S33 Risk factors for frequent exacerbations in a real-life adult population with severe refractory asthma

Autor: M Patel, SJ Smith, WT Lee, John Busby, JF Yang, Rekha Chaudhuri, Salman Siddiqui, AH Mansur, Liam G Heaney, Paul E Pfeffer, Andrew Menzies-Gow, David A. Jackson, Christopher E. Brightling, Neil C. Thomson
Rok vydání: 2019
Předmět:
Zdroj: Acute asthma: lessons from the frontline.
DOI: 10.1136/thorax-2019-btsabstracts2019.39
Popis: Introduction Severe exacerbations are an important cause of morbidity in asthma. Risk factors for exacerbations have been reported in selected asthma populations, but not in a large real-world severe asthma population. Maintenance oral corticosteroids (OCS) is used in severe asthma and can suppress inflammatory biomarkers associated with frequent exacerbations (FE). We identified risk factors for FE in a severe refractory asthma population and examined whether risk factors differ in those treated with and without maintenance OCS. Methods Adults with well-characterised refractory asthma from specialised asthma centres were recruited to a UK Severe Asthma Registry (UKSAR). Demographic data, co-morbidities, clinical and inflammatory biomarkers were collected. We conducted univariate and multivariate logistic regression to identify risk factors for FE, defined as ≥3 exacerbations treated with high-dose systemic corticosteroids in the past year. Results 1235 patients fulfilled ERS/ATS criteria for severe asthma on the UKSAR. In univariate analyses, patients who were ex-smokers (OR 1.6, p 1.5 (OR 4.85, p 1.5 were independent risk factors for FE (OR 3.46, p=0.014 and OR 9.69, p 0.45 x10^9/L or exhaled nitric oxide >50ppb (OR 1.70 and OR 1.58 respectively), however this association was not statistically significant (p=0.073 and p=0.085 respectively). ACQ-7 score >1.5 remained an independent risk factor in both the maintenance OCS and non-maintenance OCS groups (OR 8.45, p=0.006 and OR 9.86, p Conclusions Several factors were associated with FE risk in a real-world severe asthma population. ACQ-7 score was the strongest independent risk factor. Risk factors differed for patients not on maintenance OCS, but ACQ-7 score of >1.5 was an independent risk factor for FE regardless of maintenance OCS status. On behalf of the UK Severe Asthma Registry.
Databáze: OpenAIRE