci, S., Bresciani, M., Simoni, M., Latorre, M., Murgia, N., Spinozzi, F., Braschi, M., Antonicelli, L., Brunetto, B., Iacovacci, P., Roazzi, P., Pini, C., Pata, M., La Grasta, L., Paggiaro, P., Viegi, G., Angino, A., Carrozzi, L., Cerrai, S., Di Pede, F., Martini, F., Pala, A. P., Pistelli, F., Sarno, G., Silvi, P., Novelli, F., Ferri, M., and Bonifazi, F.

Subjects
Adult, Male, severe/uncontrolled asthma, medicine.medical_specialty, Exacerbation, Immunology, NO, 03 medical and health sciences, 0302 clinical medicine, exacerbations, pharmacological treatment, Internal medicine, eosinophilic inflammation, medicine, Humans, Immunology and Allergy, Nasal polyps, Registries, 030212 general & internal medicine, Sinusitis, Aged, Asthma, business.industry, Comorbidity, Eosinophilic inflammation, Exacerbations, Pharmacological treatment, Severe/uncontrolled asthma, Emergency department, Middle Aged, medicine.disease, Obesity, Allergic conjunctivitis, comorbidity, Italy, 030228 respiratory system, comorbidity, eosinophilic inflammation, exacerbations, pharmacological treatment, severe/uncontrolled asthma, Physical therapy, Female, business
Abstract

Background The Italian severe/uncontrolled asthma (SUA) web-based registry encompasses demographic, clinical, functional, inflammatory data; it aims to raise SUA awareness, identifying specific phenotypes and promoting optimal care. Methods 493 adult patients from 27 Italian centres (recruited in 2011-2014) were analyzed. Results Mean age was 53.8yrs. SUA patients were more frequently female (60.6%), with allergic asthma (83.1%). About 30% showed late onset of asthma diagnosis/symptoms (>40yrs); the mean age for asthma symptoms onset was 30.2yrs and for asthma diagnosis 34.4yrs. 97.1% used ICS (dose 2000 BDP), 93.6% LABA in association with ICS, 53.3% LTRAs, 64.1% anti-IgE, 10.7% theophylline, 16.0% oral corticosteroids. Mean FEV1% pred of 75.1%, median values of 300/mm3 of blood eosinophil count, 323 kU/l of serum total IgE, 24 ppb of FENO were shown. Most common comorbidities were allergic rhinitis (62.4%), gastroesophageal reflux (42.1%), sinusitis (37.9%), nasal polyposis (30.2%), allergic conjunctivitis (30.2%). 55.7% of SUA patients had exacerbations in the last 12 months, 9.7% emergency department visits, 7.3% hospitalizations. Factors associated with exacerbation risk were: obesity (OR, 95%CI 2.46, 1.11-5.41), psychic disorders (2.87, 0.89-9.30 - borderline), nasal polyps (1.86, 0.88-3.89 - borderline), partial/poor asthma treatment adherence (2.54, 0.97-6.67 - borderline), anti-IgE use in a protective way (0.26, 0.12-0.53). Comparisons to severe asthma multicentre studies and available registries showed data consistency across European and American populations. Conclusions An international effort in the implementation of SUA patients registries could help to better understand the clinical features and to manage severe asthma, representing a non negligible socio-economic burden for health services. This article is protected by copyright. All rights reserved.

Published
2017
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7. Frequency of tiotropium bromide use and clinical features of patients with severe asthma in a real-life setting: Data from the severe asthma network in Italy (sani) registry

Author

Puggioni, F., Brussino, L., Canonica, G. W., Blasi, F., Paggiaro, P., Caminati, M., Latorre, M., Heffler, E., Senna, G., Sani, Group, Bonavia, M., Caiaffa, Mf., Calabrese, C., Camiciottoli, G., Caruso, C., Centanni, S., Conte, Me., Corsico, Ag., Cosmi, L., Costantino, Mt., Crimi, N., D’Alo, S., D’Amato, M., Del Giacco, S., Farsi, A., Favero, E., Foschino, Bmp., Guarnieri, G., Guida, G., Yacoub, Mr., Lombardi, C., Macchia, L., Mazza, F., Menzella, F., Milanese, M., Montuschi, P., Nucera, E., Paoletti, G., Parente, R., Passalacqua, G., Patella, V., Pelaia, G., Pini, L., Ricciardi, L., Ricciardolo, Flm., Richeldi, L., Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Solidoro, P., Spadaro, G., Spanevello, A., Vianello, A., Zappa, Mc., Concetta, Sirena., Daniela, Morrone, and Silvia, Rabotti

Subjects
lcsh:Immunologic diseases. Allergy, Pulmonary and Respiratory Medicine, severe asthma, registry, long-acting muscarinic antagonists, real-ligfe, medicine.medical_specialty, Registry, Severe asthma, Respimat, real-life, Exacerbation, Long-acting muscarinic antagonists, Real-life, Umeclidinium bromide, Internal medicine, Journal of Asthma and Allergy, Immunology and Allergy, Medicine, Glycopyrronium bromide, Original Research, Asthma, Bronchiectasis, biology, business.industry, Tiotropium bromide, Lama, medicine.disease, biology.organism_classification, respiratory tract diseases, real-ligfe, lcsh:RC581-607, business, medicine.drug
Abstract

Francesca Puggioni,1,2 Luisa Brussino,3 Giorgio Walter Canonica,1,2 Francesco Blasi,4,5 Pierluigi Paggiaro,6 Marco Caminati,7,8 Manuela Latorre,6 Enrico Heffler,1,2 Gianenrico Senna7,8 On behalf of the Severe Asthma Network in Italy (SANI) group1Personalized Medicine, Asthma and Allergy – Humanitas Clinical and Research Center, IRCCS – Rozzano (MI), Milan, Italy; 2Department of Biomedical Sciences, Humanitas University – Pieve Emanuele (MI), Milan, Italy; 3Dipartimento di Scienze Mediche, SSDDU Allergologia e Immunologia Clinica, Università degli Studi di Torino, AO Ordine Mauriziano Umberto I – Torino, Torino, Italy; 4Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; 5Internal Medicine Department, Respiratory Unit and Adult Cystic Fibrosis Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy; 6Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Italy; 7Department of Medicine, University of Verona, Verona, Italy; 8Allergy Unit and Asthma Center, Verona University Hospital, Verona, Verona, ItalyCorrespondence: Enrico HefflerPersonalized Medicine, Asthma and Allergy, Istituto Clinico Humanitas, Milan, ItalyTel +39 0288247013Fax + 39 0282246484Email enrico.heffler@hunimed.euPurpose: Patients with uncontrolled asthma despite high doses of inhaled corticosteroid therapy plus another controller are defined as severe asthmatics. Tiotropium bromide respimat (TBR) is the only long-acting muscarinic antagonists (LAMA) approved for severe asthma. The aim of this study was to explore the frequency of severe asthmatics treated with TBR and characterize their clinical features in a real-life, registry-based setting.Materials and Methods: Baseline data from the Severe Asthma Network in Italy (SANI) registry have been analyzed to determine the use of TBR and other LAMA, and to compare clinical, functional and inflammatory features associated with the use of LAMA.Results: Among a total of 698 enrolled patients, 35.9% were treated with LAMA (23.3% TBR, 4.5% tiotropium bromide handihaler, 4.5% aclidinium, 3.4% glycopyrronium bromide 0.3% umeclidinium bromide). Age of asthma onset was higher in patients taking LAMA, whom, compared to others were more frequently former smokers. They also had a higher annual exacerbation rate, experienced worst asthma control, worst disease-related quality of life and poorer lung function. Bronchiectasis was more frequently found in LAMA users (25.9% vs 13.1%).Conclusion: TBR is still underused in severe asthma in a real-life setting, while a relevant proportion of patients are treated with other LAMA that are not approved for severe asthma treatment. Patients taking LAMA have features characteristic of even more severe asthma.Keywords: severe asthma, registry, long-acting muscarinic antagonists, real-ligfe

