Page 122 - ADULT-ONSET ASTHMA PREDICTORS OF CLINICAL COURSE AND SEVERITY

ADULT-ONSET ASTHMA – PREDICTORS OF CLINICAL COURSE AND SEVERITY
ABSTRACT
BACKGROUND: A propor on of pa ents with adult-onset asthma develops severe disease. Risk factors for an increase in asthma severity are poorly known.
OBJECTIVE: To iden fy predictors for the development of severe asthma in adults.
METHODS: A cohort of 200 adults with new-onset asthma was prospec vely followed for 2 years. At baseline, pa ents underwent a comprehensive assessment of clinical, func onal, and in ammatory parameters. A er 2 years, change in asthma severity was assessed by using the Global Ini a ve of Asthma (GINA) score (1-4), which is based on asthma control (ACQ), lung func on (FEV1) and inhaled cor costeroid requirement. ANOVA and mul ple regression equa ons were used in the analysis.
RESULTS: 128 pa ents completed two years of follow-up. 17 pa ents (13.3%) showed an increase in asthma severity, whereas 53 pa ents (41.4%) showed a decrease. Lower post- bronchodilator FEV1/forced vital capacity ra o and a higher number of cigare e pack years smoked at baseline were signi cantly associated with an increase in asthma severity at follow-up. Mul ple regression equa ons showed that only the number of cigare e pack years smoked was independently associated with an increase in asthma severity with an OR 1.4 (95% CI 1.02-1.91) for every 10 pack year smoked.
CONCLUSION: A history of cigare e smoking in pa ents with new-onset adult asthma predicts an increase in asthma severity during the rst 2 years of the disease in a dose-dependent way.
CLINICAL IMPLICATIONS: Adults with new-onset asthma and a posi ve smoking history are at risk of developing severe disease and might be candidates for early targeted interven ons.
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