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1. The Severe Asthma Network in Italy: Findings and Perspectives

Author

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, Enrico, Blasi, Francesco, Latorre, Manuela, Menzella, Francesco, Paggiaro, Pierluigi, Pelaia, Girolamo, Senna, Gianenrico, and Canonica, Giorgio Walter

Published
2019
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2. Shadow cost of oral corticosteroids-related adverse events: A pharmacoeconomic evaluation applied to real-life data from the Severe Asthma Network in Italy (SANI) registry

Author

Aliberti, Stefano, Bagnasco, Diego, Barbuto, Sarah, Camiciottoli, Gianna, Caminati, Marco, Colombo, Giselda, Costantino Maria, Teresa, Crimi, Claudia, Crivellaro, Mariangiola, D'Amato, Mariella, Favero, Elisabetta, Foschino Maria, Pia, Guarnieri, Gabriella, Latorre, Manuela, Lombardi, Carlo, Menzella, Francesco, Patella, Vincenzo, Puggioni, Francesca, Ridolo, Erminia, Rolla, Giovanni, Savi, Eleonora, Scichilone, Nicola, Solidoro, Paolo, Spadaro, Giuseppe, Triggiani, Massimo, Canonica, Giorgio Walter, Colombo, Giorgio Lorenzo, Bruno, Giacomo Matteo, Di Matteo, Sergio, Martinotti, Chiara, Blasi, Francesco, Bucca, Caterina, Crimi, Nunzio, Paggiaro, Pierluigi, Pelaia, Girolamo, Passalaqua, Giovanni, Senna, Gianenrico, and Heffler, Enrico

Published
2019
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3. Urticaria: recommendations from the Italian Society of Allergology, Asthma and Clinical Immunology and the Italian Society of Allergological, Occupational and Environmental Dermatology

Author

Nettis, Eustachio, Foti, Caterina, Ambrifi, Marina, Baiardini, Ilaria, Bianchi, Leonardo, Borghi, Alessandro, Caminati, Marco, Canonica, Giorgio Walter, Casciaro, Marco, Colli, Laura, Colombo, Giselda, Corazza, Monica, Cristaudo, Antonio, De Feo, Giulia, De Pita’, Ornella, Di Gioacchino, Mario, Di Leo, Elisabetta, Fassio, Filippo, Gangemi, Sebastiano, Gatta, Alessia, Hansel, Katharina, Heffler, Enrico, Incorvaia, Cristoforo, Napolitano, Maddalena, Patruno, Cataldo, Peveri, Silvia, Pigatto, Paolo Daniele, Quecchia, Cristina, Radice, Anna, Ramirez, Giuseppe Alvise, Romita, Paolo, Rongioletti, Franco, Rossi, Oliviero, Savi, Eleonora, Senna, Gianenrico, Triggiani, Massimo, Zucca, Myriam, Maggi, Enrico, and Stingeni, Luca

Published
2020
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4. Shadow cost of oral corticosteroids-related adverse events: A pharmacoeconomic evaluation applied to real-life data from the Severe Asthma Network in Italy (SANI) registry

Author

Giorgio Walter Canonica, Giorgio Lorenzo Colombo, Giacomo Matteo Bruno, Sergio Di Matteo, Chiara Martinotti, Francesco Blasi, Caterina Bucca, Nunzio Crimi, Pierluigi Paggiaro, Girolamo Pelaia, Giovanni Passalaqua, Gianenrico Senna, Enrico Heffler, Aliberti Stefano, Bagnasco Diego, Barbuto Sarah, Camiciottoli Gianna, Caminati Marco, Colombo Giselda, Costantino Maria Teresa, Crimi Claudia, Crivellaro Mariangiola, D'Amato Mariella, Favero Elisabetta, Foschino Maria Pia, Guarnieri Gabriella, Latorre Manuela, Lombardi Carlo, Francesco Menzella, Patella Vincenzo, Puggioni Francesca, Ridolo Erminia, Rolla Giovanni, Savi Eleonora, Scichilone Nicola, Solidoro Paolo, Spadaro Giuseppe, and Triggiani Massimo