Published
2020

8. Worldwide comparison of ovarian cancer survival: Histological group and stage at diagnosis (CONCORD-2)

Author

Matz, M., Coleman, M., Carreira, H., Salmerã³n, D., Chirlaque, M., Allemani, C., Bouzbid, S., Hamdi-chérif, M., Zaidi, Z., Bah, E., Swaminathan, R., Nortje, S., El Mistiri, M., Bayo, S., Malle, B., Manraj, S., Sewpaul-sungkur, R., Fabowale, A., Ogunbiyi, O., Bradshaw, D., Somdyala, N., Stefan, D., Abdel-rahman, M., Jaidane, L., Mokni, M., Kumcher, I., Moreno, F., González, M., Laura, E., Espinola, S., Calabrano, G., Carballo Quintero, B., Fita, R., Garcilazo, D., Giacciani, P., Diumenjo, M., Laspada, W., Green, M., Lanza, M., Ibañez, S., Lima, C., Lobo De Oliveira, E., Daniel, C., Scandiuzzi, C., De Souza, P., Melo, C., Del Pino, K., Laporte, C., Curado, M., De Oliveira, J., Veneziano, C., Veneziano, D., Latorre, M., Tanaka, L., Azevedo E. Silva, G., Galaz, J., Moya, J., Herrmann, D., Vargas, S., Herrera, V., Uribe, C., Bravo, L., Arias-ortiz, N., Jurado, D., Yépez, M., Galán, Y., Torres, P., Martínez-reyes, F., Pérez-meza, M., Jaramillo, L., Quinto, R., Cueva, P., Yépez, J., Torres-cintrón, C., Tortolero-luna, G., Alonso, R., Barrios, E., Nikiforuk, C., Shack, L., Coldman, A., Woods, R., Noonan, G., Turner, D., Kumar, E., Zhang, B., Mccrate, F., Ryan, S., Hannah, H., Dewar, R., Macintyre, M., Lalany, A., Ruta, M., Marrett, L., Nishri, D., Mcclure, C., Vriends, K., Bertrand, C., Louchini, R., Robb, K., Stuart-panko, H., Demers, S., Wright, S., George, J., Shen, X., Brockhouse, J., O'Brien, D., Ward, K., Almon, L., Bates, J., Rycroft, R., Mueller, L., Phillips, C., Brown, H., Cromartie, B., Schwartz, A., Vigneau, F., Mackinnon, J., Wohler, B., Bayakly, A., Clarke, C., Glaser, S., West, D., Hernandez, B., Johnson, C., Jozwik, D., Charlton, M., Lynch, C., Huang, B., Tucker, T., Deapen, D., Liu, L., Hsieh, M., Xc, W., Stern, K., Gershman, S., Knowlton, R., Alverson, J., Copeland, G., Rogers, D., Lemons, D., Williamson, L., Hood, M., Hosain, G., Rees, J., Pawlish, K., Stroup, A., Key, C., Wiggins, C., Kahn, A., Schymura, M., Leung, G., Rao, C., Giljahn, L., Warther, B., Pate, A., Patil, M., Schubert, S., Rubertone, J., Slack, S., Fulton, J., Rousseau, D., Janes, Ta:, S., Bolick, S., Hurley, D., Richards, J., Whiteside, M., Nogueira, L., Herget, K., Sweeney, C., Martin, J., Wang, S., Harrelson, D., Keitheri Cheteri, M., Farley, S., Hudson, A., Borchers, R., Stephenson, L., Espinoza, J., Weir, H., Edwards, B., Wang, N., Yang, L., Chen, J., Song, G., Xp, G., Zhang, P., Hm, G., Zhao, D., Zhang, J., Zhu, F., Tang, J., Shen, Y., Wang, J., Ql, L., Yang, X., Dong, J., Li, W., Cheng, L., Huang, Q., Huang, S., Guo, G., Wei, K., Chen, W., Zeng, H., Demetriou, A., Pavlou, P., Mang, W., Ngan, K., Kataki, A., Krishnatreya, M., Jayalekshmi, P., Sebastian, P., Sapkota, S., Verma, Y., Nandakumar, A., Suzanna, E., Keinan-boker, L., Silverman, B., Ito, H., Nakagawa, H., Hattori, M., Kaizaki, Y., Sugiyama, H., Utada, M., Katayama, K., Narimatsu, H., Kanemura, S., Koike, T., Miyashiro, I., Yoshii, M., Oki, I., Shibata, A., Matsuda, T., Nimri, O., Ab Manan, A., Bhoo-pathy, N., Tuvshingerel, S., Chimedsuren, O., Al Khater, A., Al-eid, H., Jung, K., Won, Y., Chiang, C., Lai, M., Suwanrungruang, K., Wiangnon, S., Daoprasert, K., Pongnikorn, D., Geater, S., Sriplung, H., Eser, S., Yakut, C., Hackl, M., Mühlböck, H., Oberaigner, W., Zborovskaya, A., Aleinikova, O., Henau, K., Van Eycken, L., Dimitrova, N., Valerianova, Z., Šekerija, M., Zvolský, M., Engholm, G., Storm, H., Innos, K., Mägi, M., Malila, N., Seppä, K., Jégu, J., Velten, M., Cornet, E., Troussard, X., Bouvier, A., Faivre, J., Guizard, A., Bouvier, V., Launoy, G., Arveux, P., Maynadié, M., Mounier, M., Fournier, E., Woronoff, A., Daoulas, M., Clavel, J., Le Guyader-peyrou, S., Monnereau, A., Trétarre, B., Colonna, M., Cowppli-bony, A., Molinié, F., Bara, S., Degré, D., Ganry, O., Lapôtre-ledoux, B., Grosclaude, P., Estève, J., Bray, F., Piñeros, M., Sassi, F., Stabenow, R., Eberle, A., Erb, C., Nennecke, A., Kieschke, J., Sirri, E., Kajueter, H., Emrich, K., Zeissig, S., Holleczek, B., Eisemann, N., Katalinic, A., Brenner, H., Asquez, R., Kumar, V., Ólafsdóttir, E., Tryggvadóttir, L., Comber, H., Walsh, P., Sundseth, H., Devigili, E., Mazzoleni, G., Giacomin, A., Bella, F., Castaing, M., Sutera, A., Gola, G., Ferretti, S., Serraino, D., Zucchetto, A., Lillini, R., Vercelli, M., Busco, S., Pannozzo, F., Vitarelli, S., Ricci, P., Pascucci, C., Autelitano, M., Cirilli, C., Federico, M., Fusco, M., Vitale, M., Usala, M., Cusimano, R., Mazzucco, W., Michiara, M., Sgargi, P., Maule, M., Sacerdote, C., Tumino, R., Di Felice, E., Vicentini, M., Falcini, F., Cremone, L., Budroni, M., Cesaraccio, R., Contrino, M., Tisano, F., Fanetti, A., Maspero, S., Candela, G., Scuderi, T., Gentilini, M., Piffer, S., Rosso, S., Sacchetto, L., Caldarella, A., La Rosa, F., Stracci, F., Contiero, P., Tagliabue, G., Dei Tos, A., Zorzi, M., Zanetti, R., Baili, P., Berrino, F., Gatta, G., Sant, M., Capocaccia, R., De Angelis, R., Liepina, E., Maurina, A., Smailyte, G., Agius, D., Calleja, N., Siesling, S., Visser, O., Larønningen, S., Møller, B., Dyzmann-sroka, A., Trojanowski, M., Góźdż, S., Mężyk, R., Grądalska-lampart, M., Radziszewska, A., Didkowska, J., Wojciechowska, U., Błaszczyk, J., Kępska, K., Bielska-lasota, M., Kwiatkowska, K., Forjaz, G., Rego, R., Bastos, J., Silva, M., Antunes, L., Bento, M., Mayer-da-silva, A., Miranda, A., Coza, D., Todescu, A., Valkov, M., Adamcik, J., Safaei Diba, C., Primic-žakelj, M., Žagar, T., Stare, J., Almar, E., Mateos, A., Quirós, J., Bidaurrazaga, J., Larrañaga, N., Díaz García, J., Marcos, A., Marcos-gragera, R., Vilardell Gil, M., Molina, E., Sánchez, M., Franch Sureda, P., Ramos Montserrat, M., Navarro, C., Ardanaz, E., Moreno-iribas, C., Fernández-delgado, R., Peris-bonet, R., Galceran, J., Khan, S., Lambe, M., Camey, B., Bouchardy, C., Usel, M., Ess, S., Herrmann, C., Bulliard, J., Maspoli-conconi, M., Frick, H., Kuehni, C., Schindler, M., Bordoni, A., Spitale, A., Chiolero, A., Konzelmann, I., Dehler, S., Matthes, K., Rashbass, J., Stiller, C., Fitzpatrick, D., Gavin, A., Bannon, F., Black, R., Brewster, D., Huws, D., White, C., Finan, P., Bonaventure, A., Di Carlo, V., Harewood, R., Liu, K., Montel, L., Nikšić, M., Rachet, B., Sanz, N., Spika, D., Stephens, R., Peake, M., Chalker, E., Newman, L., Baker, D., Soeberg, M., Aitken, J., Scott, C., Stokes, B., Venn, A., Farrugia, H., Giles, G., Threlfall, T., Currow, D., You, H., Hendrix, J., Lewis, C., Matz, M, Coleman, M, Carreira, H, Salmeròn, D, Chirlaque, M, Allemani, C, and Mazzucco, W

Subjects
0301 basic medicine, Oncology, Settore MED/42 - Igiene Generale E Applicata, 0302 clinical medicine, morphology, 80 and over, Stage (cooking), Aged, 80 and over, Ovarian Neoplasms, education.field_of_study, epidemiology, histology, ovarian cancer, stage, survival, Adolescent, Adult, Aged, Female, Humans, Middle Aged, Neoplasm Staging, Obstetrics and Gynecology, Transitional cell carcinoma, 030220 oncology & carcinogenesis, Clear cell carcinoma, Human, medicine.medical_specialty, Population, Socio-culturale, Article, 03 medical and health sciences, Internal medicine, medicine, ovarian cancer, epidemiology, survival, stage, morphology, histology, education, Cancer staging, Gynecology, business.industry, Ovarian Neoplasm, Cancer, medicine.disease, Cancer registry, 030104 developmental biology, Ovarian cancer, business
Abstract

Objective Ovarian cancer comprises several histological groups with widely differing levels of survival. We aimed to explore international variation in survival for each group to help interpret international differences in survival from all ovarian cancers combined. We also examined differences in stage-specific survival. Methods The CONCORD programme is the largest population-based study of global trends in cancer survival, including data from 60 countries for 695,932 women (aged 15–99years) diagnosed with ovarian cancer during 1995–2009. We defined six histological groups: type I epithelial, type II epithelial, germ cell, sex cord-stromal, other specific non-epithelial and non-specific morphology, and estimated age-standardised 5-year net survival for each country by histological group. We also analysed data from 67 cancer registries for 233,659 women diagnosed from 2001 to 2009, for whom information on stage at diagnosis was available. We estimated age-standardised 5-year net survival by stage at diagnosis (localised or advanced). Results Survival from type I epithelial ovarian tumours for women diagnosed during 2005–09 ranged from 40 to 70%. Survival from type II epithelial tumours was much lower (20–45%). Survival from germ cell tumours was higher than that of type II epithelial tumours, but also varied widely between countries. Survival for sex-cord stromal tumours was higher than for the five other groups. Survival from localised tumours was much higher than for advanced disease (80% vs. 30%). Conclusions There is wide variation in survival between histological groups, and stage at diagnosis remains an important factor in ovarian cancer survival. International comparisons of ovarian cancer survival should incorporate histology.

