Severe Asthma in a Middle-Income Country: Impact of the ASMAIRE REXPIRA Specialized Clinic
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Abstract
Introduction: The impact of specialized clinics for severe asthma on disease control in middle-income countries like Colombia is limited.
Objective: To evaluate the impact of ASMAIRE REXPIRA on clinical outcomes in a cohort of patients with severe asthma.
Methods: A real-world, retrospective, observational, before–after study was conducted in patients ≥18 years with severe asthma (high-dose ICS/LABA, GINA 2020 step 5) who were enrolled in 2022 and completed two years of follow-up. The year prior to enrollment was compared with the first and second years of follow-up. Outcomes included exacerbations requiring oral corticosteroids (OCS), emergency department visits or hospitalizations, symptoms (ACT and ACQ-5), pre- and post-bronchodilator (BD) FEV₁, and quality of life (miniAQLQ).
Results: A total of 196 patients were included; 80.1% were women, with a mean age of 51.9 years and a BMI of 27.8. At the first year, the proportion of patients with controlled asthma increased from 49.7% to 64.1%, and further to 70.4% in the second year (p<0.001). Exacerbation rates requiring OCS, emergency care or hospitalization decreased by 67%, 69%, and 78%, respectively, in the first year and continued to decrease in the second year. Quality of life improved significantly at both time points (p<0.001). No significant changes were observed in FEV₁.
Conclusions: Managing severe asthma with an interdisciplinary approach at clinics like ASMAIRE REXPIRA improves disease control. This care model may be cost-effective, pending economic evaluation, and could help reduce severe asthma burden if adopted more widely in Latin America.
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