Asthma control (AC) in the adult population from Kuwait: ESMAA study

Introduction: Management of chronic asthma (CA) is based on disease control and severity. Despite availability of effective treatments and an increasing number of international recommendations, AC remains unsatisfactory in Kuwait where few data are available. Methods: ESMAA study (NCT02153411) was an epidemiological, cross-sectional study conducted in a random sample of general practitioners and specialists (pulmonologists and allergists) from public and private sectors. Patients diagnosed for at least 12 months without acute episode of asthma within 4 weeks before enrollment were included. Primary objective was to assess AC in patients according to the GINA 2012. Results: ESMAA included 370 evaluable patients from 28 sites in Kuwait. Median age was 45 years with 52% female. Median BMI was 29.5 kg/m² with 48% of obese patients. 82% had been educated to either secondary school or university level, while 2% could not read or write; 73% had medical coverage. 77% were non-smokers and 73% had allergic rhinitis. Asthma was controlled in 43% of patients (95% CI: 38%, 48%), partly controlled in 23% (19%, 27%), while 34% (30%, 40%) had uncontrolled asthma. The median overall ACT score was 20 equivalent to partly-controlled asthma level. Combination therapy of fixed-dose inhaled corticosteroid with a long-acting bronchodilator was the most widely used medication (77%). Conclusions: Despite higher control rate in comparison with other countries, AC in patients without recent acute episode remains unsatisfactory in the adult population from Kuwait. These findings from the study highlight the need for improved AC through better access to appropriate treatments, more proactive follow-up or better education.