Published
2017

9. Laparoscopic adrenalectomy in benign disease

Author

Eduardo Lobo M, Mariana González Z, Joaquín Pérez De O, Gada Housari M, Alfonso Sanjuanbenito D, Lucía Latorre M, and Laura Tortolero G

Subjects
Laparoscopic surgery, medicine.medical_specialty, tumores suprarrenales, Hydropneumothorax, Laparoscopic adrenalectomy, Adrenalectomía laparoscópica, business.industry, medicine.medical_treatment, Retrospective cohort study, medicine.disease, Asymptomatic, laparoscopic surgery, Surgery, Abdominal wall, Hematoma, medicine.anatomical_structure, adrenal tumors, medicine, medicine.symptom, business, Adrenal tumors, cirugía laparoscópica
Abstract

Introducción: Al día de hoy el abordaje laparoscópico es el procedimiento de elección en Ia mayoría de lesiones que asientan sobre Ia glándula suprarrenal, a excepción del tumor maligno suprarrenal. Material y Métodos: Estudio descriptivo y retrospectivo de Ios 55 primeros casos de adrenalectomía laparoscópica realizados en nuestro centro en el período comprendido entre 1998 y 2011, evaluando Ios resultados a corto y largo plazo. Resultados: Hubo un caso de conversión a cirugía abierta (1,8%) en un paciente con sección accidental de Ia vena renal derecha. Un caso de reintervención por laceración hepática que pasó inadvertida durante Ia cirugía. Un caso de mortalidad en el postoperatorio inmediato por parada cardiorrespiratoria en una paciente de 71 años con riesgo anestésico ASAIII, intervenida por síndrome de Cushing. Otras complicaciones menores fueron un caso de hidroneumotórax y 3 casos de hematoma parietal en el trayecto del trocar. Se consiguió el control de Ia enfermedad de base después de un seguimiento medio de 45 meses en todos Ios casos menos en un paciente con síndrome de Cushing ectópico por un carcinoide bronquial. Conclusiones: La adrenalectomía laparoscópica es una técnica con buenos resultados y fácilmente reproducible, pero ha de ser realizada por cirujanos laparoscopistas expertos con un buen conocimiento de Ia anatomía de Ias glándulas suprarrenales y con experiencia en Ia cirugía abierta que Ies permita resolver Ias complicaciones que puedan surgir durante el procedimiento laparoscópico. Introduction: Nowadays the laparoscopic approach is the procedure of choice in adrenal diseases, except malignant adrenal tumors. Methods: A descriptive and retrospective study of the first 55 cases of laparoscopic adrenalectomy performed in our hospital between 1998 and 2011, we reviewed the short and long term results. Results: We had one case of conversion to open surgery in a patient with accidental section of the right renal vein. One case of reoperation due to hepatic injury. One case of postoperative mortality in a 71 year old woman with high anesthetic risk operated for Cushing's syndrome. Other complications were a case ofhydropneumothorax and three cases of abdominal wall hematoma in site oflaparoscopic trocar. In the follow up at 45 months all the patients remain asymptomatic, except one with ectopic Cushing's syndrome due to bronchial carcinoid. Conclusions: Laparoscopic adrenalectomy has good results and is an easily reproducible procedure, but must be performed by expert laparoscopic surgeons with a good knowledge of adrenal anatomy and experience in open surgery which allow them to solve the complications that may arise during the laparoscopic procedure.

Published
2012

10. Colangitis esclerosante primaria: revisión de 12 años en dos centros de referencia

Author

Ivonne Orellana N, José Miguel Valera M, Jaime Poniachik T, Chun Nei L, Gladys Smok S, Javier Brahm B, Zoltán Berger F, and Ricardo Latorre M.

Subjects
Hepatitis, medicine.medical_specialty, sclerosing, Cirrhosis, medicine.diagnostic_test, business.industry, Cholangitis, General Medicine, medicine.disease, Chronic liver disease, Ulcerative colitis, Gastroenterology, Ursodeoxycholic acid, Primary sclerosing cholangitis, Hepatitis, autoimmune, Primary biliary cirrhosis, Liver biopsy, Internal medicine, medicine, business, medicine.drug, Cholestasis, intraheaptic
Abstract

Background: Primary sclerosing cholangitis (PSC) is a chronic cholestatic disorder characterized by progressive inflammation and fibrosis of the biliary tract, evolving to cirrhosis. It is commonly associated with inflammatory bowel disease (IBD). Aim: To communicate the clinical characteristics of patient with PSC seen in two reference centers. Patients and methods: Review of medical records of patients with PSC confirmed by liver biopsies. The clinical picture, laboratory abnormalities, imaging studies and treatment were recorded. Results: Thirty three patients (aged 16 to 73 years, 64% female) were identified. They corresponded to 1.7% of liver biopsies done between 1991-2003. Clinical presentation was a cholestatic picture in 40%, right upper abdominal pain in 36%, a dysenteric syndrome in 9% and varied symptoms in 15%. Laboratory tests showed cholestasis in 94% and positive anti ANCA, SMA, ANA and AMA antibodies in 28, 18, 15 and 9% of cases, respectively. Endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiography were diagnostic in 43 and 58% of patients, respectively. There was an association with ulcerative colitis in 12% of cases. Liver biopsies showed grade I PSC in 76% and grade II-III in 6% of patients. It also showed a concomitant chronic hepatitis and primary biliary cirrhosis in 12 and 6% of cases, respectively. Treatment consisted on ursodeoxycholic acid (UDCA) in 45%, UDCA plus 5-aminosalicylic acid derivatives in 12% and UDCA plus immunosuppresors in 12% of patients. Two patients had to be transplanted. Conclusions: PSC is an uncommon cause of chronic liver disease. It is suspected in cholestatic patients and confirmed with a liver biopsy. It can be associated with other autoimmune hepatic and extrahepatic diseases (Rev Med Chile 2005; 133: 776-80). (Key Words: Cholangitis, sclerosing; Cholestasis, intraheaptic; Hepatitis, autoimmune; Ursodeoxycholic acid)

Published
2005

11. Economic impact of mepolizumab in uncontrolled severe eosinophilic asthma, in real life

Author

Diego Bagnasco, Massimiliano Povero, Lorenzo Pradelli, Luisa Brussino, Giovanni Rolla, Marco Caminati, Francesco Menzella, Enrico Heffler, Giorgio Walter Canonica, Pierluigi Paggiaro, Gianenrico Senna, Manlio Milanese, Carlo Lombardi, Caterina Bucca, Andrea Manfredi, Rikki Frank Canevari, Giovanni Passalacqua, Gabriella Guarnieri, Vincenzo Patella, Foschino Barbaro Maria Pia, Elisiana Carpagnano, Anna del Colle, Giulia Scioscia, Pelaia Gerolamo, Manuela Latorre, Francesca Puggioni, Francesca Racca, Elisabetta Favero, Sandra Iannacone, Eleonora Savi, Marcello Montagni, Gianna Camiciottoli, Chiara Allegrini, Giuseppe Spadaro, Caterina Detoraki, Carla Galeone, Patrizia Ruggiero, Monna Rita Yacoub, Alvise Berti, Gisella Colombo, Nicola Scichilone, Carmen Durante, Maria Teresa Costantino, Chiara Roncallo, Mariachiara Braschi, Francesco Blasi, Alice D'Adda, Erminia Ridolo, Massimo Triggiani, Roberta Parente, D'Amato Maria, Maria Vittoria Verrillo, Zappa Maria Cristina, Marianna Lilli, Nunzio Crimi, Marco Bonavia, Angelo Guido Corsico, Amelia Grosso, Stefano Del Giacco, Margherita Deidda, Luisa Ricciardi, Stefania Isola, Francesca Cicero, Giuliana Amato, Federica Vita, Antonio Spanevello, Patrizia Pignatti, Francesca Cherubino, Dina Visca, Eleonora Aletti, Fabio Luigi Massimo Ricciardolo, Vitina Maria Anna Carriero, Francesca Bertolini, Pierachille Santus, Roberta Barlassina, Andrea Airoldi, Giuseppe Guida, Nucera Eleonora, Arianna Aruanno, Angela Rizzi, Cristiano Caruso, Stefania Colantuono, Alessandra Arcolaci, Andrea Vianello, Fulvia Chieco Bianchi, Maria Rita Marchi, Stefano Centanni, Simone Luraschi, Silvia Ruggeri, Rocco Rinaldo, Elena Parazzini, Cecilia Calabrese, Martina Flora, Lorenzo Cosmi, Linda Di Pietro, Enrico Maggi, Laura Pini, Luigi Macchia, Danilo Di Bona, Luca Richeldi, Carola Condoluci, Leonello Fuso, Matteo Bonini, Alessandro Farsi, Giulia Carli, Paolo Montuschi, Giuseppe Santini, Maria Elisabetta Conte, Elisa Turchet, Carlo Barbetta, Francesco Mazza, Simona D'Alo, Stefano Pucci, Maria Filomena Caiaffa, Elena Minenna, Luciana D'Elia, Carlo Pasculli, Vittorio Viviano, Paolo Tarsia, Joyce Rolo, Mariacarmela Di Proietto, Salvatore Lo Cicero, Bagnasco, D., Povero, M., Pradelli, L., Brussino, L., Rolla, G., Caminati, M., Menzella, F., Heffler, E., Canonica, G. W., Paggiaro, P., Senna, G., Milanese, M., Lombardi, C., Bucca, C., Manfredi, A., Canevari, R. F., Passalacqua, G., Guarnieri, G., Patella, V., Maria Pia, F. B., Carpagnano, E., Colle, A. D., Scioscia, G., Gerolamo, P., Latorre, M., Puggioni, F., Racca, F., Favero, E., Iannacone, S., Savi, E., Montagni, M., Camiciottoli, G., Allegrini, C., Spadaro, G., Detoraki, C., Galeone, C., Ruggiero, P., Yacoub, M. R., Berti, A., Colombo, G., Scichilone, N., Durante, C., Costantino, M. T., Roncallo, C., Braschi, M., Blasi, F., D'Adda, A., Ridolo, E., Triggiani, M., Parente, R., Maria, D. A., Verrillo, M. V., Cristina, Z. M., Lilli, M., Crimi, N., Bonavia, M., Corsico, A. G., Grosso, A., Del Giacco, S., Deidda, M., Ricciardi, L., Isola, S., Cicero, F., Amato, G., Vita, F., Spanevello, A., Pignatti, P., Cherubino, F., Visca, D., Aletti, E., Massimo Ricciardolo, F. L., Anna Carriero, V. M., Bertolini, F., Santus, P., Barlassina, R., Airoldi, A., Guida, G., Eleonora, N., Aruanno, A., Rizzi, A., Caruso, C., Colantuono, S., Arcolaci, A., Vianello, A., Bianchi, F. C., Marchi, M. R., Centanni, S., Luraschi, S., Ruggeri, S., Rinaldo, R., Parazzini, E., Calabrese, C., Flora, M., Cosmi, L., Di Pietro, L., Maggi, E., Pini, L., Macchia, L., Di Bona, D., Richeldi, L., Condoluci, C., Fuso, L., Bonini, M., Farsi, A., Carli, G., Montuschi, P., Santini, G., Conte, M. E., Turchet, E., Barbetta, C., Mazza, F., D'Alo, S., Pucci, S., Caiaffa, M. F., Minenna, E., D'Elia, L., Pasculli, C., Viviano, V., Tarsia, P., Rolo, J., Di Proietto, M., Lo Cicero, S., Bagnasco, Diego, Povero, Massimiliano, Pradelli, Lorenzo, Brussino, Luisa, Rolla, Giovanni, Caminati, Marco, Menzella, Francesco, Heffler, Enrico, Canonica, Giorgio Walter, Paggiaro, Pierluigi, Senna, Gianenrico, Milanese, Manlio, Lombardi, Carlo, Bucca, Caterina, Manfredi, Andrea, Canevari, Rikki Frank, Passalacqua, Giovanni, Guarnieri, Gabriella, Patella, Vincenzo, Foschino Barbaro, Maria Pia, Carpagnano, Elisiana, D' Amato, Maria, Verrillo, Mariavittoria, Zappa, Maria Cristina, Lo Cicero, Salvatore, Di Proietto, Maria Carmela, Walter Canonica, Giorgio, Frank Canevari, Rikki, Spadaro, Giuseppe, Bagnasco D., Povero M., Pradelli L., Brussino L., Rolla G., Caminati M., Menzella F., Heffler E., Canonica G.W., Paggiaro P., Senna G., Milanese M., Lombardi C., Bucca C., Manfredi A., Canevari R.F., Passalacqua G., Guarnieri G., Patella V., Maria Pia F.B., Carpagnano E., Colle A.D., Scioscia G., Gerolamo P., Latorre M., Puggioni F., Racca F., Favero E., Iannacone S., Savi E., Montagni M., Camiciottoli G., Allegrini C., Spadaro G., Detoraki C., Galeone C., Ruggiero P., Yacoub M.R., Berti A., Colombo G., Scichilone N., Durante C., Costantino M.T., Roncallo C., Braschi M., Blasi F., D'Adda A., Ridolo E., Triggiani M., Parente R., Maria D.A., Verrillo M.V., Cristina Z.M., Lilli M., Crimi N., Bonavia M., Corsico A.G., Grosso A., Del Giacco S., Deidda M., Ricciardi L., Isola S., Cicero F., Amato G., Vita F., Spanevello A., Pignatti P., Cherubino F., Visca D., Aletti E., Massimo Ricciardolo F.L., Anna Carriero V.M., Bertolini F., Santus P., Barlassina R., Airoldi A., Guida G., Eleonora N., Aruanno A., Rizzi A., Caruso C., Colantuono S., Arcolaci A., Vianello A., Bianchi F.C., Marchi M.R., Centanni S., Luraschi S., Ruggeri S., Rinaldo R., Parazzini E., Calabrese C., Flora M., Cosmi L., Di Pietro L., Maggi E., Pini L., Macchia L., Di Bona D., Richeldi L., Condoluci C., Fuso L., Bonini M., Farsi A., Carli G., Montuschi P., Santini G., Conte M.E., Turchet E., Barbetta C., Mazza F., D'Alo S., Pucci S., Caiaffa M.F., Minenna E., D'Elia L., Pasculli C., Viviano V., Tarsia P., Rolo J., Di Proietto M., and Lo Cicero S.

