Clinical and Inflammatory Features of Exacerbation-Prone Asthma: A Cross-Sectional Study Using Multidimensional Assessment.

Feng, M; Zhang, X; Wu, WW; Chen, ZH; Oliver, BG; McDonald, VM; Zhang, HP; Xie, M; Qin, L; Zhang, J; Wang, L; Li, WM; Wang, G; Gibson, PG

Clinical and Inflammatory Features of Exacerbation-Prone Asthma: A Cross-Sectional Study Using Multidimensional Assessment.

Feng, M Zhang, X Wu, WW Chen, ZH Oliver, BG McDonald, VM Zhang, HP Xie, M Qin, L Zhang, J Wang, L Li, WM Wang, G Gibson, PG

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Publisher:: Karger Publishers
Publication Type:: Journal Article
Citation:: Respiration; international review of thoracic diseases, 2021, 99, (12), pp. 1-13
Issue Date:: 2021

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Field	Value	Language
dc.contributor.author	Feng, M
dc.contributor.author	Zhang, X
dc.contributor.author	Wu, WW
dc.contributor.author	Chen, ZH
dc.contributor.author	Oliver, BG
dc.contributor.author	McDonald, VM
dc.contributor.author	Zhang, HP
dc.contributor.author	Xie, M
dc.contributor.author	Qin, L
dc.contributor.author	Zhang, J
dc.contributor.author	Wang, L
dc.contributor.author	Li, WM
dc.contributor.author	Wang, G
dc.contributor.author	Gibson, PG
dc.date.accessioned	2022-01-14T01:48:47Z
dc.date.available	2020-08-06
dc.date.available	2022-01-14T01:48:47Z
dc.date.issued	2021
dc.identifier.citation	Respiration; international review of thoracic diseases, 2021, 99, (12), pp. 1-13
dc.identifier.issn	0025-7931
dc.identifier.issn	1423-0356
dc.identifier.uri	http://hdl.handle.net/10453/153100
dc.description.abstract	<h4>Background</h4>Reducing asthma exacerbations is a major target of current clinical guidelines, but identifying features of exacerbation-prone asthma (EPA) using multidimensional assessment (MDA) is lacking.<h4>Objective</h4>To systemically explore the clinical and inflammatory features of adults with EPA in a Chinese population.<h4>Methods</h4>We designed a cross-sectional study using the Severe Asthma Web-based Database from the Australasian Severe Asthma Network (ASAN). Eligible Chinese adults with asthma (n = 546) were assessed using MDA. We stratified patients based on exacerbation frequency: none, few (1 or 2), and exacerbation prone (≥3). Univariate and multivariable negative binomial regression analyses were performed to investigate features associated with the frequency of exacerbations.<h4>Results</h4>Of 546 participants, 61.9% had no exacerbations (n = 338), 29.6% had few exacerbations (n = 162), and 8.4% were exacerbation prone (n = 46) within the preceding year. EPA patients were characterized by elevated blood and sputum eosinophils but less atopy, with more controller therapies but worse asthma control and quality of life (all p < 0.05). In multivariable models, blood and sputum eosinophils (adjusted rate ratio = 2.23, 95% confidence interval = [1.26, 3.84] and 1.67 [1.27, 2.21], respectively), FEV1 (0.90 [0.84, 0.96]), bronchodilator responsiveness (1.16 [1.05, 1.27]), COPD (2.22 [1.41, 3.51]), bronchiectasis (2.87 [1.69, 4.89]), anxiety (2.56 [1.10, 5.95]), and depression (1.94 [1.20, 3.13]) were found. Further, upper respiratory tract infection (1.83 [1.32, 2.54]) and food allergy (1.67 [1.23, 2.25]) were at high risk of asthma symptom triggers.<h4>Conclusion</h4>EPA is a clinically recognizable phenotype associated with several recognizable traits that could be addressed by targeted treatment.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Karger Publishers
dc.relation.ispartof	Respiration; international review of thoracic diseases
dc.relation.isbasedon	10.1159/000510793
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1102 Cardiorespiratory Medicine and Haematology
dc.subject.classification	Respiratory System
dc.subject.mesh	Adult
dc.subject.mesh	Asthma
dc.subject.mesh	Bronchodilator Agents
dc.subject.mesh	China
dc.subject.mesh	Comorbidity
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Female
dc.subject.mesh	Forced Expiratory Volume
dc.subject.mesh	Humans
dc.subject.mesh	Inflammation
dc.subject.mesh	Male
dc.subject.mesh	Middle Aged
dc.subject.mesh	Patient Acuity
dc.subject.mesh	Phenotype
dc.subject.mesh	Regression Analysis
dc.subject.mesh	Socioeconomic Factors
dc.subject.mesh	Symptom Assessment
dc.subject.mesh	Humans
dc.subject.mesh	Asthma
dc.subject.mesh	Inflammation
dc.subject.mesh	Bronchodilator Agents
dc.subject.mesh	Forced Expiratory Volume
dc.subject.mesh	Regression Analysis
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Comorbidity
dc.subject.mesh	Phenotype
dc.subject.mesh	Socioeconomic Factors
dc.subject.mesh	Adult
dc.subject.mesh	Middle Aged
dc.subject.mesh	China
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Symptom Assessment
dc.subject.mesh	Patient Acuity
dc.title	Clinical and Inflammatory Features of Exacerbation-Prone Asthma: A Cross-Sectional Study Using Multidimensional Assessment.
dc.type	Journal Article
utslib.citation.volume	99
utslib.location.activity	Switzerland
utslib.for	1102 Cardiorespiratory Medicine and Haematology
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Science
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
pubs.organisational-group	/University of Technology Sydney/Faculty of Science/School of Life Sciences
pubs.organisational-group	/University of Technology Sydney/Centre for Health Technologies (CHT)
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2022-01-14T01:48:46Z
pubs.issue	12
pubs.publication-status	Published
pubs.volume	99
utslib.citation.issue	12

