Guus A Westerhof1, Elise M Vollema2, Els J Weersink2, Susanne M Reinartz3, Selma B de Nijs2, Elisabeth H Bel2. 1. Department of Respiratory Medicine, Academic Medical Centre (AMC), University of Amsterdam, Amsterdam, The Netherlands. Electronic address: G.A.Westerhof@amc.uva.nl. 2. Department of Respiratory Medicine, Academic Medical Centre (AMC), University of Amsterdam, Amsterdam, The Netherlands. 3. Department of Otorhinolaryngology, Academic Medical Centre (AMC), University of Amsterdam, Amsterdam, The Netherlands.
Abstract
BACKGROUND: A proportion of patients with adult-onset asthma have severe disease. Risk factors for an increase in asthma severity are poorly known. OBJECTIVE: We sought to identify predictors for the development of severe asthma in adults. METHODS: A cohort of 200 adults with new-onset asthma was prospectively followed for 2 years. At baseline, patients underwent a comprehensive assessment of clinical, functional, and inflammatory parameters. After 2 years, change in asthma severity was assessed by using the Global Initiative for Asthma score (range, 1-4), which is based on asthma control (Asthma Control Questionnaire), lung function (FEV1), and inhaled corticosteroid requirement. ANOVA and multiple regression equations were used in the analysis. RESULTS: One hundred twenty-eight patients completed 2 years of follow-up. Seventeen (13.3%) patients had an increase in asthma severity, whereas 53 (41.4%) patients had a decrease. A lower postbronchodilator FEV1/forced vital capacity ratio and a higher number of cigarette pack years smoked at baseline were significantly associated with an increase in asthma severity at follow-up. Multiple regression equations showed that only the number of cigarette pack years smoked was independently associated with an increase in asthma severity, with an odds ratio of 1.4 (95% CI, 1.02-1.91) for every 10 pack years smoked. CONCLUSION: A history of cigarette smoking in patients with new-onset adult asthma predicts an increase in asthma severity during the first 2 years of the disease in a dose-dependent manner.
BACKGROUND: A proportion of patients with adult-onset asthma have severe disease. Risk factors for an increase in asthma severity are poorly known. OBJECTIVE: We sought to identify predictors for the development of severe asthma in adults. METHODS: A cohort of 200 adults with new-onset asthma was prospectively followed for 2 years. At baseline, patients underwent a comprehensive assessment of clinical, functional, and inflammatory parameters. After 2 years, change in asthma severity was assessed by using the Global Initiative for Asthma score (range, 1-4), which is based on asthma control (Asthma Control Questionnaire), lung function (FEV1), and inhaled corticosteroid requirement. ANOVA and multiple regression equations were used in the analysis. RESULTS: One hundred twenty-eight patients completed 2 years of follow-up. Seventeen (13.3%) patients had an increase in asthma severity, whereas 53 (41.4%) patients had a decrease. A lower postbronchodilator FEV1/forced vital capacity ratio and a higher number of cigarette pack years smoked at baseline were significantly associated with an increase in asthma severity at follow-up. Multiple regression equations showed that only the number of cigarette pack years smoked was independently associated with an increase in asthma severity, with an odds ratio of 1.4 (95% CI, 1.02-1.91) for every 10 pack years smoked. CONCLUSION: A history of cigarette smoking in patients with new-onset adult asthma predicts an increase in asthma severity during the first 2 years of the disease in a dose-dependent manner.
Authors: Hannu Kankaanranta; Pinja Ilmarinen; Terhi Kankaanranta; Leena E Tuomisto Journal: NPJ Prim Care Respir Med Date: 2015-06-25 Impact factor: 2.871
Authors: Helena Backman; Caroline Stridsman; Linnea Hedman; Lina Rönnebjerg; Bright I Nwaru; Thomas Sandström; Hannu Kankaanranta; Anne Lindberg; Eva Rönmark Journal: J Asthma Allergy Date: 2022-10-10