Subjects
OR, Odds Ratio, Pediatrics, Severe asthma, Exacerbation, Anti IL-5, Comorbidities, Mepolizumab, OCS, Pharmacoeconomics, gastroesophageal reflux disease, Settore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO, ICS, inhaled corticosteroid, Rate ratio, OCS, Oral Corticosteroids, law.invention, LAMA, long acting muscarinic antagonist, 0302 clinical medicine, Randomized controlled trial, fractional nitric oxide, Interquartile range, law, long acting beta 2 agonist, Odds Ratio, Immunology and Allergy, RR, Rate Ratio, 030223 otorhinolaryngology, Pharmacoeconomic, LOS, Length of stay, LOS, IQR, LAMA, MEP, Mepolizumab, OR, CI, SD, Standard Deviation, MEP, ACT, Asthma Control Test, Comorbiditie, CI, Confidence Intervals, medicine.drug, lcsh:Immunologic diseases. Allergy, Pulmonary and Respiratory Medicine, medicine.medical_specialty, interquartile range, long acting muscarinic antagonist, Immunology, LABA, LABA, long acting beta 2 agonist, Comorbidities, Mepolizumab, OCS, Pharmacoeconomics, Severe asthma, Anti IL-5, RR, Article, Rate Ratio, chronic obstructive pulmonary disease, 03 medical and health sciences, OCS, Oral Corticosteroid, Asthma Control Test, Confidence Intervals, FeNO, fractional nitric oxide, RCTs, Randomized Controlled Trial, medicine, COPD, GERD, gastroesophageal reflux disease, FeNO, IQR, interquartile range, SD, Asthma, RCTs, Oral Corticosteroids, business.industry, GERD, medicine.disease, ICS, inhaled corticosteroids, ACT, Comorbidity, Randomized Controlled Trials, CI, Confidence Interval, RCTs, Randomized Controlled Trials, COPD, chronic obstructive pulmonary disease, 030228 respiratory system, ICS, Standard Deviation, Length of stay, inhaled corticosteroids, lcsh:RC581-607, business
Abstract

Background and aims Severe asthma is burdened by frequent exacerbations and use of oral corticosteroids (OCS) which worsen patients’ health and increase healthcare spending. Aim of this study was to assess the clinical and economic effect of adding mepolizumab (MEP) for the treatment of these patients. Methods Patients >18 years old, referred to 8 asthma clinics, starting MEP between May 2017 and December 2018, were enrolled and followed-up for 12 months. Information in the 12 months before mepolizumab were collected retrospectively. The evaluation parameters included: OCS use, number of exacerbations/hospitalizations, concomitant therapies, comorbidity, and annual number of working days lost due to the disease. The primary objective was to compare the annual total cost per patient pre- and post-MEP. Secondary outcomes included rates of exacerbations and number of OCS-dependent patients. Results 106 patients were enrolled in the study: 46 male, median age 58 years. Mean annual cost pre- and post-MEP (cost of biologic excluded) was €3996 and €1,527, respectively. Total savings due to MEP resulted in €2469 (95%CI 1945–2993), 62% due to exacerbations reduction and 33% due to productivity increase. Such savings could fund about 22% of the total cost of MEP for one year. The introduction of MEP induced a clinical benefit by reducing both OCS-dependent patients (OR = 0.12, 95%CI 0.06–0.23) and exacerbation rate (RR = 0.19, 95%CI 0.15–0.24). Conclusions Patients with severe eosinophilic asthma experienced a clinical benefit in asthma control adding MEP to standard therapy. Biologic therapy can be, partially, funded by the savings produced by patients’ improvement.

Published
2021

12. Evaluation of the gut microbiota after metformin intervention in children with obesity: A metagenomic study of a randomized controlled trial

Author

Javier Caballero-Villarraso, Raúl Hoyos, Miriam Latorre, Ramón Cañete, Rocío Vázquez-Cobela, María Dolores Cañete, Alejandro Egea-Zorrilla, Gloria Bueno, Concepción M. Aguilera, Julio Plaza-Díaz, Angel Gil, Rosaura Leis, Belén Pastor-Villaescusa, [Pastor-Villaescusa,B] Institute for Nutritional Medicine, Else Kröner-Fresenius-Center for Nutritional Medicine, School of Life Sciences, Technical University of Munich, Freising Germany. [Pastor-Villaescusa,B, Plaza-Díaz,J, Gil,A, Aguilera,CM] Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, Granada, Spain. [Pastor-Villaescusa,B, Egea-Zorrilla,A, Aguilera,CM] Institute of Nutrition and Food Technology 'José Mataix', Centre of Biomedical Research, University of Granada, Armilla, Granada, Spain. [Plaza-Díaz,J, Aguilera,CM] Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, Granada, Spain. [Leis,R, Bueno,G, Aguilera,CM] CIBEROBN (CIBER Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, Madrid, Spain. [Leis,R, Vázquez-Cobela,R] Unit of Investigation in Nutrition, Growth and Human Development of Galicia, Paediatric Department, Clinic University Hospital of Santiago, University of Santiago de Compostela, Santiago de Compostela, Spain. [Bueno,G, Latorre,M] Pediatric Department, Lozano Blesa University Clinical Hospital, University of Zaragoza, Zaragoza, Spain. [Hoyos,R] Pediatric Department, Virgen de Las Nieves University Hospital, Andalusian Health Service, Granada, Spain. [Latorre,M] Pediatric Department and Health Sciences Institute in Aragon, Zaragoza, Spain. [Cañete,MD, Cañete,R] PAIDI CTS-329, Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), Córdoba, Spain. [Caballero-Villarraso,J] Clinical Analysis Services, IMIBIC/Reina Sofía Hospital, Córdoba University, Córdoba, Spain. [Latorre,M] Unit of Paediatric Endocrinology, Reina Sofia University Hospital, Córdoba, Spain, and The authors acknowledge the Spanish Ministry of Health, Social and Equality, General Department for Pharmacy and Health Products for financing this study and the Instituto de Salud Carlos III-Fondo de Investigación Sanitaria (FONDOS FEDER), Redes temáticas de investigación cooperativa RETIC (Red SAMID RD12/0026/0015).

Subjects
0301 basic medicine, Male, Pediatric Obesity, Time Factors, Phenomena and Processes::Physical Phenomena::Time::Time Factors [Medical Subject Headings], Obesidad, Psychological intervention, Bacillus, Ensayo clínico controlado aleatorio, Organisms::Bacteria::Gram-Positive Bacteria::Actinobacteria [Medical Subject Headings], Gut flora, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Principal Component Analysis [Medical Subject Headings], law.invention, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], 0302 clinical medicine, Randomized controlled trial, law, Medicine, Child, biology, Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Age Factors [Medical Subject Headings], Organisms::Bacteria::Verrucomicrobia [Medical Subject Headings], Microbiota, Age Factors, Disciplines and Occupations::Natural Science Disciplines::Biological Science Disciplines::Biology::Genetics::Genomics::Metagenomics [Medical Subject Headings], General Medicine, Organisms::Bacteria::Bacteroidetes [Medical Subject Headings], Metformin, ddc, Actinobacteria, Intestines, Treatment Outcome, Niño, 030220 oncology & carcinogenesis, Chemicals and Drugs::Organic Chemicals::Amidines::Guanidines::Biguanides::Metformin [Medical Subject Headings], Female, Anatomy::Digestive System::Gastrointestinal Tract::Intestines [Medical Subject Headings], medicine.drug, medicine.medical_specialty, Microbioma gastrointestinal, Adolescent, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Research Design::Sample Size [Medical Subject Headings], Publication Type::Study Characteristics::Clinical Trial::Randomized Controlled Trial [Medical Subject Headings], Healthy lifestyle, Firmicutes, Check Tags::Male [Medical Subject Headings], RM1-950, Gut microbiota, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Feeding Behavior [Medical Subject Headings], Placebo, Persons::Persons::Age Groups::Adolescent [Medical Subject Headings], 03 medical and health sciences, Verrucomicrobia, Double-Blind Method, Intervention (counseling), Internal medicine, Humans, Hypoglycemic Agents, Persons::Persons::Age Groups::Child [Medical Subject Headings], Obesity, Metformina, Life Style, Organisms::Bacteria [Medical Subject Headings], Organisms::Bacteria::Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Rods::Bacillaceae::Bacillus [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome [Medical Subject Headings], Geographical Locations::Geographic Locations::Europe::Spain [Medical Subject Headings], Pharmacology, Bacteria, Bacteroidetes, business.industry, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Psychology, Social::Life Style [Medical Subject Headings], biology.organism_classification, medicine.disease, Gastrointestinal Microbiome, Children population, Clinical trial, Diseases::Nutritional and Metabolic Diseases::Nutrition Disorders::Overnutrition::Obesity::Pediatric Obesity [Medical Subject Headings], 030104 developmental biology, Pubertal stage, Check Tags::Female [Medical Subject Headings], Spain, Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Hypoglycemic Agents [Medical Subject Headings], Metagenome, Therapeutics. Pharmacology, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Research Design::Double-Blind Method [Medical Subject Headings], Metagenomics, Estilo de vida saludable, business, Phenomena and Processes::Genetic Phenomena::Genetic Structures::Genome::Metagenome [Medical Subject Headings]
Abstract

