Page 125 - ADULT-ONSET ASTHMA PREDICTORS OF CLINICAL COURSE AND SEVERITY

PREDICTORS FOR THE DEVELOPMENT OF PROGRESSIVE SEVERITY IN NEW-ONSET ADULT ASTHMA
Care Fusion, Hoechberg, Germany) and cons tuted FEV1 and FVC.12 Post-bronchodilator measurements were done 10-15 minutes a er inhala on of 400 μg salbutamol.
INFLAMMATORY PARAMETERS
Frac on of exhaled nitric oxide (FeNO) was measured with a portable rapid-response chemoluminescent analyser ( ow rate 50mL/s; NIOX System, Aerocrine, Sweden).13
Venous blood was collected and white blood cells were counted. Total and speci c IgE to common aeroallergens were measured by ImmunoCAP; atopy was de ned as IgE >0.35 Ku/L for at least one allergen.
Sputum induc on was performed according to interna onal standards.14 All pa ents were nebulised 3 mes for 5 minutes with a 4.5% saline solu on. Sputum processing was done according to full sample method and di eren al cell counts were analysed on cytospin prepara ons.
ASSESSMENT OF CHRONIC RHINOSINUSITIS (CRS) AND NASAL POLYPOSIS
CRS was diagnosed according to the European Posi on Paper on Rhinosinusi s and Nasal Polyps (EP3OS).15 In short, this diagnosis is based on symptoms, assessed by SNOT-22 ques onnaire, combined with sinus CT-scan abnormali es (Lund-Mackay score >11)16 and/ or endoscopic signs of CRS/nasal polyps.15
ASTHMA SEVERITY SCORE
Assessment of asthma severity was based on the GINA 2002 guidelines.17 The GINA score is a composite score based on treatment and clinical measures.17-20 Pa ents are divided into four asthma severity categories: intermi ent, mild persistent, moderate persistent and severe persistent, that are reported as score 1 to 4. (see Figure E1 in the Online Repository)
Three parameters (inhaled cor costeroid dose, FEV1 and symptom score) for calcula on of GINA severity score were available in all pa ents at baseline. At follow-up, 20 pa ents (10%) were lacking a FEV1 or ACQ-score due to lack of me or prac cal di cul es in comple ng study visits. Using the two available parameters, a “least GINA score” was calculated, corresponding with their mildest GINA classi ca on (see Figure E1 in the Online Repository). This modi ed GINA score for these 20 pa ents was used for further analysis.
To assess the change in asthma severity; the di erence in GINA score at 2 year follow-up with respect to baseline was determined. A nega ve number represented deteriora on of asthma severity, “zero” represented no change and a posi ve number represented improvement of asthma severity. Pa ents were divided into one of these three categories.
STATISTICAL ANALYSIS
Comparison of baseline mean values between included and lost-to-follow-up pa ents were made by Student’s t-test or Mann-Whitney rank sum test (for non-normally distributed data).
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