In:
Respiration, S. Karger AG, Vol. 99, No. 12 ( 2020), p. 1109-1121
Abstract:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Reducing asthma exacerbations is a major target of current clinical guidelines, but identifying features of exacerbation-prone asthma (EPA) using multidimensional assessment (MDA) is lacking. 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 To systemically explore the clinical and inflammatory features of adults with EPA in a Chinese population. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We designed a cross-sectional study using the Severe Asthma Web-based Database from the Australasian Severe Asthma Network (ASAN). Eligible Chinese adults with asthma ( 〈 i 〉 n 〈 /i 〉 = 546) were assessed using MDA. We stratified patients based on exacerbation frequency: none, few (1 or 2), and exacerbation prone (≥3). Univariate and multivariable negative binomial regression analyses were performed to investigate features associated with the frequency of exacerbations. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Of 546 participants, 61.9% had no exacerbations ( 〈 i 〉 n 〈 /i 〉 = 338), 29.6% had few exacerbations ( 〈 i 〉 n 〈 /i 〉 = 162), and 8.4% were exacerbation prone ( 〈 i 〉 n 〈 /i 〉 = 46) within the preceding year. EPA patients were characterized by elevated blood and sputum eosinophils but less atopy, with more controller therapies but worse asthma control and quality of life (all 〈 i 〉 p 〈 /i 〉 & #x3c; 0.05). In multivariable models, blood and sputum eosinophils (adjusted rate ratio = 2.23, 95% confidence interval = [1.26, 3.84] and 1.67 [1.27, 2.21] , respectively), FEV 〈 sub 〉 1 〈 /sub 〉 (0.90 [0.84, 0.96]), bronchodilator responsiveness (1.16 [1.05, 1.27] ), COPD (2.22 [1.41, 3.51]), bronchiectasis (2.87 [1.69, 4.89] ), anxiety (2.56 [1.10, 5.95]), and depression (1.94 [1.20, 3.13] ) were found. Further, upper respiratory tract infection (1.83 [1.32, 2.54]) and food allergy (1.67 [1.23, 2.25] ) were at high risk of asthma symptom triggers. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 EPA is a clinically recognizable phenotype associated with several recognizable traits that could be addressed by targeted treatment.
Type of Medium:
Online Resource
ISSN:
0025-7931
,
1423-0356
Language:
English
Publisher:
S. Karger AG
Publication Date:
2020
detail.hit.zdb_id:
1464419-8
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