Jeanne-Marie Perotin, Lisa Gauquelin, Nicolas Just, Gilles Devouassoux, Cécile Chenivesse, Arnaud Bourdin, Gilles Garcia, Christel Saint Raymond, Amel Boudjemaa, Philippe Bonniaud, Pascal Chanez, Cindy Barnig, Antoine Beurnier, Cyril Maurer, Nathalie Freymond, Toufik Didi, C. Tcherakian, M. Russier, Mélanie Drucbert, Sylvie Guillo, Candice Estellat, Camille Taillé
{"title":"Severe asthma care trajectories: the French RAMSES cohort","authors":"Jeanne-Marie Perotin, Lisa Gauquelin, Nicolas Just, Gilles Devouassoux, Cécile Chenivesse, Arnaud Bourdin, Gilles Garcia, Christel Saint Raymond, Amel Boudjemaa, Philippe Bonniaud, Pascal Chanez, Cindy Barnig, Antoine Beurnier, Cyril Maurer, Nathalie Freymond, Toufik Didi, C. Tcherakian, M. Russier, Mélanie Drucbert, Sylvie Guillo, Candice Estellat, Camille Taillé","doi":"10.1183/23120541.00837-2023","DOIUrl":null,"url":null,"abstract":"The French RAMSES study is an observational prospective multicentre real-life cohort including severe asthmatics. The objective of the study was to compare the characteristics of patients, in terms of phenotype and asthma care trajectories, between those managed by tertiary referral centres (TRC) or secondary care centres (SCC).Patients were prospectively recruited and enrolled for a 5-year follow-up. Patients’ characteristics were analysed at inclusion and compared between TRC and SCC.Fifty-two centres (24 TRC, 28 SCC) included 2046 patients: 1502 (73.4%) were included by a TRC and 544 (26.6%) by a SCC. Patients were mainly women (62%), 53±15 yr old, 67% with Asthma control test <20, 14% received at inclusion oral corticosteroids and 66% biologics. Compared with SCC, the TRC group had more frequent comorbidities, and lower blood eosinophil count (262/mm3versus340/mm3, p=0.0036). OCS and biologics use did not differ between groups but patients in the TRC group benefited more frequently from an educational program (26%versus18%, p=0.0008), and received more frequently ≥2 sequential lines of biologics (33%versus24%, p=0.0105). In-depth investigations were more frequently performed in the TRC group (allergy tests: 74%versus62%, p<0.0001; FeNO: 56%versus21%, p<0.0001; induced sputum: 6%versus3%, p=0.0390).Phenotypes and care trajectories differed in the RAMSES cohort between SCC and TRC, probably related to different levels of asthma severity and differences in medical resources and practices among centres. This highlights the need for standardisation of severe asthma care.","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ERJ Open Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1183/23120541.00837-2023","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
Abstract
The French RAMSES study is an observational prospective multicentre real-life cohort including severe asthmatics. The objective of the study was to compare the characteristics of patients, in terms of phenotype and asthma care trajectories, between those managed by tertiary referral centres (TRC) or secondary care centres (SCC).Patients were prospectively recruited and enrolled for a 5-year follow-up. Patients’ characteristics were analysed at inclusion and compared between TRC and SCC.Fifty-two centres (24 TRC, 28 SCC) included 2046 patients: 1502 (73.4%) were included by a TRC and 544 (26.6%) by a SCC. Patients were mainly women (62%), 53±15 yr old, 67% with Asthma control test <20, 14% received at inclusion oral corticosteroids and 66% biologics. Compared with SCC, the TRC group had more frequent comorbidities, and lower blood eosinophil count (262/mm3versus340/mm3, p=0.0036). OCS and biologics use did not differ between groups but patients in the TRC group benefited more frequently from an educational program (26%versus18%, p=0.0008), and received more frequently ≥2 sequential lines of biologics (33%versus24%, p=0.0105). In-depth investigations were more frequently performed in the TRC group (allergy tests: 74%versus62%, p<0.0001; FeNO: 56%versus21%, p<0.0001; induced sputum: 6%versus3%, p=0.0390).Phenotypes and care trajectories differed in the RAMSES cohort between SCC and TRC, probably related to different levels of asthma severity and differences in medical resources and practices among centres. This highlights the need for standardisation of severe asthma care.
期刊介绍:
ERJ Open Research is a fully open access original research journal, published online by the European Respiratory Society. The journal aims to publish high-quality work in all fields of respiratory science and medicine, covering basic science, clinical translational science and clinical medicine. The journal was created to help fulfil the ERS objective to disseminate scientific and educational material to its members and to the medical community, but also to provide researchers with an affordable open access specialty journal in which to publish their work.