Subjects
Immunologic diseases. Allergy, RC581-607
Abstract

Background: Asthma is one of the most common non-communicable respiratory diseases, affecting about 6% of the general population. Severe asthma, even if afflicts a minority of asthmatics, drives the majority of costs of the disease. The aim of this study is to create a pharmacoeconomic model to predict the costs of corticosteroid-related adverse events in severe asthmatics and applying it to the first published epidemiologic data from the Severe Asthma Network in Italy (SANI) registry. Methods: The analysis was conducted from the perspective of the Italian National Healthcare System (INHS). Model inputs, derived from literature, included: asthma epidemiology data, frequency of adverse events, percentage of severe asthma treated with OCS and adverse event cost (Diagnosis-Related Group (DRG) national tariffs). We estimated costs per different patient groups: non-asthma controls, mild/moderate and severe asthmatics. Final results report estimated direct cost per patient and total direct cost for overall target population, showing economic impact related to corticosteroid complication. Results: Based on epidemiological data input, in Italy, asthmatic subjects resulted about 3,999,600, of which 199,980 with severe asthma. The number of patients with severe asthma OCS-treated was estimated at 123,988. Compared to the non-asthma control cohort and to that with moderate asthma annual cost per severe asthmatic patient resulted respectively about €892 and €606 higher, showing a corticosteroids shadow cost ranging from 45% to 30%.Applying the cost per patient to the target population identified for Italy, the budget impact model estimated a total annual cost related to OCS-related adverse events of €242.7 million for severe asthmatics. In respect with non-asthmatic and moderate population, an incremental expenditure of about € 110.6 million and €75.2, respectively, were shown. Conclusions: Our study provides the first estimates of additional healthcare costs related to corticosteroid induced adverse events in severe asthma patient. Budget impact model results highlighted the relevant economic impact of OCS-related adverse events in severe asthma patients. The future extrapolation of additional data from SANI registry will support the development of a model to investigate the role of corticosteroids sparing drugs. Keywords: Severe asthma, Oral corticosteroids, Adverse events, Pharmacoeconomy, Costs, Diabetes, Glaucoma, Obesity, Bone fracture, Chronic kidney disease

Published
2019
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6. Resuscitation Fluids

Author

Della-Torre, Emanuel, Yacoub, Mona-Rita, and Colombo, Giselda

Published
2013

10. Eosinophils from Physiology to Disease: A Comprehensive Review

Author

Ramirez, Giuseppe A., Yacoub, Mona-Rita, Ripa, Marco, Mannina, Daniele, Cariddi, Adriana, Saporiti, Nicoletta, Ciceri, Fabio, Castagna, Antonella, Colombo, Giselda, and Dagna, Lorenzo

Subjects
Article Subject
Abstract

Despite being the second least represented granulocyte subpopulation in the circulating blood, eosinophils are receiving a growing interest from the scientific community, due to their complex pathophysiological role in a broad range of local and systemic inflammatory diseases as well as in cancer and thrombosis. Eosinophils are crucial for the control of parasitic infections, but increasing evidence suggests that they are also involved in vital defensive tasks against bacterial and viral pathogens including HIV. On the other side of the coin, eosinophil potential to provide a strong defensive response against invading microbes through the release of a large array of compounds can prove toxic to the host tissues and dysregulate haemostasis. Increasing knowledge of eosinophil biological behaviour is leading to major changes in established paradigms for the classification and diagnosis of several allergic and autoimmune diseases and has paved the way to a “golden age” of eosinophil-targeted agents. In this review, we provide a comprehensive update on the pathophysiological role of eosinophils in host defence, inflammation, and cancer and discuss potential clinical implications in light of recent therapeutic advances.

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

Author

Heffler, Enrico, primary, Blasi, Francesco, additional, Latorre, Manuela, additional, Menzella, Francesco, additional, Paggiaro, Pierluigi, additional, Pelaia, Girolamo, additional, Senna, Gianenrico, additional, Canonica, Giorgio Walter, additional, Barbuto, Sarah, additional, Bradicich, Matteo, additional, Camiciottoli, Gianna, additional, Caminati, Marco, additional, Colombo, Giselda, additional, Costantino, Maria Teresa, additional, Crimi, Nunzio, additional, Crivellaro, Mariangiola, additional, D’Adda, Alice, additional, D’Amato, Mariella, additional, Favero, Elisabetta, additional, Foschino, Maria Pia, additional, Galeone, Carla, additional, Guarnieri, Gabriella, additional, Lombardi, Carlo, additional, Parente, Roberta, additional, Passalacqua, Giovanni, additional, Patella, Vincenzo, additional, Puggioni, Francesca, additional, Ridolo, Erminia, additional, Rolla, Giovanni, additional, Savi, Eleonora, additional, Scichilone, Nicola, additional, Solidoro, Paolo, additional, and Spadaro, Giuseppe, additional

Published
2019
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13. Shadow cost of oral corticosteroids-related adverse events: A pharmacoeconomic evaluation applied to real-life data from the Severe Asthma Network in Italy (SANI) registry