Background: Metformin, a first-line oral antidiabetic agent that has shown promising results in terms of treating childhood and adolescent obesity, might influence the composition of the gut microbiota. We aimed to evaluate whether the gut microbiota of non-diabetic children with obesity changes after a metformin intervention. Methods: The study was a multicenter and double-blind randomized controlled trial in 160 children with obesity. Children were randomly assigned to receive either metformin (1 g/day) or placebo for 6 months in combination with healthy lifestyle recommendations in both groups. Then, we conducted a metagenomic analysis in a subsample obtained from 33 children (15 metformin, 18 placebo). A linear mixed-effects model (LMM) was used to determine the abundance changes from baseline to six months according to treatment. To analyze the data by clusters, a principal component analysis was performed to understand whether lifestyle habits have a different influence on the microbiota depending on the treatment group. Results: Actinobacteria abundance was higher after placebo treatment compared with metformin. However, the interaction time x treatment just showed a trend to be significant (4.6% to 8.1% after placebo vs. 3.8 % to 2.6 % after metformin treatment, p = 0.055). At genus level, only the abundance of Bacillus was significantly higher after the placebo intervention compared with metformin (2.5% to 5.7% after placebo vs. 1.5 % to 0.8 % after metformin treatment, p = 0.044). Furthermore, different ensembles formed by Firmicutes, Bacteroidetes, and Verrucomicrobia were found according to the interventions under a similar food consumption, Spanish Ministry of Health, Social and Equality, General Department for Pharmacy and Health Products, Instituto de Salud Carlos III-Fondo de Investigación Sanitaria (FONDOS FEDER), Redes temáticas de investigación cooperativa RETIC Red SAMID RD12/0026/0015

Published
2020

13. Asthma control in severe asthmatics under treatment with omalizumab: A cross-sectional observational study in Italy

Author

Novelli, Federica, Latorre, Matteo, Vergura, Letizia, Caiaffa, Maria Filomena, Camiciottoli, Gianna, Guarnieri, Gabriella, Matucci, Andrea, Macchia, Luigi, Vianello, Andrea, Vultaggio, Alessandra, Celi, Alessandro, Cazzola, Mario, Paggiaro, Pierluigi, Camiciottoli, G., Maselli, R., Pelaia, G., Busceti, M. T., Sabato, E., Cagnazzo, M. G., Colombo, F., Palumbo, Laura, Ravazzi, Aldo, Bucca, C., Caiaffa, M. F., Berra, A., Calabrese, C., Stanziola, A. A., Schino, P., Di Gioacchino, M., Cazzola, M., Segreti, A., Pastorello, E. A., Scibilia, G., Vianello, A., Marchi, M. R., Paladini, L., Baglioni, S., Abbritti, M., Almerigogna, F., Matucci, A., Vultaggio, A., Maggi, E., Maestrelli, P., Guarnieri, G., Steinhilber, G., Bonavia, M., Rottoli, P., Bargagli, E., Senna, G., Caminati, M., Macchia, L., Bellia, V., Scichilone, N., Paggiaro, P., Novelli, F., Vergura, L., Novelli F., Latorre M., Vergura L., Caiaffa M.F., Camiciottoli G., Guarnieri G., Matucci A., Macchia L., Vianello A., Vultaggio A., Celi A., Cazzola M., Paggiaro P., Maselli R., Pelaia G., Busceti M.T., Sabato E., Cagnazzo M.G., Colombo F., Palumbo L., Ravazzi A., Bucca C., Berra A., Calabrese C., Stanziola A.A., Schino P., Di Gioacchino M., Segreti A., Pastorello E.A., Scibilia G., Marchi M.R., Paladini L., Baglioni S., Abbritti M., Almerigogna F., Maggi E., Maestrelli P., Steinhilber G., Bonavia M., Rottoli P., Bargagli E., Senna G., Caminati M., Bellia V., Scichilone N., Novelli, F., Latorre, M., Vergura, L., Caiaffa, M. F., Camiciottoli, G., Guarnieri, G., Matucci, A., Macchia, L., Vianello, A., Vultaggio, A., Celi, A., Cazzola, M., Paggiaro, P., Maselli, R., Pelaia, G., Busceti, M. T., Sabato, E., Cagnazzo, M. G., Colombo, F., Palumbo, L., Ravazzi, A., Bucca, C., Berra, A., Calabrese, C., Stanziola, A. A., Schino, P., Di Gioacchino, M., Segreti, A., Pastorello, E. A., Scibilia, G., Marchi, M. R., Paladini, L., Baglioni, S., Abbritti, M., Almerigogna, F., Maggi, E., Maestrelli, P., Steinhilber, G., Bonavia, M., Rottoli, P., Bargagli, E., Senna, G., Caminati, M., Bellia, V., and Scichilone, N.

Subjects
Adult, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Exacerbation, Cross-sectional study, Omalizumab, Comorbidity, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Exhaled nitric oxide, Exacerbations, Comorbidities, Asthma, Control, Severity of Illness Index, Internal medicine, Severity of illness, Medicine, Anti-Asthmatic Agent, Humans, Pharmacology (medical), Anti-Asthmatic Agents, Inflammation Mediator, Respiratory Function Test, Aged, Cross-Sectional Studie, business.industry, Biochemistry (medical), Middle Aged, medicine.disease, Respiratory Function Tests, Cross-Sectional Studies, Italy, Physical therapy, Observational study, Female, Inflammation Mediators, Comorbiditie, business, medicine.drug, Human
Abstract

Few data are available on the proportion of asthmatics achieving a good asthma control (according GINA guidelines) and on the level of airway inflammation during omalizumab treatment. The aim of this cross-sectional national observational study was to assess the level of control (according to GINA guidelines) achieved in a group of asthmatics on omalizumab treatment, and to characterize the factors that influence the lack of control. We studied 306 asthmatics under omalizumab treatment for a median of 32 months (range 4-120). The level of control according to GINA was good in 25.2%, partial in 47.1% and poor in 24.5% of patients (data were missing for the remaining 3.2%). Comparison between poorly controlled and partially or well controlled asthmatics showed a statistically significant higher prevalence of some comorbidities in the first group, namely obesity, gastro-oesophageal reflux disease (GORD), aspirin intolerance and mental disorders (all p

Published
2015

14. Differences in the efficacy and safety among inhaled corticosteroids (ICS)/long-acting beta2-agonists (LABA) combinations in the treatment of chronic obstructive pulmonary disease (COPD): Role of ICS

Author

Alessandro Sanduzzi, Pierluigi Paggiaro, Manuela Latorre, Fulvio Braido, Alberto Papi, Nicola Scichilone, Pierachille Santus, Federica Novelli, Barbara Vagaggini, Latorre, M., Novelli, F., Vagaggini, B., Braido, F., Papi, A., Sanduzzi, A., Santus, P., Scichilone, N., Paggiaro, P., Latorre, M, Novelli, F, Vagaggini, B, Braido, F, Papi, A, SANDUZZI ZAMPARELLI, Alessandro, Santus, P, and Scichilone, N

Subjects
Budesonide, Adrenergic beta-2 Receptor Agonist, Pulmonary and Respiratory Medicine, Chronic Obstructive, medicine.medical_specialty, medicine.drug_class, Population, Settore MED/10 - Malattie Dell'Apparato Respiratorio, COPD, Fluticasone, Pneumonia, Administration, Inhalation, Adrenergic beta-2 Receptor Agonists, Drug Combinations, Glucocorticoids, Humans, Pulmonary Disease, Chronic Obstructive, Quality of Life, Biochemistry (medical), Pharmacology (medical), Pulmonary Disease, Glucocorticoid, Internal medicine, Drug Combination, medicine, education, Asthma, education.field_of_study, business.industry, medicine.disease, respiratory tract diseases, Inhalation, Anesthesia, Administration, Corticosteroid, Formoterol, Salmeterol, business, hormones, hormone substitutes, and hormone antagonists, medicine.drug, Human
Abstract

Inhaled corticosteroids (ICS) are frequently recommended for the treatment of asthma and COPD, often in combination with long-acting beta2-agonists (LABA), depending on the severity of the disease and/or on the specific phenotype. Several ICS/LABA combinations are currently available that differ in their pharmacokinetic characteristics and dose of both components. Thus, this review assesses differences in the efficacy and the safety profiles of the ICS components in the two more frequently used ICS/LABA combinations (budesonide/formoterol and fluticasone/salmeterol) for the management of COPD. Whereas the basic mechanism of action is similar for all ICS (binding with the intracellular glucocorticoid receptor, which mediates both genomic and non genomic effects), the pharmacokinetic and characteristics of ICS are quite different in terms of receptor affinity, bioavailability, lipophilicity and drug persistence in the airways. Fluticasone persists longer in airway mucus and requires more time to dissolve in the lining fluid and then enter the airway wall, whereas budesonide is cleared more quickly from the airways. Comparative efficacy of the two major ICS/LABA combinations recommended for the treatment of COPD show similar efficacy in terms of reduction of exacerbations, improvement in forced expiratory volume in the first second (FEV1) and quality of life. One retrospective cohort study suggested a greater efficacy for the budesonide/formoterol combination on hospital or emergency department admissions, oral corticosteroid courses, and addition of tiotropium, and an observational real-life study reported a greater reduction of COPD exacerbations with budesonide/formoterol than with fluticasom/salmeterol combination. Among the potential side effects of chronic ICS treatment in patients with COPD, recently the use of fluticasone or fluticasone/salmeterol combination has been associated with a higher prevalence of pneumonia in the major long-term studies. On the other hand, no similar increased risk of pneumonia has been reported in patients with COPD treated with the budesonide/formoterol combination. A recent population-based cohort study from the Quebec database showed that the adjusted odds ratio for having severe pneumonia was higher for fluticasone (2.1) than for budesonide (1.17) or other ICS (1.41). Of the ICS studied, only fluticasone demonstrated a dose-related increase in risk of pneumonia in patients with COPD. This difference between fluticasone and budesonide may be explained by the longer retention of fluticasone in the airways, with potentially greater inhibition of type-1 innate immunity. Therefore, the risk:benefit ratio should be evaluated thoroughly when choosing an ICS/LABA combination for patients with COPD.