Abstract:

Background

Reducing asthma exacerbations is a major target of current clinical guidelines, but identifying features of exacerbation-prone asthma (EPA) using multidimensional assessment (MDA) is lacking.

Objective

To systemically explore the clinical and inflammatory features of adults with EPA in a Chinese population.

Methods

We designed a cross-sectional study using the Severe Asthma Web-based Database from the Australasian Severe Asthma Network (ASAN). Eligible Chinese adults with asthma (n = 546) were assessed using MDA. We stratified patients based on exacerbation frequency: none, few (1 or 2), and exacerbation prone (≥3). Univariate and multivariable negative binomial regression analyses were performed to investigate features associated with the frequency of exacerbations.

Results

Of 546 participants, 61.9% had no exacerbations (n = 338), 29.6% had few exacerbations (n = 162), and 8.4% were exacerbation prone (n = 46) within the preceding year. EPA patients were characterized by elevated blood and sputum eosinophils but less atopy, with more controller therapies but worse asthma control and quality of life (all p < 0.05). In multivariable models, blood and sputum eosinophils (adjusted rate ratio = 2.23, 95% confidence interval = [1.26, 3.84] and 1.67 [1.27, 2.21], respectively), FEV1 (0.90 [0.84, 0.96]), bronchodilator responsiveness (1.16 [1.05, 1.27]), COPD (2.22 [1.41, 3.51]), bronchiectasis (2.87 [1.69, 4.89]), anxiety (2.56 [1.10, 5.95]), and depression (1.94 [1.20, 3.13]) were found. Further, upper respiratory tract infection (1.83 [1.32, 2.54]) and food allergy (1.67 [1.23, 2.25]) were at high risk of asthma symptom triggers.

Conclusion

EPA is a clinically recognizable phenotype associated with several recognizable traits that could be addressed by targeted treatment.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/153100