Page 144 - ADULT-ONSET ASTHMA PREDICTORS OF CLINICAL COURSE AND SEVERITY

ADULT-ONSET ASTHMA – PREDICTORS OF CLINICAL COURSE AND SEVERITY
ABSTRACT
BACKGROUND: Persistent eosinophilic airway in amma on is an important driver for asthma exacerba ons in non-smokers with asthma. Whether eosinophilic in amma on is also a predictor of asthma exacerba ons in (ex)smokers is not known.
OBJECTIVE: The aim was to inves gate factors associated with frequent exacerba ons in never smokers and (ex)smokers with asthma.
METHODS: (Ex)smoking (n=83) and never smoking (n=70) pa ents with uncontrolled asthma despite high dose asthma medica on (GINA treatment step 4-5) were selected from a cohort of 571 adult-onset asthma pa ents. Clinical, func onal and in ammatory parameters were used in mul variate logis c regression analyses to iden fy factors associated with frequent exacerba ons (≥3 oral cor costeroid (OCS) bursts in the previous year).
RESULTS: Frequent exacerba ons 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 exacerba ons 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 pa ents with severe asthma have di erent predictors of frequent exacerba ons: higher blood neutrophils in (ex)smokers versus higher blood eosinophils in never smokers. This suggests that di erent types of systemic background in amma on play a role in the ae ology of exacerba ons in these pa ents.
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