D2.134 - Transitioning adolescents and young adults with asthma: insights from a severe asthma series

Thanks to improvement in asthma care and availability of new biologic treatments, a  relatively novel population of adolescents and young adults with severe asthma (SA) is growing.  

Transition from pediatric to adult care represents a critical phase in the management of chronic diseases such as severe bronchial asthma. We herein describe clinical outcomes, therapeutic options and disease management in a series of SA patients transitioning from the pediatric to the adult asthma center of the University Hospital of Naples, Federico II.  

We retrospectively collected demographic and clinical (comorbidities, baseline treatment, number of asthma attacks, spirometry, airway inflammation [fractional exhaled nitric oxide (FENO) measurements, compliance) data of four SA patients during visits in the Pediatric center as well as after transition into the adult asthma center. 

All patients transitioned at 18 years of age. Clinical and functional (spirometry and FENO) parameters, showed significant improvement following the addition of biologics to baseline asthma regimen during pediatric follow-up and the early transition phase. Female patients maintained asthma control throughout transition, early and late follow-up, two males experienced severe asthma exacerbations following voluntary discontinuation of the biologic treatment several months after transition to the adult center. Symptom control was gained after a phenotype driven re-introduction of a biologic drug in the regimen. Male patients were less compliant and independent than females in the adult setting.  

Transition from pediatric to adult care for patients with SA can be effectively  managed with coordinated and structured transition processes. While some patients maintain stable clinical and respiratory outcomes, others risk to loose asthma control. A personalized and perhaps, gender driven approach, supporting both patient’s independence and adherence to treatment is requested for a successful long-term management.