A study has identified several factors associated with frequent exacerbations in patients with severe asthma in the UK. Poor symptom control was the strongest risk factor, regardless of maintenance oral corticosteroid (OCS) therapy. The findings were published in The Journal of Allergy and Clinical Immunology: In Practice.
Researchers collected data on demography, co-morbidities and physiological parameters from 1592 patients with severe asthma from the UK Severe Asthma Registry. Frequent exacerbations were defined as three or more exacerbations managed with high-dose systemic corticosteroids in the past year.
Patients with frequent exacerbations had a greater likelihood of having gastroesophageal reflux disease (P=.006), higher Asthma Control Questionnaire-6 (ACQ-6) score (P<.001 higher baseline blood eosinophil count and being ex-smokers versus those without frequent exacerbations.>
In multivariable regression analyses, ACQ-6 score >1.5 (OR, 4.25; P<.001 past smoking history p=".024)" and feno>50 ppb (OR, 1.54; P=.044) had an independent association with frequent exacerbations. ACQ-6 score >1.5 had an independent correlation with frequent exacerbations, irrespective of whether the patients received maintenance OCS therapy (OR, 2.74; P=.017) or not (OR, 6.42; P<.001>
"Tools to aid identification of poor symptom control in severe asthma are key to identifying patients with higher risk of frequent exacerbations," the authors said.