Page 148 - ADULT-ONSET ASTHMA PREDICTORS OF CLINICAL COURSE AND SEVERITY

ADULT-ONSET ASTHMA – PREDICTORS OF CLINICAL COURSE AND SEVERITY
RESULTS
Characteris cs of (ex)smoking and never smoking pa ents with severe asthma are given in Table 1.
FREQUENT EXACERBATIONS IN (EX)SMOKERS
(Ex)smokers with frequent exacerba ons had a longer dura on of asthma, used higher doses of inhaled cor costeroids (ICS), were more likely to be using chronic oral cor costeroids (OCS), had a higher blood neutrophil count and a lower post-bronchodilator FEV1 (trend) as compared (ex)smokers without frequent exacerba ons (Table 2). The univariate logis c regression analysis revealed chronic OCS use, blood neutrophil count, higher ICS dose and asthma dura on as factors associated with frequent exacerba ons. Blood neutrophils and higher ICS dose were independently associated with frequent exacerba ons in the mul variate model (Table 4). Pa ents with a blood neutrophil count of ≥4.3*109 cells/L had an odds ra o of 2.91 (95% CI:1.2-7.2; p=0.021) for frequent exacerba ons.
FREQUENT EXACERBATIONS IN NEVER SMOKERS
Never smokers with frequent exacerba ons had increased airway hyperresponsiveness to methacholine compared to never smokers without frequent exacerba ons (Table 3). Higher blood eosinophil count and higher ICS dose were associated with frequent exacerba ons in the univariate logis c regression analysis. Blood eosinophils were the only signi cant factor when combined in a mul variate model with ICS dose (Table 4). A blood eosinophil cuto of ≥0.25*109 cells/L gave an odds ra o of 2.94 (95% CI:1.1-8.1; p=0.038) for frequent exacerba ons.
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