|
Title
|
|
|
|
Atopy modifies the association between inhaled corticosteroid use and lung function decline in patients with asthma
| |
|
Author
|
|
|
|
| |
|
Institution/Organisation
|
|
|
|
Ageing Lungs European Cohorts ALEC
| |
|
Abstract
|
|
|
|
| BACKGROUND: Inhaled corticosteroids (ICSs) are the mainstay of asthma treatment, but response to medication is variable. Patients with allergic inflammation generally show a better short-term response to ICSs; however, studies on predictors of long-term response are few. OBJECTIVE: To assess whether allergic sensitization can modify the association between ICS use and lung function decline over 20 years in adult asthma. METHODS: We used data from the 3 clinical examinations of the European Community Respiratory Health Survey. We measured ICS use (no use, and use for <1.3, 1.3-8, and >8 years) and FEV1 decline among subjects with asthma over the 2 periods between consecutive examinations. We conducted a cohort study combining data of the 2 periods (906 observations from 745 subjects) to assess whether the association between ICS use and FEV1 decline was modified by allergic sensitization (IgE > 0.35 kU/L for any of house-dust mite, timothy grass, cat, or Cladosporium). RESULTS: FEV1 decline was similar for non-ICS users, as well as ICS users for less than 1.3 years, with and without allergic sensitization. However, among subjects on ICSs for a longer period, sensitization was associated with an attenuated decline (P-interaction = .006): in the group treated for more than 8 years, FEV1 decline was on average 27 mL/y (95% CIBonferroni-adjusted, 11-42) lower for subjects with sensitization compared with nonsensitized subjects. CONCLUSIONS: Our study suggests that biomarkers of atopy can predict a more favorable long-term response to ICSs. Randomized controlled studies are needed to confirm these findings. (C) 2019 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. |
| |
|
Language
|
|
|
|
English
| |
|
Source (journal)
|
|
|
|
The journal of allergy and clinical immunology. In practice. - New York, NY, 2013, currens
| |
|
Publication
|
|
|
|
New York, NY
:
Elsevier Inc
,
2020
| |
|
ISSN
|
|
|
|
2213-2198
| |
|
DOI
|
|
|
|
10.1016/J.JAIP.2019.10.023
| |
|
Volume/pages
|
|
|
|
8
:3
(2020)
, p. 980-988
| |
|
ISI
|
|
|
|
000519197300014
| |
|
Pubmed ID
|
|
|
|
31704441
| |
|
Full text (Publisher's DOI)
|
|
|
|
| |
|
Full text (open access)
|
|
|
|
| |
|