Prevalence and factors associated with exertional dyspnea in severe asthma: data at inclusion from the French RAMSES cohort
Abstract
Objectives To estimate the prevalence of exertional dyspnea in a French cohort of patients with severe asthma and to explore associated factors, with a focus on biologics. Methods RAMSES is a French, multicenter, prospective cohort of patients with severe asthma. The primary outcome was exertional dyspnea defined by a modified Medical Research Council (mMRC) score ≥2. Secondary outcomes were mMRC score ≥1 and ≥ 3. To study factors associated with exertional dyspnea, logistic regressions were performed. We hypothesized that the potential effect of biologics on exertional dyspnea relied on improved asthma control, and explored it through a mediation model. Results A total of 569 participants from the RAMSES cohort were included. Among them, 360 (65.5%) had uncontrolled asthma and 307 (54.1%) were treated with biologics. The prevalence of exertional dyspnea defined by an mMRC score ≥1, ≥2 and ≥ 3 was respectively 73.8 [70.2; 77.4] %, 48.5 [44.4; 52.6] % and 21.6 [18.2; 25] %. The Asthma Control Test (ACT) score was the factor most strongly associated with exertional dyspnea (mMRC score ≥2) (OR = 0.8 [0.74; 0.86] for 1-point increase). Biologic therapy was associated with a lower rate of exertional dyspnea (OR = 0.46 [0.25–0.84]), with the effect largely mediated by an improvement in the ACT score (mediation ratio: 63.4% [5.1–254.2]) Conclusion Our results highlight the high prevalence of dyspnea-related disability in severe asthma, justifying considering this treatable trait as a priority therapeutic goal. Exertional dyspnea was associated with uncontrolled asthma and biologics, primarily through asthma control.
Related
- Prevalence and Functional Outcomes of Post-Exertional Malaise among Adults with prior COVID-19: Results from a Representative Survey of New York City Residents
- Prevalence and factors associated with obesity among healthcare workers in Oman: a cross-sectional study
- Prevalence of depressive symptoms and associated factors among empty-nest elderly in China: a meta-analysis
- Occupational Noise-Induced Hearing Loss in Indian Black Tea-Processing Factories: Assessing the Prevalence and Associated Factors of an Overlooked Problem
- Prevalence and associated factors of type 2 diabetes among HIV-infected patients at Arsi University Teaching and Referral Hospital, Southeast Ethiopia, 2023
BibTeX
@article{giovannelli2026prevalence,
title = {{Prevalence and factors associated with exertional dyspnea in severe asthma: data at inclusion from the French RAMSES cohort}},
author = {Jonathan Giovannelli and Thierry Perez and Gilles Garcia and Gilles Devouassoux and Stéphanie Fry and Arnaud Bourdin and Pascal Chanez and Philippe Bonniaud and Amel Boudjemaa and Christel Saint-Raymond and Antoine Beurnier and Nathalie Bautin and Candice Estellat and Camille Taillé and Cécile Chenivesse},
journal = {Respiratory Medicine},
year = {2026},
month = oct,
doi = {10.1016/j.rmed.2026.109239},
url = {https://hal.science/hal-05838833v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Prevalence and factors associated with exertional dyspnea in severe asthma: data at inclusion from the French RAMSES cohort
AU - Jonathan Giovannelli
AU - Thierry Perez
AU - Gilles Garcia
AU - Gilles Devouassoux
AU - Stéphanie Fry
AU - Arnaud Bourdin
AU - Pascal Chanez
AU - Philippe Bonniaud
AU - Amel Boudjemaa
AU - Christel Saint-Raymond
AU - Antoine Beurnier
AU - Nathalie Bautin
AU - Candice Estellat
AU - Camille Taillé
AU - Cécile Chenivesse
PY - 2026
DA - 2026/10/26
JO - Respiratory Medicine
DO - 10.1016/j.rmed.2026.109239
UR - https://hal.science/hal-05838833v1
AB - Objectives To estimate the prevalence of exertional dyspnea in a French cohort of patients with severe asthma and to explore associated factors, with a focus on biologics. Methods RAMSES is a French, multicenter, prospective cohort of patients with severe asthma. The primary outcome was exertional dyspnea defined by a modified Medical Research Council (mMRC) score ≥2. Secondary outcomes were mMRC score ≥1 and ≥ 3. To study factors associated with exertional dyspnea, logistic regressions were performed. We hypothesized that the potential effect of biologics on exertional dyspnea relied on improved asthma control, and explored it through a mediation model. Results A total of 569 participants from the RAMSES cohort were included. Among them, 360 (65.5%) had uncontrolled asthma and 307 (54.1%) were treated with biologics. The prevalence of exertional dyspnea defined by an mMRC score ≥1, ≥2 and ≥ 3 was respectively 73.8 [70.2; 77.4] %, 48.5 [44.4; 52.6] % and 21.6 [18.2; 25] %. The Asthma Control Test (ACT) score was the factor most strongly associated with exertional dyspnea (mMRC score ≥2) (OR = 0.8 [0.74; 0.86] for 1-point increase). Biologic therapy was associated with a lower rate of exertional dyspnea (OR = 0.46 [0.25–0.84]), with the effect largely mediated by an improvement in the ACT score (mediation ratio: 63.4% [5.1–254.2]) Conclusion Our results highlight the high prevalence of dyspnea-related disability in severe asthma, justifying considering this treatable trait as a priority therapeutic goal. Exertional dyspnea was associated with uncontrolled asthma and biologics, primarily through asthma control.
SN - 0954-6111
SN - 1532-3064
ER -