Author

Canonica, Giorgio Walter, primary, Colombo, Giorgio Lorenzo, additional, Bruno, Giacomo Matteo, additional, Di Matteo, Sergio, additional, Martinotti, Chiara, additional, Blasi, Francesco, additional, Bucca, Caterina, additional, Crimi, Nunzio, additional, Paggiaro, Pierluigi, additional, Pelaia, Girolamo, additional, Passalaqua, Giovanni, additional, Senna, Gianenrico, additional, Heffler, Enrico, additional, Aliberti, Stefano, additional, Bagnasco, Diego, additional, Barbuto, Sarah, additional, Camiciottoli, Gianna, additional, Caminati, Marco, additional, Colombo, Giselda, additional, Costantino Maria, Teresa, additional, Crimi, Claudia, additional, Crivellaro, Mariangiola, additional, D'Amato, Mariella, additional, Favero, Elisabetta, additional, Foschino Maria, Pia, additional, Guarnieri, Gabriella, additional, Latorre, Manuela, additional, Lombardi, Carlo, additional, Menzella, Francesco, additional, Patella, Vincenzo, additional, Puggioni, Francesca, additional, Ridolo, Erminia, additional, Rolla, Giovanni, additional, Savi, Eleonora, additional, Scichilone, Nicola, additional, Solidoro, Paolo, additional, Spadaro, Giuseppe, additional, and Triggiani, Massimo, additional

Published
2019
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15. A survey of clinical features of allergic rhinitis in adults

