Clinical and epidemiological characteristics of patients with bronchial asthma in comorbid patients according to the registry of patients with bronchial asthma in Kursk region

Objective - to evaluate the clinical and epidemiological characteristics of patients with bronchial asthma in comorbid patients based on the analysis of data from the registry of patients with bronchial asthma in the Kursk region.

Materials and methods. A retrospective randomized study of 3698 patients with bronchial asthma included in the registry of patients with bronchial asthma in the Kursk region was conducted, of which concomitant (comorbid) pathology was detected in 3158 patients (85,4%), and isolated bronchial asthma was detected in 540 patients (14,6%).

Results. According to the results of the asthma control test, the controlled course of bronchial asthma was registered in only one third of patients (36%), partial control in 49%, and in 15% of patients, despite the etiopathogenetic therapy, asthma has an uncontrolled course. Concomitant (comorbid) pathology was detected in 85.4% of people, while the group of patients with bronchial asthma without concomitant pathology accounted for 13,6% of patients in the Registry. The duration of bronchial asthma with concomitant pathology is 14,5±0,8 years, and in patients without comorbid pathology - 5,8±0,4 years. Coronary heart disease was registered in 41.2% of patients with bronchial asthma, a history of myocardial infarction in 4,5%, cardiac arrhythmias in 14,6%, hypertension in 72,8%, chronic heart failure was diagnosed in 33% of patients on the Registry. Comorbid patients were more likely to have exacerbations, unscheduled visits to doctors, and calls for emergency medical teams, especially when bronchial asthma was combined with hypertension and/or coronary heart disease.

Conclusion. Based on the analysis of the clinical and epidemiological characteristics of patients with bronchial asthma included in the registry of patients with bronchial asthma in the Kursk region, the most common phenotype of a comorbid patient suffering from bronchial asthma was determined, the effectiveness of preventive and diagnostic measures was assessed, as well as the effectiveness of treatment, which should be used by health care organizers, district physicians and internists in hospitals, general practitioners and pulmonologists to develop prevention methods and algorithms for timely diagnosis, as well as rational planning of the volume of anti-asthmatic care to the population.

1. Chuchalin A.G., Avdeev S.N., Aisanov Z.R., Belevskiy A.S., Vasil’eva O.S., Geppe N.A., Ignatova G.L., Knyazheskaya N.P., et al. Federal guidelines on diagnosis and treatment of bronchial asthma. Pulmonology. 2022;32(3):393-447 (in Russ.). DOI: 10.18093/0869-0189-2022-32-3-393-447. EDN: HZEHSI.

2. Centers for Disease Control and Prevention (CDC). Most Recent Asthma. URL: http://www.cdc.gov/asthma/most_recent_data.htm.

3. Arkhipov V.V., Grigoryeva E.V., Gavrishina E.V. Control of bronchial asthma in Russia: results of NIKA multicenter observational study. Pulmonology. 2011;(6):87-93 (in Russ.). EDN: RCMQNO.

4. Emelyanov A.V., Leshenkova E.V., Sergeeva G.R. Bronchial asthma in the elderly and senile age: features of diagnosis and treatment. Pharmateca 2020;27(5):85-94 (in Russ.). DOI 10.18565/pharmateca.2020.5.85-94

5. Pribylov S.A., Pribylova N.N., Makhova O.Y., Barbashina T.A., Krasovskaya A.O. Antihypertensive therapy in patients with a combination of hypertension and bronchial asthma. Arterial hypertension. 2016;22(3):274-281 (in Russ.). EDN: WXTEID.

6. Vogelmeier C., D'Urzo A., Pauwels R., Merino J.M., Jaspal M., Boutet S., Naya I., Price D. Budesonide/formoterol maintenance and reliever therapy: an effective asthma treatment option? Eur Respir J. 2005;26(5):819-28. DOI: 10.1183/09031936.05.00028305

7. Nathan R.A., Sorkness C.A., Kosinski M., Schatz M., Li J.T., Marcus P., Murray J.J., Pendergraft T.B. Development of the asthma control test: a survey for assessing asthma control. J Allergy Clin Immunol. 2004;113(1):59-65. DOI: 10.1016/j.jaci.2003.09.008

8. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention (2025 Update). URL: https://ginasthma.org/wp-content/uploads/2025/05/GINA-Strategy-Report_2025-WEB-WMS.pdf

9. Noskova E.V., Simonova Zh.G. Acute myocardial infarction. features of the clinical course in a patient with bronchial asthma. Vyatka Medical Bulletin. 2023;3(79): 101-104 (in Russ.). DOI: 10.24412/2220-7880-2023-3-101-104. EDN: VBWLLO.

10. Sergeeva G.R., Emelyanov A.V. Stability of severe asthma phenotypes. Meditsinskiy Sovet. 2024;18(20):60-68 (in Russ.). DOI: 10.21518/ms2024-453. EDN: CYTDDW.

11. Makarevich A.E. The clinical aspects of severe bronchial asthma. Medical business: a scientific and practical therapeutic journal. 2023;3(86):7-22 (in Russ.). EDN: TARUTX.

12. Majellano E.C., Clark V.L., Winter N.A., Gibson P.G., McDonald V.M. Approaches to the assessment of severe asthma: barriers and strategies. J Asthma Allergy. 2019;12:235-251. DOI: 10.2147/JAA.S178927

13. Papi A., Blasi F., Canonica G.W., Morandi L., Richeldi L., Rossi A. Treatment strategies for asthma: reshaping the concept of asthma management. Allergy Asthma Clin Immunol. 2020;16:75. DOI: 10.1186/s13223-020-00472-8.

14. Alshabanat A., Zafari Z., Albanyan O., Dairi M., FitzGerald J.M. Asthma and COPD Overlap Syndrome (ACOS): A Systematic Review and Meta Analysis. PLoS One. 2015;10(9):e0136065. DOI 10.1371/journal.pone.0136065.

15. Cosio B.G., Soriano J.B., López-Campos J.L., Calle-Rubio M., Soler-Cataluna J.J., de-Torres J.P., Marín J.M., Martínez-Gonzalez C., et al. Defining the Asthma-COPD Overlap Syndrome in a COPD Cohort. Chest. 2016;149(1):45-52. DOI 10.1378/chest.15-1055.

16. Bagnasco D., Ferrando M., Varricchi G., Passalacqua G., Canonica G.W. A Critical Evaluation of Anti-IL-13 and Anti-IL-4 Strategies in Severe Asthma.Int Arch Allergy Immunol. 2016;170(2):122-131. DOI: 10.1159/000447692.