Predictors of exacerbation in Japanese patients with severe asthma: Analysis of the severe asthma research program (Okayama-SARP) cohort

IF 2.4 Q2 RESPIRATORY SYSTEM
Hisao Higo , Akihiko Taniguchi , Satoru Senoo , Taichi Ozeki , Naoki Nakamura , Masaki Atokawa , Junko Itano , Naohiro Oda , Ryota Sunami , Yutaro Shiota , Yukako Arakawa , Yoshihiro Mori , Naomi Kunichika , Ichiro Takata , Toshimitsu Suwaki , Norihiko Nakanishi , Yasushi Tanimoto , Arihiko Kanehiro , Yoshinobu Maeda , Katsuyuki Kiura , Nobuaki Miyahara
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引用次数: 0

Abstract

Background

Because exacerbation of severe asthma decreases patients’ quality of life, this study aimed to identify predictive factors for asthma exacerbation.

Methods

Japanese patients with severe asthma requiring treatment according to the Global Initiative for Asthma (GINA) guidelines ≥ Step 4 between January 2018 and August 2021 were prospectively enrolled and followed up for one year at facilities participating in the Okayama Respiratory Disease Study Group (Okayama Severe Asthma Research Program).

Results

A total of 85 patients (29 men and 56 women) were included. The median age was 64 (interquartile range [IQR], 51–72) years. Treatment according to GINA Steps 4 and 5 was required in 29 and 56 patients, respectively, and 44 patients (51.8%) were treated with biologics. The median peripheral-blood eosinophil count, fractional exhaled nitric oxide, IgE level, and percent predicted FEV1 (%FEV1) at enrollment were 204 (IQR, 49–436)/μL, 28 (IQR, 15–43) ppb, 172 (IQR, 56–473) IU/mL, and 80.0 (IQR, 61.1–96.1) %, respectively. Exacerbation during the previous year, asthma control test (ACT) score <20, %FEV1 <60%, and serum IL-10 level >6.7 pg/mL were associated with exacerbation during the observation period.

Conclusions

Exacerbation during the previous year, low ACT score, and low %FEV1 were predictive factors of future exacerbation, even in a cohort with >50% of patients treated with biologics. Furthermore, high serum IL-10 levels might be a new predictive factor.

日本重症哮喘患者病情恶化的预测因素:重症哮喘研究计划(冈山-SARP)队列分析
背景由于重症哮喘的恶化会降低患者的生活质量,本研究旨在确定哮喘恶化的预测因素。方法在2018年1月至2021年8月期间,根据全球哮喘防治倡议(GINA)指南≥第4步需要治疗的日本重症哮喘患者在参与冈山呼吸系统疾病研究组(冈山重症哮喘研究项目)的机构中进行了前瞻性登记和为期一年的随访。结果共纳入85名患者(29名男性和56名女性)。中位年龄为 64 岁(四分位数间距 [IQR],51-72)。分别有 29 名和 56 名患者需要按照 GINA 第 4 步和第 5 步进行治疗,其中 44 名患者(51.8%)接受了生物制剂治疗。入组时外周血嗜酸性粒细胞计数、呼出一氧化氮分数、IgE水平和预测FEV1百分比(%FEV1)的中位数分别为204(IQR,49-436)/μL、28(IQR,15-43)ppb、172(IQR,56-473)IU/mL和80.0(IQR,61.1-96.1)%。上一年的病情加重、哮喘控制测试(ACT)得分20分、FEV1%60%以及血清IL-10水平6.7 pg/mL均与观察期间的病情加重有关。结论上一年的病情加重、ACT得分低以及FEV1%低是未来病情加重的预测因素,即使在50%的患者接受生物制剂治疗的队列中也是如此。此外,高血清IL-10水平可能是一个新的预测因素。
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来源期刊
Respiratory investigation
Respiratory investigation RESPIRATORY SYSTEM-
CiteScore
4.90
自引率
6.50%
发文量
114
审稿时长
64 days
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