Author

Frati, Franco, Dell’Albani, Ilaria, Passalacqua, Giovanni, Bonini, Sergio, Rossi, Oliviero, Senna, Gianenrico, Incorvaia, Cristoforo, Albano, Monica, Allegretti, Lucrezia, Altomonte, Giorgia, Antico, Andrea, Arena, ANTONIO IGNAZIO, Ariano, Renato, Arigliano, Pasquale, Arrigoni, Paola, Arsieni, Augusto, Aruanno, Arianna, Bernardis, Paola, Berra, Adriano, Billeri, Lucia, Boccafogli, Arrigo, Borghesan, Franco, Borgonovo, Linda, Borrelli, Paolo, Braga, Marina, Bresciani, Megan, Bruno, Guglielmo, Bruno, Massimo, Bruzzese, Domenico, Buonomo, Alessandro, Cadario, Gianni, Candi, Paolo, Cantone, Renato, Capretti, Stefania, Carabelli, Anna, Caramazza, Rino, Carbonara, Annamaria, Carosso, Aurelia, Caruso, Cristiano, Caruso, Riccardo, Casino, Giuseppe, Casotto, Stefano, Castellano, Francesco, Castiglioni, Gloria, Cecchi, Lidia, Chiarini, Francesca, Bianchi, Fulvia Chieco, Cinquepalmi, Giuseppe, Cinquini, Massimo, Cocchi, Silvia, Colangelo, Caterina, Colombo, Giselda, Cortellini, Gabriele, Crescioli, Stefano, Crimi, Nunzio, Cucinelli, Francesco, Curcio, Antonio, Cutajar, Marina, D’Amato, Gennaro, De Palma, Rafaele, Del Pozzo, Giuseppe, Torre, Fabrizio Della, Donne, Pantalea Delle, Di Claudio, Fabio, Di Leo, Elisabetta, Di Lorenzo, Gabriele, Di Marco, Giuseppe, Di Rocco Cesinaro, Paola, Distaso, Maria, Ditta, Vito, Emiliani, Francesca, Ermini, Giuseppe, Facchetti, Susanna, Farsi, Alessandro, Favero, Elisabetta, Folletti, Ilenia, Franchini, Maurizio, Gammeri, Enrico, Gangemi, Sebastiano, Gani, Federica, Gargano, Domenico, Giannoccaro, Francesco, Giro, Giuseppina, Gracefa, Dario, Greco, Giacomo, Guarnieri, Gabriella, Ingrassia, Antonino, Intravaia, Rossella, Iorno, Loredana, Piana, Simona La, Rosa, Luigi La, Laddaga, Rocco, Lamanna, Carlo, Landi, Massimo, Leonetti, Luigi, Barone, Stefania Leto, Liccardi, Gennaro, Lodi Rizzini, Fabio, Losappio, Laura, Lucivero, Giacomo, Macchia, Donatella, Madonna, Francesco, Mafezzoni, Enrico, Mancuso, Vincenzo, Manetti, Roberto, Manfredi, Giacomo, Manzoni, Silvia, Marcotulli, Maria, Marengo, Fulvia, D’Ippolito, Gianna Maria, Masieri, Simonetta, Matucci, Andrea, Mauro, Marina, Melchiorre, Antonietta, Menzella, Francesco, Micucci, Corrado, Mietta, Sabrina, Milanese, Manlio, Minetti, Stefano, Modiano, Ambra, Modica, Stella, Moinaghi, Marcello, Mondino, Michela, Munno, Giorgio, Muratore, Lionello, Murzilli, Francesco, Natoli, Rosalba, Nebiolo, Franco, Nettis, Eustachio, Olivieri, Elisa, Pannofno, Alessandro, Parpanesi, Mauro, Patella, Vincenzo, Petraroli, Angelica, Peveri, Silvia, Piantanida, Marta, Pietrafesa, Maria, Pinter, Elena, Pizzimenti, Stefano, Pompilio, Luana, Porcaro, Valeria, Prandini, Paolo, Pravettoni, Valerio, Pugliese, Salvatore, Quarta, Carlo, Quecchia, Cristina, Quercia, Oliviero, Quilleri, Roberto, Raie, Alberto, Randazzo, Salvatore, Ridolo, Erminia, Rolla, Giovanni, Romano, Antonino, Rota, Federica, Russello, Marina, Santucci, Annalisa, Savi, Eleonora, Scarantino, Giovanna, Scarpa, Sergio, Schiavino, Domenico, Sciacca, Angelo Rito, Serra, Paolo, Severino, Maurizio, Sirena, Alberto, Spadaro, Giuseppe, Spina, Francesca, Sugamiele, Mario, Taddeo, Giordano, Ventura, Maria Teresa, Testi, Sergio, Tombetti, Enrico, Tosoni, Cinzia, Triggiani, Massimo, Tripodi, Salvatore, Vallerani, Elisabetta, Vargiu, Arnoldo, Varricchio, Attilio, Zambito, Marcello, Zanforlin, Mario, Zanoni, Giovanna, Frati, F, Dell’Albani, I, Passalacqua, G, Bonini, Sergio, Rossi, O, Senna, G, Incorvaia, C, Adult SURF Study, Group, DE PALMA, Raffaele, Frati, Franco, Dell’Albani, Ilaria, Passalacqua, Giovanni, Rossi, Oliviero, Senna, Gianenrico, Incorvaia, Cristoforo, Albano, Monica, Allegretti, Lucrezia, Altomonte, Giorgia, Antico, Andrea, Arena, Antonio, Ariano, Renato, Arigliano, Pasquale, Arrigoni, Paola, Arsieni, Augusto, Aruanno, Arianna, Bernardis, Paola, Berra, Adriano, Billeri, Lucia, Boccafogli, Arrigo, Borghesan, Franco, Borgonovo, Linda, Borrelli, Paolo, Braga, Marina, Bresciani, Megan, Bruno, Guglielmo, Bruno, Massimo, Bruzzese, Domenico, Buonomo, Alessandro, Cadario, Gianni, Candi, Paolo, Cantone, Renato, Capretti, Stefania, Carabelli, Anna, Caramazza, Rino, Carbonara, Annamaria, Carosso, Aurelia, Caruso, Cristiano, Caruso, Riccardo, Casino, Giuseppe, Casotto, Stefano, Castellano, Francesco, Castiglioni, Gloria, Cecchi, Lidia, Chiarini, Francesca, Bianchi, Fulvia Chieco, Cinquepalmi, Giuseppe, Cinquini, Massimo, Cocchi, Silvia, Colangelo, Caterina, Colombo, Giselda, Cortellini, Gabriele, Crescioli, Stefano, Crimi, Nunzio, Cucinelli, Francesco, Curcio, Antonio, Cutajar, Marina, D’Amato, Gennaro, De Palma, Rafaele, Del Pozzo, Giuseppe, Torre, Fabrizio, Donne, Pantalea Delle, Di Claudio, Fabio, Di Leo, Elisabetta, Di Lorenzo, Gabriele, Di Marco, Giuseppe, Di Rocco Cesinaro, Paola, Distaso, Maria, Ditta, Vito, Emiliani, Francesca, Ermini, Giuseppe, Facchetti, Susanna, Farsi, Alessandro, Favero, Elisabetta, Folletti, Ilenia, Franchini, Maurizio, Gammeri, Enrico, Gangemi, Sebastiano, Gani, Federica, Gargano, Domenico, Giannoccaro, Francesco, Giro, Giuseppina, Gracefa, Dario, Greco, Giacomo, Guarnieri, Gabriella, Ingrassia, Antonino, Intravaia, Rossella, Iorno, Loredana, Piana, Simona La, Rosa, Luigi La, Laddaga, Rocco, Lamanna, Carlo, Landi, Massimo, Leonetti, Luigi, Barone, Stefania Leto, Liccardi, Gennaro, Lodi-Rizzini, Fabio, Losappio, Laura, Lucivero, Giacomo, Macchia, Donatella, Madonna, Francesco, Mafezzoni, Enrico, Mancuso, Vincenzo, Manetti, Roberto, Manfredi, Giacomo, Manzoni, Silvia, Marcotulli, Maria, Marengo, Fulvia, D’Ippolito, Gianna Maria, Masieri, Simonetta, Matucci, Andrea, Mauro, Marina, Melchiorre, Antonietta, Menzella, Francesco, Micucci, Corrado, Mietta, Sabrina, Milanese, Manlio, Minetti, Stefano, Modiano, Ambra, Modica, Stella, Moinaghi, Marcello, Mondino, Michela, Munno, Giorgio, Muratore, Lionello, Murzilli, Francesco, Natoli, Rosalba, Nebiolo, Franco, Nettis, Eustachio, Olivieri, Elisa, Pannofno, Alessandro, Parpanesi, Mauro, Patella, Vincenzo, Petraroli, Angelica, Peveri, Silvia, Piantanida, Marta, Pietrafesa, Maria, Pinter, Elena, Pizzimenti, Stefano, Pompilio, Luana, Porcaro, Valeria, Prandini, Paolo, Pravettoni, Valerio, Pugliese, Salvatore, Quarta, Carlo, Quecchia, Cristina, Quercia, Oliviero, Quilleri, Roberto, Raie, Alberto, Randazzo, Salvatore, Ridolo, Erminia, Rolla, Giovanni, Romano, Antonino, Rota, Federica, Russello, Marina, Santucci, Annalisa, Savi, Eleonora, Scarantino, Giovanna, Scarpa, Sergio, Schiavino, Domenico, Sciacca, Angelo Rito, Serra, Paolo, Severino, Maurizio, Sirena, Alberto, Spadaro, Giuseppe, Spina, Francesca, Sugamiele, Mario, Taddeo, Giordano, Ventura, Maria Teresa, Testi, Sergio, Tombetti, Enrico, Tosoni, Cinzia, Triggiani, Massimo, Tripodi, Salvatore, Vallerani, Elisabetta, Vargiu, Arnoldo, Varricchio, Attilio, Zambito, Marcello, Zanforlin, Mario, and Zanoni, Giovanna

