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Clinical and functional evolution in patients with severe asthma in a specialized clinic: 12-month follow-up

Abstract:

INTRODUCTION: Severe asthma affects approximately 3-10% of asthma patients and requires high-dose inhaled corticosteroids, a second controller, and/or systemic corticosteroids for disease control. This study aimed to describe the clinical and functional changes observed in a specialized clinic for severe asthma after 12 months of follow-up. MATERIALS AND METHODS: A retrospective cohort study was conducted between December 2010 and January 2024. Adult patients who met the criteria for severe asthma according to GINA 2023 and GEMA 2024 guidelines were included. Follow-up was carried out in a multidisciplinary clinic staffed by specialists in pulmonology, otolaryngology, and allergy. Asthma control (ACT score), annual exacerbation frequency, systemic corticosteroid use, and lung function were assessed. A p-value < 0.05 was considered statistically significant. RESULTS: A total of 72 patients were included, with a median age of 56 years; 74% were female. Systemic corticosteroid use decreased from 43.9% to 6% (p < 0.001). The median number of exacerbations dropped from 6 to 1 per year (p < 0.001), the ACT score increased from 14 to 22 (p < 0.001), and the average FEV1 improved from 63% to 76% of predicted value (p < 0.001). DISCUSSION: In this retrospective cohort, significant improvements in clinical and functional variables were observed after 12 months of follow-up in patients with severe asthma. These findings support the potential usefulness of a multidisciplinary approach in the comprehensive management of severe asthma.