Published
2015

15. Factors reducing omalizumab response in severe asthma

Author

Manuela Latorre, Andrea Matucci, Marco Scalese, Pierachille Santus, Bruno Sposato, Alberto Cresti, Simonetta Masieri, Nicola Scichilone, Manlio Milanese, Pierluigi Paggiaro, Alessandra Vultaggio, Carlo Cavaliere, Alberto Ricci, Antonio Perrella, Sposato, B., Scalese, M., Milanese, M., Masieri, S., Cavaliere, C., Latorre, M., Scichilone, N., Matucci, A., Vultaggio, A., Ricci, A., Cresti, A., Santus, P., Perrella, A., and Paggiaro, P.L.

Subjects
Male, Severe asthma, Drug Resistance, Comorbidity, Omalizumab, Adrenal Cortex Hormone, Comorbidities, 0302 clinical medicine, Retrospective Studie, Adrenal Cortex Hormones, Risk Factors, Forced Expiratory Volume, Age Factor, Nasal polyps, Anti-Asthmatic Agents, 030212 general & internal medicine, Multivariate Analysi, Smoking, Age Factors, Real-life, Middle Aged, Treatment Outcome, Italy, Female, Comorbiditie, Human, medicine.drug, Adult, age, comorbidities, obesity, omalizumab, real-life, severe asthma, therapeutic response, internal medicine, medicine.medical_specialty, Logistic Model, Therapeutic response, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Nitric Oxide, 03 medical and health sciences, FEV1/FVC ratio, Nasal Polyps, Age, Internal medicine, Internal Medicine, medicine, Anti-Asthmatic Agent, Humans, Obesity, Risk factor, Retrospective Studies, Asthma, business.industry, Risk Factor, medicine.disease, respiratory tract diseases, Logistic Models, 030228 respiratory system, Concomitant, Multivariate Analysis, Exhaled nitric oxide, Nasal Polyp, business
Abstract

Background: Despite adding Omalizumab to conventional therapy, several severe asthmatics still show poor disease control. We investigated the factors that may affect a reduced Omalizumab response in a large population of severe asthmatics. Methods: 340 patients were retrospectively evaluated. FEV1%, FVC%, Asthma Control Test (ACT), fractional exhaled nitric oxide (FENO), possible step-downs/step-ups of concomitant therapies, exacerbations, disease control levels, ICS doses and SABA use, observed at the end of treatment, were considered as a response to Omalizumab. Results: Age was an independent risk factor for a reduced response concerning FEV1%, FVC%, ACT and for a lower asthma control. Obesity (vs normal weight) was a determinant condition for exacerbations (OR:3.114[1.509–6.424], p = 0.002), for a disease partial/no control (OR:2.665[1.064–6.680], p = 0.036), for excessive SABA use (OR:4.448[1.837–10.768], p = 0.002) and for an unchanged/increased level of concomitant asthma medications. Furthermore, obesity also reduced the response in FEV1 (β = −6.981,p = 0.04), FVC (β = −11.689,p = 0.014) and ACT (β = −2.585, p = 0.027) and was associated with a higher FENO level (β = 49.045,p = 0.040). Having at least one comorbidity was a risk factor for exacerbations (OR:1.383[1.128–1.697], p = 0.008) and for an ACT

Published
2018
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16. The Severe Asthma Network in Italy: Findings and Perspectives

Author

Giovanni Rolla, Girolamo Pelaia, Mariangiola Crivellaro, Maria Teresa Costantino, Maria Pia Foschino, Enrico Heffler, Alice D'Adda, Carlo Lombardi, Gabriella Guarnieri, Pierluigi Paggiaro, Nunzio Crimi, Francesco Blasi, Eleonora Savi, Manuela Latorre, Carla Galeone, Nicola Scichilone, Giselda Colombo, Giorgio Walter Canonica, Giovanni Passalacqua, M D'Amato, Francesco Menzella, Vincenzo Patella, Francesca Puggioni, Roberta Parente, Paolo Solidoro, Giuseppe Spadaro, Sarah Barbuto, Erminia Ridolo, Elisabetta Favero, Matteo Bradicich, Marco Caminati, Gianna Camiciottoli, Gianenrico Senna, Heffler, Enrico, Blasi, Francesco, Latorre, Manuela, Menzella, Francesco, Paggiaro, Pierluigi, Pelaia, Girolamo, Senna, Gianenrico, Canonica, Giorgio Walter, Barbuto, Sarah, Bradicich, Matteo, Camiciottoli, Gianna, Caminati, Marco, Colombo, Giselda, Costantino, Maria Teresa, Crimi, Nunzio, Crivellaro, Mariangiola, D'Adda, Alice, D'Amato, Mariella, Favero, Elisabetta, Foschino, Maria Pia, Galeone, Carla, Guarnieri, Gabriella, Lombardi, Carlo, Parente, Roberta, Passalacqua, Giovanni, Patella, Vincenzo, Puggioni, Francesca, Ridolo, Erminia, Rolla, Giovanni, Savi, Eleonora, Scichilone, Nicola, Solidoro, Paolo, Spadaro, Giuseppe, Heffler E., Blasi F., Latorre M., Menzella F., Paggiaro P., Pelaia G., Senna G., Canonica G.W., Barbuto S., Bradicich M., Camiciottoli G., Caminati M., Colombo G., Costantino M.T., Crimi N., Crivellaro M., D'Adda A., D'Amato M., Favero E., Foschino M.P., Galeone C., Guarnieri G., Lombardi C., Parente R., Passalacqua G., Patella V., Puggioni F., Ridolo E., Rolla G., Savi E., Scichilone N., Solidoro P., and Spadaro G.

Subjects
Adult, Male, medicine.medical_specialty, Registry, Severe asthma, Exacerbation, Bronchiectasis, Comorbidities, Late-onset asthma, Nasal polyps, SANI, Immunology and Allergy, Omalizumab, Comorbidity, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Atopy, 03 medical and health sciences, Bronchiectasi, 0302 clinical medicine, Food allergy, Internal medicine, Aged, Asthma, Eosinophils, Female, Humans, Immunoglobulin E, Italy, Middle Aged, Nasal Polyps, Registries, Rhinitis, Medicine, Bronchiectasis, Comorbidities, Late-onset asthma, Nasal polyps, Registry, SANI, Severe asthma, Immunology and Allergy, 030212 general & internal medicine, business.industry, Nasal polyp, medicine.disease, 030228 respiratory system, Asthma Control Questionnaire, Comorbiditie, business, Mepolizumab, medicine.drug
Abstract

Background Severe Asthma Network in Italy (SANI) is a registry of patients recruited by accredited centers on severe asthma. Objective To analyze epidemiological, clinical, inflammatory, functional, and treatment characteristics of severe asthmatics from the SANI registry. Methods All consecutive patients with severe asthma were included into the registry, without exclusion criteria to have real-life data on demographics, asthma control, treatments (including biologics), inflammatory biomarkers, and comorbidities. Results A total of 437 patients (mean age: 54.1 years, 57.2% females, 70.7% atopics, 94.5% in Global Initiative for Asthma severity step V) were enrolled into the study. The mean annual exacerbation rate was 3.75. The mean blood eosinophil level was 536.7 cells/mcL, and the average serum total IgE was 470.3 kU/L. Approximately 64% of patients were on regular oral corticosteroid treatment, 57% with omalizumab and 11.2% with mepolizumab. Most common comorbidities were rhinitis, nasal polyposis, and bronchiectasis. Patients with nasal polyposis had higher age of disease onset, higher blood eosinophil count, and lower frequency of atopy and atopic eczema. Bronchiectasis was associated with more frequent severe exacerbations, higher blood eosinophils, and total IgE. Stratifying patients, those with late-onset asthma were less frequently atopic (with less frequent allergic rhinitis and food allergy), and more frequently with nasal polyposis and higher serum total IgE levels. Conclusions This study revealed a high frequency of relevant comorbidities and that a substantial proportion of patients have late-onset asthma; all these features define specific different disease phenotypes. Severe asthma complexity and comorbidities require multidisciplinary approaches, led by specifically trained pulmonologists and allergists.