Subjects
Adult, Male, medicine.medical_specialty, Allergen immunotherapy, Sublingual, Adolescent, medicine.medical_treatment, ARIA guidelines, Desensitization, allergic rhinitis, survey data, Drug treatment, Young Adult, Patient satisfaction, Allergic, Immunologic, Allergic Rhinitis, Internal medicine, Administration, Patient compliance, Rhinitis, Seasonal, Female, Humans, Italy, Middle Aged, Patient Satisfaction, Rhinitis, Allergic, Skin Tests, Treatment Outcome, Data Collection, Medicine (all), medicine, In patient, Young adult, Rhiniti, Desensitization (medicine), High prevalence, Skin Test, Adult patients, business.industry, Settore MED/09 - MEDICINA INTERNA, General Medicine, Surgery, Public Health, business, Human
Abstract

Background: Allergic rhinitis (AR) has high prevalence and substantial socio-economic burden.Material/Methods: The study included 35 Italian Centers recruiting an overall number of 3383 adult patients with rhinitis (48% males, 52% females, mean age 29.1, range 18-45 years). For each patient, the attending physician had to fill in a standardized questionnaire, covering, in particular, some issues such as the ARIA classification of allergic rhinitis (AR), the results of skin prick test (SPT), the kind of treatment, the response to treatment, and the satisfaction with treatment.Results: Out of the 3383 patients with rhinitis, 2788 (82.4%) had AR: 311 (11.5%) had a mild intermittent, 229 (8.8%) a mild persistent, 636 (23.5%) a moderate-severe intermittent, and 1518 (56.1%) a moderate-severe persistent form. The most frequently used drugs were oral antihistamines (77.1%) and topical corticosteroids (60.8%). The response to treatment was judged as excellent in 12.2%, good in 41.3%, fair in 31.2%, poor in 14.5%, and very bad in 0.8% of subjects. The rate of treatment dissatisfaction was significantly higher in patients with moderate-to-severe AR than in patients with mild AR (p

Published
2014

16. Respiratory Allergies: A General Overview of Remedies, Delivery Systems, and the Need to Progress

Author

Molinari, Giuliano, Colombo, Giselda, and Celenza, Cinzia

Subjects
Article Subject
Abstract

The spread of respiratory allergies is increasing in parallel with the alarm of the scientific community. Evidently, our knowledge of the onset mechanisms of these diseases and, as a consequence, of the available remedies is inadequate. This review provides a brief, general description of current therapeutic resources and the state of research with regard to both drugs and medical devices in order to highlight their limits and the urgent need for progress. Increasing the amount of basic biochemical research will improve our knowledge of such onset mechanisms and the potential efficacy of therapeutic preparations.

