잠시만 기다려 주세요. 로딩중입니다.

Risk Factors Predicting Severe Asthma Exacerbations in Adult Asthmatics: A Real-World Clinical Evidence

Allergy, Asthma & Immunology Research : AAIR 2021년 13권 3호 p.420 ~ 434
반가영, 김수진, 이현영, 예영민, 신유섭, 박해심,
소속 상세정보
반가영 ( Ban Ga-Young ) - Hallym University College of Medicine Kangdong Sacred Heart Hospital Department of Pulmonary, Allergy and Critical Care Medicine
김수진 ( Kim Su-Chin ) - Ajou University Medical Center Clinical Trial Center
이현영 ( Lee Hyun-Young ) - Ajou University Medical Center Clinical Trial Center
예영민 ( Ye Young-Min ) - Ajou University School of Medicine Department of Allergy and Clinical Immunology
신유섭 ( Shin Yoo-Seob ) - Ajou University School of Medicine Department of Allergy and Clinical Immunology
박해심 ( Park Hae-sim ) - Ajou University School of Medicine Department of Allergy and Clinical Immunology

Abstract


Purpose: Minimizing the future risk of asthma exacerbation (AE) is one of the main goals of asthma management. We investigated prognostic factors for risk of severe AE (SAE) in a real-world clinical setting.

Methods: This is an observational study evaluating subjects who were diagnosed with asthma and treated with anti-asthmatic medications from January 1995 to June 2018. Risk factors for SAE were analyzed in 2 treatment periods (during the initial 2 years and the following 3?10 years of treatment) using the big data of electronic medical records.

Results: In this study, 5,058 adult asthmatics were enrolled; 1,335 (28.64%) experienced ≥ 1 SAE during the initial 2 years of treatment. Female sex, higher peripheral eosinophil/basophil counts, and lower levels of forced expiratory volume in 1 second (FEV1; %) were factors predicting the risk of SAEs (P < 0.001 for all). Higher serum total immunoglobulin E levels increased the risk of SAEs among the patients having ≤ 2 SAEs (P = 0.025). Patients with more frequent SAEs during the initial 2 years of treatment had significantly higher risks of SAEs during the following years of treatment (P < 0.001, for all) (patients with ≥ 4 SAEs, odds ratio [OR], 29.147; those with 3 SAEs, OR, 14.819; those with 2 SAEs, OR, 9.867; those with 1 SAE, OR, 5.116), had higher maintenance doses of systemic steroids, and showed more gradual decline in FEV1 (%) and FEV1/forced vital capacity levels maintained during the following years of treatment (P < 0.001 for all).

Conclusions: Asthmatics having risk factors for SAEs (female sex, higher peripheral eosinophil/basophil counts, and lower FEV1) should be strictly monitored to prevent future risk and improve clinical outcomes.

키워드

Asthma; adults; female; eosinophils; basophils; IgE; risk factors; steroids; respiratory function tests

원문 및 링크아웃 정보

 

등재저널 정보