[Exacerbations in severe persistent asthma--impact of risk factors control]

It is estimated that in developed countries between 1% and 2% of total healthcare expenditure goes on asthma treatment. The natural progression and causes of severe asthma are still not well defined. Severe persistent asthma is a less common situation, accounting for 5% of total asthma patients. Despite representing a small percentage of total patients, this group is largely responsible for the high health costs of asthma. Consequently, the improvement of risk factors can lead to both socioeconomic and health gains. The aim of this study was to examine risk factors for exacerbations in a group of patients with severe persistent asthma. It was a retrospective study, based on patient case histories that included subjects with severe persistent asthma with follow-up in an allergy unit between 1984 and 2005. A total 27 patients were included (mean age=50.64+/-12.7 years), 81.5% female. Main risk factors for exacerbations analysed were atopy, respiratory infections, premenstrual asthma, nasal symptoms, gastroesophageal reflux disease (GERD), psychological factors and obesity. Correction of these risk factors improved asthma control. The most significant impact was achieved with polypectomy and oral contraceptives in a teenager. In conclusion, correct identification of all risk factors for exacerbation in asthma, selection of those that can be controlled and their correction can improve asthma control.