Published
2014
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18. Drug induced exfoliative dermatitis: state of the art

Author

Yacoub, Mona-Rita, primary, Berti, Alvise, additional, Campochiaro, Corrado, additional, Tombetti, Enrico, additional, Ramirez, Giuseppe Alvise, additional, Nico, Andrea, additional, Di Leo, Elisabetta, additional, Fantini, Paola, additional, Sabbadini, Maria Grazia, additional, Nettis, Eustachio, additional, and Colombo, Giselda, additional

Published
2016
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19. Are atopy and eosinophilic bronchial inflammation associated with relapsing forms of chronic rhinosinusitis with nasal polyps?

Author

Yacoub, Mona-Rita, primary, Trimarchi, Matteo, additional, Cremona, George, additional, Dal Farra, Sara, additional, Ramirez, Giuseppe Alvise, additional, Canti, Valentina, additional, Della Torre, Emanuel, additional, Baldini, Mattia, additional, Pignatti, Patrizia, additional, Bussi, Mario, additional, Sabbadini, Maria Grazia, additional, Manfredi, Angelo A, additional, and Colombo, Giselda, additional

Published
2015
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26. Asthma and panic attacks

Author

Perna, Giampaolo, primary, Bertani, Angelo, additional, Politi, Ernestina, additional, Colombo, Giselda, additional, and Bellodi, Laura, additional

Published
1997
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28. Shadow cost of oral corticosteroids-related adverse events: A pharmacoeconomic evaluation applied to real-life data from the Severe Asthma Network in Italy (SANI) registry

Author

Giovanni Rolla, Pierluigi Paggiaro, Marco Caminati, Girolamo Pelaia, Claudia Crimi, Pia Foschino Maria, Vincenzo Patella, Sarah Barbuto, Gianenrico Senna, Stefano Aliberti, Nunzio Crimi, Manuela Latorre, Giselda Colombo, Giorgio L Colombo, Giuseppe Spadaro, Teresa Costantino Maria, Nicola Scichilone, Giovanni Passalaqua, Mariangiola Crivellaro, Massimo Triggiani, Enrico Heffler, Caterina Bucca, Francesco Menzella, Sergio Di Matteo, Eleonora Savi, Elisabetta Favero, Chiara Martinotti, Diego Bagnasco, Gabriella Guarnieri, Gianna Camiciottoli, Francesco Blasi, M D'Amato, GM Bruno, Francesca Puggioni, Paolo Solidoro, Carlo Lombardi, Giorgio Walter Canonica, Erminia Ridolo, Giorgio Walter, Canonica, Giorgio Lorenzo, Colombo, Giacomo Matteo, Bruno, Sergio Di, Matteo, Chiara, Martinotti, Francesco, Blasi, Caterina, Bucca, Nunzio, Crimi, Pierluigi, Paggiaro, Girolamo, Pelaia, Giovanni, Passalaqua, Gianenrico, Senna, Enrico, Heffler, Aliberti, Stefano, Bagnasco, Diego, Barbuto, Sarah, Camiciottoli, Gianna, Caminati, Marco, Colombo, Giselda, Costantino Maria, Teresa, Crimi, Claudia, Crivellaro, Mariangiola, D'Amato, Mariella, Favero, Elisabetta, Foschino Maria, Pia, Guarnieri, Gabriella, Latorre, Manuela, Lombardi, Carlo, Menzella, Francesco, Patella, Vincenzo, Puggioni, Francesca, Ridolo, Erminia, Rolla, Giovanni, Savi, Eleonora, Scichilone, Nicola, Solidoro, Paolo, Spadaro, Giuseppe, and Triggiani, Massimo

