Predictors of frequent exacerbations in (ex)smoking and never smoking adults with severe asthma - 29/08/16
, Jantina C. de Groot b, Marijke Amelink a, Selma B. de Nijs a, Anneke ten Brinke b, Els J. Weersink a, Elisabeth H. Bel aAbstract |
Background |
Persistent eosinophilic airway inflammation is an important driver for asthma exacerbations in non-smokers with asthma. Whether eosinophilic inflammation is also a predictor of asthma exacerbations in (ex)smokers is not known.
Objective |
The aim was to investigate factors associated with frequent exacerbations in never smokers and (ex)smokers with asthma.
Methods |
(Ex)smoking (n = 83) and never smoking (n = 70) patients with uncontrolled asthma despite high dose asthma medication (GINA treatment step 4–5) were selected from a cohort of 571 adult-onset asthma patients. Clinical, functional and inflammatory parameters were used in multivariate logistic regression analyses to identify factors associated with frequent exacerbations (≥3 oral corticosteroid (OCS) bursts in the previous year).
Results |
Frequent exacerbations in (ex)smokers were independently associated with ICS dose (OR 1.2, 95%CI: 1.1–1.3) and blood neutrophil count (OR 1.5, 95%CI: 1.2–2.1). In never smokers frequent exacerbations were independently associated with blood eosinophil count (OR 18.9, 95%CI: 1.8–202.1).
Conclusion and clinical relevance |
This study shows that never smoking and (ex)smoking patients with severe asthma have different predictors of frequent exacerbations: higher blood neutrophils in (ex)smokers versus higher blood eosinophils in never smokers. This suggests that different types of systemic background inflammation play a role in the aetiology of exacerbations in these patients.
Clinical trial registration |
Netherlands Trial Register: NTR2217, NTR1846 and NTR1838.
El texto completo de este artículo está disponible en PDF.Highlights |
• | Different predictors of exacerbations in never-smoking and (ex)smoking severe asthma patients. |
• | Blood eosinophil counts predict frequent asthma exacerbations in never-smokers. |
• | Blood neutrophil counts predict frequent asthma exacerbations in (ex)smokers. |
• | This suggests different types of background inflammation in these patients. |
Keywords : Adult asthma, Severe asthma, Exacerbation, Smokers, Predictors
Abbreviations : ACQ, AQLQ, BMI, FeNO, FEV1, FVC, GERD, GINA, ICS, OCS, OR, PC20, RV, TLC, TLCOc/VA
Esquema
| ☆ | The data used in this manuscript has been presented in a poster discussion session during the ERS conference 2015 in Amsterdam (Eur Respir J 2015; 46: Suppl. 59, PA3618). |
Vol 118
P. 122-127 - septembre 2016 Regresar al número
Artículo precedente
- Safety and tolerability of once-daily tiotropium Respimat® as add-on to at least inhaled corticosteroids in adult patients with symptomatic asthma: A pooled safety analysis
- Ronald Dahl, Michael Engel, Daniel Dusser, David Halpin, Huib A.M. Kerstjens, Liliana Zaremba-Pechmann, Petra Moroni-Zentgraf, William W. Busse, Eric D. Bateman
- Heart involvement in cystic fibrosis: A specific cystic fibrosis-related myocardial changes?
- Fabien Labombarda, Eric Saloux, Jacques Brouard, Emmanuel Bergot, Paul Milliez
¿Ya suscrito a @@106933@@ revista ?