Published
2018

17. The histology of ovarian cancer: worldwide distribution and implications for international survival comparisons (CONCORD-2)

Author

Matz, Melissa, Coleman, Michel P, Sant, Milena, Chirlaque, Maria Dolores, Visser, Otto, Gore, Martin, Allemani, Claudia, Bouzbid, S, Hamdi-chérif, M, Zaidi, Z, Bah, E, Swaminathan, R, Nortje, Sh, El Mistiri, Mm, Bayo, S, Malle, B, Manraj, Ss, Sewpaul-sungkur, R, Fabowale, A, Ogunbiyi, Oj, Bradshaw, D, Somdyala, Nim, Stefan, Dc, Abdel-rahman, M, Jaidane, L, Mokni, M, Kumcher, I, Moreno, F, González, Ms, Laura, Ea, Espinola, Sb, Calabrano, Gh, Carballo Quintero, B, Fita, R, Garcilazo, Da, Giacciani, Pl, Diumenjo, Mc, Laspada, Wd, Green, Ma, Lanza, Mf, Ibañez, Sg, Lima, Ca, Lobo De Oliveira, E, Daniel, C, Scandiuzzi, C, De Souza, Pcf, Melo, Cd, Del Pino, K, Laporte, C, Curado, Mp, De Oliveira, Jc, Veneziano, Cla, Veneziano, Db, Latorre, Mrdo, Tanaka, Lf, Azevedo E. Silva, G, Galaz, Jc, Moya, Ja, Herrmann, Da, Vargas, S, Herrera, Vm, Uribe, Cj, Bravo, Le, Arias-ortiz, Ne, Jurado, Dm, Yépez, Mc, Galán, Yh, Torres, P, Martínez-reyes, F, Pérez-meza, Ml, Jaramillo, L, Quinto, R, Cueva, P, Yépez, Jg, Torres-cintrón, Cr, Tortolero-luna, G, Alonso, R, Barrios, E, Nikiforuk, C, Shack, L, Coldman, Aj, Woods, Rr, Noonan, G, Turner, D, Kumar, E, Zhang, B, Mccrate, Fr, Ryan, S, Hannah, H, Dewar, Rad, Macintyre, M, Lalany, A, Ruta, M, Marrett, L, Nishri, De, Mcclure, C, Vriends, Ka, Bertrand, C, Louchini, R, Robb, K, Stuart-panko, H, Demers, S, Wright, S, George, Jt, Shen, X, Brockhouse, Jt, O'brien, Dk, Ward, Kc, Almon, L, Bates, J, Rycroft, R, Mueller, L, Phillips, C, Brown, H, Cromartie, B, Schwartz, Ag, Vigneau, F, Mackinnon, Ja, Wohler, B, Bayakly, Ar, Clarke, Ca, Glaser, Sl, West, D, Green, Md, Hernandez, By, Johnson, Cj, Jozwik, D, Charlton, Me, Lynch, Cf, Huang, B, Tucker, Tc, Deapen, D, Liu, L, Hsieh, Mc, Wu, Xc, Stern, K, Gershman, St, Knowlton, Rc, Alverson, J, Copeland, Ge, Rogers, Db, Lemons, D, Williamson, Ll, Hood, M, Hosain, Gm, Rees, Jr, Pawlish, Ks, Stroup, A, Key, C, Wiggins, C, Kahn, Ar, Schymura, Mj, Leung, G, Rao, C, Giljahn, L, Warther, B, Pate, A, Patil, M, Schubert, Ss, Rubertone, Jj, Slack, Sj, Fulton, Jp, Rousseau, Dl, Janes, Ta: Schwartz, Bolick, Sw, Hurley, Dm, Richards, J, Whiteside, Ma, Nogueira, Lm, Herget, K, Sweeney, C, Martin, J, Wang, S, Harrelson, Dg, Keitheri Cheteri, Mb, Farley, S, Hudson, Ag, Borchers, R, Stephenson, L, Espinoza, Jr, Weir, Hk, Edwards, Bk, Wang, N, Yang, L, Chen, Js, Song, Gh, Gu, Xp, Zhang, P, Ge, Hm, Zhao, Dl, Zhang, Jh, Zhu, Fd, Tang, Jg, Shen, Y, Wang, J, Li, Ql, Yang, Xp, Dong, J, Li, W, Cheng, Lp, Chen, Jg, Huang, Qh, Huang, Sq, Guo, Gp, Wei, K, Chen, Wq, Zeng, H, Demetriou, Av, Pavlou, P, Mang, Wk, Ngan, Kc, Kataki, Ac, Krishnatreya, M, Jayalekshmi, Pa, Sebastian, P, Sapkota, Sd, Verma, Y, Nandakumar, A, Suzanna, E, Keinan-boker, L, Silverman, Bg, Ito, H, Nakagawa, H, Hattori, M, Kaizaki, Y, Sugiyama, H, Utada, M, Katayama, K, Narimatsu, H, Kanemura, S, Koike, T, Miyashiro, I, Yoshii, M, Oki, I, Shibata, A, Matsuda, T, Nimri, O, Ab Manan, A, Bhoo-pathy, N, Tuvshingerel, S, Chimedsuren, O, Al Khater, Ahm, Al-eid, H, Jung, Kw, Won, Yj, Chiang, Cj, Lai, Ms, Suwanrungruang, K, Wiangnon, S, Daoprasert, K, Pongnikorn, D, Geater, Sl, Sriplung, H, Eser, S, Yakut, Ci, Hackl, M, Mühlböck, H, Oberaigner, W, Zborovskaya, Aa, Aleinikova, Ov, Henau, K, Van Eycken, L, Dimitrova, N, Valerianova, Z, Šekerija, M, Zvolský, M, Engholm, G, Storm, H, Innos, K, Mägi, M, Malila, N, Seppä, K, Jégu, J, Velten, M, Cornet, E, Troussard, X, Bouvier, Am, Faivre, J, Guizard, Av, Bouvier, V, Launoy, G, Arveux, P, Maynadié, M, Mounier, M, Fournier, E, Woronoff, As, Daoulas, M, Clavel, J, Le Guyader-peyrou, S, Monnereau, A, Trétarre, B, Colonna, M, Cowppli-bony, A, Molinié, F, Bara, S, Degré, D, Ganry, O, Lapôtre-ledoux, B, Grosclaude, P, Estève, J, Bray, F, Piñeros, M, Sassi, F, Stabenow, R, Eberle, A, Erb, C, Nennecke, A, Kieschke, J, Sirri, E, Kajueter, H, Emrich, K, Zeissig, Sr, Holleczek, B, Eisemann, N, Katalinic, A, Brenner, H, Asquez, Ra, Kumar, V, Ólafsdóttir, Ej, Tryggvadóttir, L, Comber, H, Walsh, Pm, Sundseth, H, Devigili, E, Mazzoleni, G, Giacomin, A, DI BELLA, Francesca, Castaing, M, Sutera, A, Gola, G, Ferretti, S, Serraino, D, Zucchetto, A, Lillini, R, Vercelli, M, Busco, S, Pannozzo, F, Vitarelli, S, Ricci, P, Pascucci, C, Autelitano, M, Cirilli, C, Federico, M, FUSCO, Elena Maria, Vitale, Mf, Usala, M, Cusimano, R, Mazzucco, W, Michiara, M, Sgargi, P, Maule, Mm, Sacerdote, C, Tumino, R, Di Felice, E, Vicentini, M, Falcini, F, Cremone, L, Budroni, M, Cesaraccio, R, Contrino, Ml, Tisano, F, Fanetti, Ac, Maspero, S, Candela, G, Scuderi, T, Gentilini, Ma, Piffer, S, Rosso, S, Sacchetto, L, Caldarella, A, La Rosa, F, Stracci, F, Contiero, P, Tagliabue, G, Dei Tos, Ap, Zorzi, M, Zanetti, R, Baili, P, Berrino, F, Gatta, G, Sant, M, Capocaccia, R, De Angelis, R, Liepina, E, Maurina, A, Smailyte, G, Agius, D, Calleja, N, Siesling, S, Visser, O, Larønningen, S, Møller, B, Dyzmann-sroka, A, Trojanowski, M, Góźdż, S, Mężyk, R, Grądalska-lampart, M, Radziszewska, Au, Didkowska, Ja, Wojciechowska, U, Błaszczyk, J, Kępska, K, Bielska-lasota, M, Kwiatkowska, K, Forjaz, G, Rego, Ra, Bastos, J, Silva, Ma, Antunes, L, Bento, Mj, Mayer-da-silva, A, Miranda, A, Coza, D, Todescu, Ai, Valkov, My, Adamcik, J, Safaei Diba, C, Primic-žakelj, M, Žagar, T, Stare, J, Almar, E, Mateos, A, Quirós, Jr, Bidaurrazaga, J, Larrañaga, N, Díaz García, Jm, Marcos, Ai, Marcos-gragera, R, Vilardell Gil, Ml, Molina, E, Sánchez, Mj, Franch Sureda, P, Ramos Montserrat, M, Chirlaque, Md, Navarro, C, Ardanaz, Ee, Moreno-iribas, Cc, Fernández-delgado, R, Peris-bonet, R, Galceran, J, Khan, S, Lambe, M, Camey, B, Bouchardy, C, Usel, M, Ess, Sm, Herrmann, C, Bulliard, Jl, Maspoli-conconi, M, Frick, H, Kuehni, Ce, Schindler, M, Bordoni, A, Spitale, A, Chiolero, A, Konzelmann, I, Dehler, Si, Matthes, Kl, Rashbass, J, Stiller, Ca, Fitzpatrick, D, Gavin, A, Bannon, F, Black, Rj, Brewster, Dh, Huws, Dw, White, C, Finan, P, Allemani, C, Bonaventure, A, Carreira, H, Coleman, Mp, Di Carlo, V, Harewood, R, Liu, K, Matz, M, Montel, L, Nikšić, M, Rachet, B, Sanz, N, Spika, D, Stephens, R, Peake, M, Chalker, E, Newman, L, Baker, D, Soeberg, Mj, Aitken, J, Scott, C, Stokes, Bc, Venn, A, Farrugia, H, Giles, Gg, Threlfall, T, Currow, D, You, H, Hendrix, J, Lewis, C., Matz, M., Coleman, M., Sant, M., Chirlaque, M., Visser, O., Gore, M., Allemani, C., Bouzbid, S., Hamdi-chérif, M., Zaidi, Z., Bah, E., Swaminathan, R., Nortje, S., El Mistiri, M., Bayo, S., Malle, B., Manraj, S., Sewpaul-sungkur, R., Fabowale, A., Ogunbiyi, O., Bradshaw, D., Somdyala, N., Stefan, D., Abdel-rahman, M., Jaidane, L., Mokni, M., Kumcher, I., Moreno, F., González, M., Laura, E., Espinola, S., Calabrano, G., Carballo Quintero, B., Fita, R., Garcilazo, D., Giacciani, P., Diumenjo, M., Laspada, W., Green, M., Lanza, M., Ibañez, S., Lima, C., Lobo De Oliveira, E., Daniel, C., Scandiuzzi, C., De Souza, P., Melo, C., Del Pino, K., Laporte, C., Curado, M., De Oliveira, J., Veneziano, C., Veneziano, D., Latorre, M., Tanaka, L., Azevedo E. Silva, G., Galaz, J., Moya, J., Herrmann, D., Vargas, S., Herrera, V., Uribe, C., Bravo, L., Arias-ortiz, N., Jurado, D., Yépez, M., Galán, Y., Torres, P., Martínez-reyes, F., Pérez-meza, M., Jaramillo, L., Quinto, R., Cueva, P., Yépez, J., Torres-cintrón, C., Tortolero-luna, G., Alonso, R., Barrios, E., Nikiforuk, C., Shack, L., Coldman, A., Woods, R., Noonan, G., Turner, D., Kumar, E., Zhang, B., Mccrate, F., Ryan, S., Hannah, H., Dewar, R., Macintyre, M., Lalany, A., Ruta, M., Marrett, L., Nishri, D., Mcclure, C., Vriends, K., Bertrand, C., Louchini, R., Robb, K., Stuart-panko, H., Demers, S., Wright, S., George, J., Shen, X., Brockhouse, J., O'Brien, D., Ward, K., Almon, L., Bates, J., Rycroft, R., Mueller, L., Phillips, C., Brown, H., Cromartie, B., Schwartz, A., Vigneau, F., Mackinnon, J., Wohler, B., Bayakly, A., Clarke, C., Glaser, S., West, D., Hernandez, B., Johnson, C., Jozwik, D., Charlton, M., Lynch, C., Huang, B., Tucker, T., Deapen, D., Liu, L., Hsieh, M., Xc, W., Stern, K., Gershman, S., Knowlton, R., Alverson, J., Copeland, G., Rogers, D., Lemons, D., Williamson, L., Hood, M., Hosain, G., Rees, J., Pawlish, K., Stroup, A., Key, C., Wiggins, C., Kahn, A., Schymura, M., Leung, G., Rao, C., Giljahn, L., Warther, B., Pate, A., Patil, M., Schubert, S., Rubertone, J., Slack, S., Fulton, J., Rousseau, D., Janes, Ta:, S., Sm, Bolick, S., Hurley, D., Richards, J., Whiteside, M., Nogueira, L., Herget, K., Sweeney, C., Martin, J., Wang, S., Harrelson, D., Keitheri Cheteri, M., Farley, S., Hudson, A., Borchers, R., Stephenson, L., Espinoza, J., Weir, H., Edwards, B., Wang, N., Yang, L., Chen, J., Song, G., Xp, G., Zhang, P., Hm, G., Zhao, D., Zhang, J., Zhu, F., Tang, J., Shen, Y., Wang, J., Ql, L., Yang, X., Dong, J., Li, W., Cheng, L., Huang, Q., Huang, S., Guo, G., Wei, K., Chen, W., Zeng, H., Demetriou, A., Pavlou, P., Mang, W., Ngan, K., Kataki, A., Krishnatreya, M., Jayalekshmi, P., Sebastian, P., Sapkota, S., Verma, Y., Nandakumar, A., Suzanna, E., Keinan-boker, L., Silverman, B., Ito, H., Nakagawa, H., Hattori, M., Kaizaki, Y., Sugiyama, H., Utada, M., Katayama, K., Narimatsu, H., Kanemura, S., Koike, T., Miyashiro, I., Yoshii, M., Oki, I., Shibata, A., Matsuda, T., Nimri, O., Ab Manan, A., Bhoo-pathy, N., Tuvshingerel, S., Chimedsuren, O., Al Khater, A., Al-eid, H., Jung, K., Won, Y., Chiang, C., Lai, M., Suwanrungruang, K., Wiangnon, S., Daoprasert, K., Pongnikorn, D., Geater, S., Sriplung, H., Eser, S., Yakut, C., Hackl, M., Mühlböck, H., Oberaigner, W., Zborovskaya, A., Aleinikova, O., Henau, K., Van Eycken, L., Dimitrova, N., Valerianova, Z., Šekerija, M., Zvolský, M., Engholm, G., Storm, H., Innos, K., Mägi, M., Malila, N., Seppä, K., Jégu, J., Velten, M., Cornet, E., Troussard, X., Bouvier, A., Faivre, J., Guizard, A., Bouvier, V., Launoy, G., Arveux, P., Maynadié, M., Mounier, M., Fournier, E., Woronoff, A., Daoulas, M., Clavel, J., Le Guyader-peyrou, S., Monnereau, A., Trétarre, B., Colonna, M., Cowppli-bony, A., Molinié, F., Bara, S., Degré, D., Ganry, O., Lapôtre-ledoux, B., Grosclaude, P., Estève, J., Bray, F., Piñeros, M., Sassi, F., Stabenow, R., Eberle, A., Erb, C., Nennecke, A., Kieschke, J., Sirri, E., Kajueter, H., Emrich, K., Zeissig, S., Holleczek, B., Eisemann, N., Katalinic, A., Brenner, H., Asquez, R., Kumar, V., Ólafsdóttir, E., Tryggvadóttir, L., Comber, H., Walsh, P., Sundseth, H., Devigili, E., Mazzoleni, G., Giacomin, A., DI BELLA, F., Castaing, M., Sutera, A., Gola, G., Ferretti, S., Serraino, D., Zucchetto, A., Lillini, R., Vercelli, M., Busco, S., Pannozzo, F., Vitarelli, S., Ricci, P., Pascucci, C., Autelitano, M., Cirilli, C., Federico, M., Fusco, E., Vitale, M., Usala, M., Cusimano, R., Mazzucco, W., Michiara, M., Sgargi, P., Maule, M., Sacerdote, C., Tumino, R., Di Felice, E., Vicentini, M., Falcini, F., Cremone, L., Budroni, M., Cesaraccio, R., Contrino, M., Tisano, F., Fanetti, A., Maspero, S., Candela, G., Scuderi, T., Gentilini, M., Piffer, S., Rosso, S., Sacchetto, L., Caldarella, A., La Rosa, F., Stracci, F., Contiero, P., Tagliabue, G., Dei Tos, A., Zorzi, M., Zanetti, R., Baili, P., Berrino, F., Gatta, G., Capocaccia, R., De Angelis, R., Liepina, E., Maurina, A., Smailyte, G., Agius, D., Calleja, N., Siesling, S., Larønningen, S., Møller, B., Dyzmann-sroka, A., Trojanowski, M., Góźdż, S., Mężyk, R., Grądalska-lampart, M., Radziszewska, A., Didkowska, J., Wojciechowska, U., Błaszczyk, J., Kępska, K., Bielska-lasota, M., Kwiatkowska, K., Forjaz, G., Rego, R., Bastos, J., Silva, M., Antunes, L., Bento, M., Mayer-da-silva, A., Miranda, A., Coza, D., Todescu, A., Valkov, M., Adamcik, J., Safaei Diba, C., Primic-žakelj, M., Žagar, T., Stare, J., Almar, E., Mateos, A., Quirós, J., Bidaurrazaga, J., Larrañaga, N., Díaz García, J., Marcos, A., Marcos-gragera, R., Vilardell Gil, M., Molina, E., Sánchez, M., Franch Sureda, P., Ramos Montserrat, M., Navarro, C., Ardanaz, E., Moreno-iribas, C., Fernández-delgado, R., Peris-bonet, R., Galceran, J., Khan, S., Lambe, M., Camey, B., Bouchardy, C., Usel, M., Ess, S., Herrmann, C., Bulliard, J., Maspoli-conconi, M., Frick, H., Kuehni, C., Schindler, M., Bordoni, A., Spitale, A., Chiolero, A., Konzelmann, I., Dehler, S., Matthes, K., Rashbass, J., Stiller, C., Fitzpatrick, D., Gavin, A., Bannon, F., Black, R., Brewster, D., Huws, D., White, C., Finan, P., Bonaventure, A., Carreira, H., Di Carlo, V., Harewood, R., Liu, K., Montel, L., Nikšić, M., Rachet, B., Sanz, N., Spika, D., Stephens, R., Peake, M., Chalker, E., Newman, L., Baker, D., Soeberg, M., Aitken, J., Scott, C., Stokes, B., Venn, A., Farrugia, H., Giles, G., Threlfall, T., Currow, D., You, H., Hendrix, J., and Lewis, C.