Subjects
Pulmonary and Respiratory Medicine, lcsh:Immunologic diseases. Allergy, medicine.medical_specialty, Severe asthma, Immunology, Population, Disease, Article, Pharmacoeconomy, Chronic kidney disease, Health care, Epidemiology, Oral corticosteroids, medicine, Immunology and Allergy, Obesity, Adverse effect, education, Asthma, education.field_of_study, business.industry, Diabetes, Adverse events, Bone fracture, Costs, Glaucoma, medicine.disease, Emergency medicine, Cohort, business, Complication, lcsh:RC581-607
Abstract

Background: Asthma is one of the most common non-communicable respiratory diseases, affecting about 6% of the general population. Severe asthma, even if afflicts a minority of asthmatics, drives the majority of costs of the disease. The aim of this study is to create a pharmacoeconomic model to predict the costs of corticosteroid-related adverse events in severe asthmatics and applying it to the first published epidemiologic data from the Severe Asthma Network in Italy (SANI) registry. Methods: The analysis was conducted from the perspective of the Italian National Healthcare System (INHS). Model inputs, derived from literature, included: asthma epidemiology data, frequency of adverse events, percentage of severe asthma treated with OCS and adverse event cost (Diagnosis-Related Group (DRG) national tariffs). We estimated costs per different patient groups: non-asthma controls, mild/moderate and severe asthmatics. Final results report estimated direct cost per patient and total direct cost for overall target population, showing economic impact related to corticosteroid complication. Results: Based on epidemiological data input, in Italy, asthmatic subjects resulted about 3,999,600, of which 199,980 with severe asthma. The number of patients with severe asthma OCS-treated was estimated at 123,988. Compared to the non-asthma control cohort and to that with moderate asthma annual cost per severe asthmatic patient resulted respectively about €892 and €606 higher, showing a corticosteroids shadow cost ranging from 45% to 30%.Applying the cost per patient to the target population identified for Italy, the budget impact model estimated a total annual cost related to OCS-related adverse events of €242.7 million for severe asthmatics. In respect with non-asthmatic and moderate population, an incremental expenditure of about € 110.6 million and €75.2, respectively, were shown. Conclusions: Our study provides the first estimates of additional healthcare costs related to corticosteroid induced adverse events in severe asthma patient. Budget impact model results highlighted the relevant economic impact of OCS-related adverse events in severe asthma patients. The future extrapolation of additional data from SANI registry will support the development of a model to investigate the role of corticosteroids sparing drugs. Keywords: Severe asthma, Oral corticosteroids, Adverse events, Pharmacoeconomy, Costs, Diabetes, Glaucoma, Obesity, Bone fracture, Chronic kidney disease

Published
2019

29. Diamine Oxidase Supplementation in Chronic Spontaneous Urticaria: A Randomized, Double-Blind Placebo-Controlled Study

Author

Nicoletta Saporiti, Giuseppe A. Ramirez, Samuele E. Burastero, Giselda Colombo, Daniela Breda, Lorenzo Dagna, Giuseppe Mercurio, Alvise Berti, Mona-Rita Yacoub, Yacoub, Mona-Rita, Ramirez, Giuseppe A, Berti, Alvise, Mercurio, Giuseppe, Breda, Daniela, Saporiti, Nicoletta, Burastero, Samuele, Dagna, Lorenzo, and Colombo, Giselda

Subjects
0301 basic medicine, Adult, Male, medicine.medical_specialty, Urticaria, medicine.medical_treatment, Immunology, Placebo-controlled study, Placebo, Gastroenterology, 03 medical and health sciences, Basal (phylogenetics), chemistry.chemical_compound, 0302 clinical medicine, Double-Blind Method, Internal medicine, medicine, Humans, Immunology and Allergy, Diamine oxidase, Aged, Meal, Gastrointestinal tract, Cross-Over Studies, business.industry, General Medicine, Cross-Over Studie, Middle Aged, Chronic spontaneous urticaria, 030104 developmental biology, 030228 respiratory system, chemistry, Chronic Disease, Dietary Supplements, Histamine intolerance, Antihistamine, Female, Amine Oxidase (Copper-Containing), business, Histamine, Human
Abstract

Introduction: Diamine oxidase (DAO) catabolizes and inactivates histamine, a key player in a wide range of invalidating conditions, such as migraine and chronic spontaneous urticaria (CSU). The highest expression of DAO occurs in the gastrointestinal tract, possibly to control the burden of histamine intake from food. Methods: Here, we tested the hypothesis that a 30-day oral supplementation with DAO (1 capsule b.i.d., 15 min before a meal) could reduce the severity of CSU as estimated by the 7-Day Urticaria Activity Score (UAS-7). The study was designed as a double-blind, placebo-controlled, crossover investigation of 22 patients with CSU incompletely controlled by first-line antihistamine therapy. Results: Twenty patients completed the study. Supplemental therapy with DAO caused a 3.8 ± 1.2 point mean ± SEM UAS-7 score reduction in patients with low serum DAO levels at time 0 (p = 0.041 compared to placebo). The degree of UAS-7 improvement was inversely correlated with the levels of basal DAO (p = 0.019). Patients receiving DAO supplementation were able to slightly reduce their daily antihistamine dose (p = 0.049). Conclusion: These data suggest that DAO may be involved in the pathogenic cascade of CSU and that DAO supplementation could be effective for symptom relief in patients with low DAO levels in serum.

