Izabela Kupryś-Lipińska, Tomasz Dębowski, Cezary Palczyński, Roman Hożejowski, Piotr Lacwik, Piotr Kuna
{"title":"吸烟对体外倍氯米松/福莫特罗控制哮喘的影响:一项前瞻性队列研究的事后分析。","authors":"Izabela Kupryś-Lipińska, Tomasz Dębowski, Cezary Palczyński, Roman Hożejowski, Piotr Lacwik, Piotr Kuna","doi":"10.1080/02770903.2025.2526373","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Exposure to tobacco smoke is a major risk factor for poor asthma control. We aimed to assess the response to asthma treatment based on patients' smoking status.</p><p><strong>Methods: </strong>This post hoc analysis used data from a large prospective asthma cohort treated with inhaled extrafine beclomethasone/formoterol. Patients were retrospectively categorized as current smokers, former smokers, or nonsmokers. Asthma control and symptom severity were evaluated over 6 months using Global Initiative for Asthma (GINA) criteria. The primary outcome was the proportion of patients who achieved an improved GINA category of asthma control, while the secondary outcome was the proportion with well-controlled asthma. To account for baseline differences, the cohorts were propensity score-matched (1:1:1) based on age, sex, body mass index, self-reported physical activity, education level, and FEV<sub>1</sub>.</p><p><strong>Results: </strong>From an initial cohort of 17 098 patients, a matched sample of 2856 (952 per group) was selected, ensuring comparable baseline characteristics. After 6 months, an improved GINA category was observed in 78% of current smokers, 75% of former smokers, and 77% of nonsmokers (<i>p</i> = 0.381). The rates of well-controlled asthma were comparable across groups (current smokers: 58%, former smokers: 54%; nonsmokers: 57%, <i>p</i> = 0.255). Uncontrolled asthma remained infrequent but was more prevalent in current (10%) and former (8.9%) smokers than in nonsmokers (5.7%) (<i>p</i> = 0.002 and <i>p</i> = 0.033, respectively).</p><p><strong>Conclusions: </strong>Asthma patients, regardless of smoking status, demonstrate a similar response to treatment. Uncontrolled asthma, though rare under treatment, is more common among smokers, due to their higher baseline severity.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-9"},"PeriodicalIF":1.7000,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of smoking on asthma control with extrafine beclomethasone/formoterol: post hoc analysis of a prospective cohort study.\",\"authors\":\"Izabela Kupryś-Lipińska, Tomasz Dębowski, Cezary Palczyński, Roman Hożejowski, Piotr Lacwik, Piotr Kuna\",\"doi\":\"10.1080/02770903.2025.2526373\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Exposure to tobacco smoke is a major risk factor for poor asthma control. We aimed to assess the response to asthma treatment based on patients' smoking status.</p><p><strong>Methods: </strong>This post hoc analysis used data from a large prospective asthma cohort treated with inhaled extrafine beclomethasone/formoterol. Patients were retrospectively categorized as current smokers, former smokers, or nonsmokers. Asthma control and symptom severity were evaluated over 6 months using Global Initiative for Asthma (GINA) criteria. The primary outcome was the proportion of patients who achieved an improved GINA category of asthma control, while the secondary outcome was the proportion with well-controlled asthma. To account for baseline differences, the cohorts were propensity score-matched (1:1:1) based on age, sex, body mass index, self-reported physical activity, education level, and FEV<sub>1</sub>.</p><p><strong>Results: </strong>From an initial cohort of 17 098 patients, a matched sample of 2856 (952 per group) was selected, ensuring comparable baseline characteristics. After 6 months, an improved GINA category was observed in 78% of current smokers, 75% of former smokers, and 77% of nonsmokers (<i>p</i> = 0.381). The rates of well-controlled asthma were comparable across groups (current smokers: 58%, former smokers: 54%; nonsmokers: 57%, <i>p</i> = 0.255). Uncontrolled asthma remained infrequent but was more prevalent in current (10%) and former (8.9%) smokers than in nonsmokers (5.7%) (<i>p</i> = 0.002 and <i>p</i> = 0.033, respectively).</p><p><strong>Conclusions: </strong>Asthma patients, regardless of smoking status, demonstrate a similar response to treatment. Uncontrolled asthma, though rare under treatment, is more common among smokers, due to their higher baseline severity.</p>\",\"PeriodicalId\":15076,\"journal\":{\"name\":\"Journal of Asthma\",\"volume\":\" \",\"pages\":\"1-9\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-07-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Asthma\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/02770903.2025.2526373\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ALLERGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Asthma","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/02770903.2025.2526373","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ALLERGY","Score":null,"Total":0}
Impact of smoking on asthma control with extrafine beclomethasone/formoterol: post hoc analysis of a prospective cohort study.
Objective: Exposure to tobacco smoke is a major risk factor for poor asthma control. We aimed to assess the response to asthma treatment based on patients' smoking status.
Methods: This post hoc analysis used data from a large prospective asthma cohort treated with inhaled extrafine beclomethasone/formoterol. Patients were retrospectively categorized as current smokers, former smokers, or nonsmokers. Asthma control and symptom severity were evaluated over 6 months using Global Initiative for Asthma (GINA) criteria. The primary outcome was the proportion of patients who achieved an improved GINA category of asthma control, while the secondary outcome was the proportion with well-controlled asthma. To account for baseline differences, the cohorts were propensity score-matched (1:1:1) based on age, sex, body mass index, self-reported physical activity, education level, and FEV1.
Results: From an initial cohort of 17 098 patients, a matched sample of 2856 (952 per group) was selected, ensuring comparable baseline characteristics. After 6 months, an improved GINA category was observed in 78% of current smokers, 75% of former smokers, and 77% of nonsmokers (p = 0.381). The rates of well-controlled asthma were comparable across groups (current smokers: 58%, former smokers: 54%; nonsmokers: 57%, p = 0.255). Uncontrolled asthma remained infrequent but was more prevalent in current (10%) and former (8.9%) smokers than in nonsmokers (5.7%) (p = 0.002 and p = 0.033, respectively).
Conclusions: Asthma patients, regardless of smoking status, demonstrate a similar response to treatment. Uncontrolled asthma, though rare under treatment, is more common among smokers, due to their higher baseline severity.
期刊介绍:
Providing an authoritative open forum on asthma and related conditions, Journal of Asthma publishes clinical research around such topics as asthma management, critical and long-term care, preventative measures, environmental counselling, and patient education.