Subjects
Epidemiology, Histology, Morphology, Ovarain cancer, Worldwide, 0301 basic medicine, Oncology, Pathology, endocrine system diseases, Sex Cord-Gonadal Stromal Tumors, Carcinoma, Ovarian Epithelial, 0302 clinical medicine, Neoplasms, Neoplasms, Glandular and Epithelial, Ovarian Neoplasms, education.field_of_study, Adolescent, Adult, Aged, Female, Humans, Middle Aged, Neoplasms, Germ Cell and Embryonal, Obstetrics and Gynecology, Glandular and Epithelial, female genital diseases and pregnancy complications, Transitional cell carcinoma, 030220 oncology & carcinogenesis, Clear cell carcinoma, Human, endocrine system, medicine.medical_specialty, Population, Socio-culturale, 03 medical and health sciences, Internal medicine, medicine, education, Mixed tumor, business.industry, Ovarian Neoplasm, Sex Cord-Gonadal Stromal Tumor, medicine.disease, 030104 developmental biology, Germ Cell and Embryonal, Ovarian cancer, business
Abstract

OBJECTIVE: Ovarian cancers comprise several histologically distinct tumour groups with widely different prognosis. We aimed to describe the worldwide distribution of ovarian cancer histology and to understand what role this may play in international variation in survival. METHODS: The CONCORD programme is the largest population-based study of global trends in cancer survival. Data on 681,759 women diagnosed during 1995-2009 with cancer of the ovary, fallopian tube, peritoneum and retroperitonum in 51 countries were included. We categorised ovarian tumours into six histological groups, and explored the worldwide distribution of histology. RESULTS: During 2005-2009, type II epithelial tumours were the most common. The proportion was much higher in Oceania (73.1%), North America (73.0%) and Europe (72.6%) than in Central and South America (65.7%) and Asia (56.1%). By contrast, type I epithelial tumours were more common in Asia (32.5%), compared with only 19.4% in North America. From 1995 to 2009, the proportion of type II epithelial tumours increased from 68.6% to 71.1%, while the proportion of type I epithelial tumours fell from 23.8% to 21.2%. The proportions of germ cell tumours, sex cord-stromal tumours, other specific non-epithelial tumours and tumours of non-specific morphology all remained stable over time. CONCLUSIONS: The distribution of ovarian cancer histology varies widely worldwide. Type I epithelial, germ cell and sex cord-stromal tumours are generally associated with higher survival than type II tumours, so the proportion of these tumours may influence survival estimates for all ovarian cancers combined. The distribution of histological groups should be considered when comparing survival between countries and regions.

Published
2016

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