Published
2018

30. 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

31. Eosinophils from Physiology to Disease: A Comprehensive Review

Author

Giuseppe A. Ramirez, Marco Ripa, Adriana Cariddi, Mona-Rita Yacoub, Daniele Mannina, Antonella Castagna, Giselda Colombo, Lorenzo Dagna, Fabio Ciceri, Nicoletta Saporiti, Ramirez, Giuseppe A., Yacoub, Mona-Rita, Ripa, Marco, Mannina, Daniele, Cariddi, Adriana, Saporiti, Nicoletta, Ciceri, Fabio, Castagna, Antonella, Colombo, Giselda, and Dagna, Lorenzo

Subjects
0301 basic medicine, Immunology and Microbiology (all), Large array, lcsh:Medicine, Inflammation, Disease, Review Article, Granulocyte, Models, Biological, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, 0302 clinical medicine, medicine, Animals, Humans, Biochemistry, Genetics and Molecular Biology (all), General Immunology and Microbiology, business.industry, lcsh:R, Cancer, General Medicine, Host defence, Eosinophil, medicine.disease, Eosinophils, 030104 developmental biology, medicine.anatomical_structure, Phenotype, Immunology, medicine.symptom, business, 030215 immunology
Abstract

Despite being the second least represented granulocyte subpopulation in the circulating blood, eosinophils are receiving a growing interest from the scientific community, due to their complex pathophysiological role in a broad range of local and systemic inflammatory diseases as well as in cancer and thrombosis. Eosinophils are crucial for the control of parasitic infections, but increasing evidence suggests that they are also involved in vital defensive tasks against bacterial and viral pathogens including HIV. On the other side of the coin, eosinophil potential to provide a strong defensive response against invading microbes through the release of a large array of compounds can prove toxic to the host tissues and dysregulate haemostasis. Increasing knowledge of eosinophil biological behaviour is leading to major changes in established paradigms for the classification and diagnosis of several allergic and autoimmune diseases and has paved the way to a “golden age” of eosinophil-targeted agents. In this review, we provide a comprehensive update on the pathophysiological role of eosinophils in host defence, inflammation, and cancer and discuss potential clinical implications in light of recent therapeutic advances.

Published
2017

32. Effects of sublingual immunotherapy on allergic inflammation: an update.

Author

Yacoub MR, Colombo G, Marcucci F, Caminati M, Sensi L, Di Cara G, Frati F, and Incorvaia C

Subjects
Administration, Sublingual, Allergens administration & dosage, Allergens immunology, Humans, Immune Tolerance drug effects, Immune Tolerance immunology, Mouth Mucosa immunology, Desensitization, Immunologic methods, Inflammation immunology, Inflammation therapy
Abstract

The most common allergic diseases, and especially the respiratory disorders such as rhinitis and asthma, are closely related to the allergic inflammation elicited by the causative allergen. This makes inflammation the main target of anti-allergic therapies. Among the available treatments, allergen specific immunotherapy (AIT) has a patent effect on allergic inflammation, which persists also after its discontinuation, and is the only therapy able to modify the natural history of allergy. The traditional, subcutaneous route of administration was demonstrated to modify the allergen presentation by dendritic cells (DCs) that in turn correct the phenotype of allergen-specific T cells, switching from the Th2-type response, typical of allergic inflammation and characterized by the production of IL-4, IL-5, IL-13, IL-17, and IL-32 cytokines to a Th1-type response. This immune deviation is related to an increased IFN-gamma and IL-2 production as well as to the anergy of Th2 or to tolerance, the latter being related to the generation of allergen-specific T regulatory (Treg) cells, which produce cytokines such as IL-10 and TGF-beta. Anti-inflammatory mechanisms observed during sublingual AIT with high allergen doses proved to be similar to subcutaneous immunotherapy. Data obtained from biopsies clearly indicate that the pathophysiology of the oral mucosa, with particular importance for mucosal DCs, plays a crucial role in inducing tolerance to the administered allergen.

Published
2012
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