{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T14:17:35Z","timestamp":1781187455078,"version":"3.54.1"},"reference-count":38,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T00:00:00Z","timestamp":1760832000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Global Initiative for Asthma Italy\/Federasma\/Italian Society of Allergy, Asthma and Clinical Immunology\/Italian Respiratory Society"},{"name":"AstraZeneca, GlaxoSmithKline, and Sanofi"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Severe asthma is associated with an increased risk of osteoporosis, largely due to chronic corticosteroid exposure and persistent systemic inflammation. Data from different international registries indicate a significant prevalence of osteoporosis among patients with severe asthma, with large variations attributed to differences in treatment strategies and optimization of care. Aims and Methods: This study aims to assess the prevalence of osteoporosis among patients with severe asthma enrolled in the Severe Asthma Network Italy (SANI) registry who are receiving treatment with monoclonal antibodies (mAbs) and\/or long-acting muscarinic antagonists (LAMAs) and compare the characteristics of patients with and without osteoporosis to identify key risk factors contributing to osteoporosis. Results: A total of 1813 patients receiving Step 5 GINA (mAbs, LAMAs) treatment were included in the final analysis, of whom 282 (15.5%) had osteoporosis. Osteoporosis prevalence was significantly higher in women (20.3%) compared to men (8.0%). The prevalence also increased with age (p &lt; 0.001) and with asthma duration (p = 0.008). Patients with osteoporosis exhibited poorer asthma control, lower lung function (FEV1 and FVC), a higher rate of exacerbations, and more frequent chronic oral corticosteroid (OCS) use compared to those without osteoporosis. Nasal polyposis was not significantly associated with osteoporosis in this cohort. Conclusions: Osteoporosis is highly prevalent in individuals with severe asthma, mainly due to chronic corticosteroid exposure and persistent inflammation, and is associated with asthma duration, sex, age, frequent exacerbations, cumulative exposure to OCS, and reduced lung function. Early recognition of osteoporosis risk is essential, and biologic therapies offer a promising strategy to reduce OCS dependence, mitigate adverse effects, and improve long-term outcomes.<\/jats:p>","DOI":"10.3390\/jcm14207387","type":"journal-article","created":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T12:27:29Z","timestamp":1760963249000},"page":"7387","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Osteoporosis in Severe Asthmatic Patients: Data from the Severe Asthma Network in Italy (SANI) Registry"],"prefix":"10.3390","volume":"14","author":[{"given":"Manuela","family":"Latorre","sequence":"first","affiliation":[{"name":"Pulmonary Unit, UOC Pneumologia Nord, Toscana Nord Ovest, Nuovo Ospedale Apuano, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2269-0439","authenticated-orcid":false,"given":"Giulia","family":"Costanzo","sequence":"additional","affiliation":[{"name":"Department of Public Health and Medical Science, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5456-2359","authenticated-orcid":false,"given":"Andrea Giovanni","family":"Ledda","sequence":"additional","affiliation":[{"name":"Department of Public Health and Medical Science, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6815-5614","authenticated-orcid":false,"given":"Giada","family":"Sambugaro","sequence":"additional","affiliation":[{"name":"Department of Public Health and Medical Science, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7779-9370","authenticated-orcid":false,"given":"Cristina","family":"Cardini","sequence":"additional","affiliation":[{"name":"Fondazione per la Salute Respiratoria della Societ\u00e0 Italiana di Pneumologia SIP-IRS, 20126 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Sala","sequence":"additional","affiliation":[{"name":"Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy"},{"name":"Department of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0079-6446","authenticated-orcid":false,"given":"Chiara","family":"Oriecuia","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy"},{"name":"Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Bagnardi","sequence":"additional","affiliation":[{"name":"Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2285-9970","authenticated-orcid":false,"given":"Francesco","family":"Blasi","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano, 20122 Milan, Italy"},{"name":"Respiratory Unit and Cystic Fibrosis Center, Fondazione IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico di Milano, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Paggiaro","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio Walter","family":"Canonica","sequence":"additional","affiliation":[{"name":"Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center, IRCCS, 20089 Rozzano, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0492-5663","authenticated-orcid":false,"given":"Enrico","family":"Heffler","sequence":"additional","affiliation":[{"name":"Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center, IRCCS, 20089 Rozzano, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4172-3216","authenticated-orcid":false,"given":"Gianenrico","family":"Senna","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Verona, 37124 Verona, Italy"},{"name":"Asthma Center and Allergy Unit, Verona University Hospital, 37134 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5768-391X","authenticated-orcid":false,"given":"Davide","family":"Firinu","sequence":"additional","affiliation":[{"name":"Department of Public Health and Medical Science, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Puxeddu","sequence":"additional","affiliation":[{"name":"Immunoallergology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6563-4942","authenticated-orcid":false,"given":"Laura","family":"Pini","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Del Giacco","sequence":"additional","affiliation":[{"name":"Department of Public Health and Medical Science, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the SANI Study 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