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Atopy modifies the association between inhaled corticosteroid use and lung function decline in patients with asthma

Marcon, Alessandro and Marchetti, Pierpaolo and Antó, Josep M. and Cazzoletti, Lucia and Cerveri, Isa and Corsico, Angelo and Ferreira, Diogenes Seraphim and Garcia-Aymerich, Judith and Gislason, David and Heinrich, Joachim and Jõgi, Rain and Johannessen, Ane and Leynaert, Bénédicte and Malinovschi, Andrei and Pin, Isabelle and Probst-Hensch, Nicole and Weyler, Joost and Janson, Christer and Jarvis, Deborah and Accordini, Simone and Ageing Lungs in European Cohorts study, . (2020) Atopy modifies the association between inhaled corticosteroid use and lung function decline in patients with asthma. The journal of allergy and clinical immunology. In practice, 8 (3). pp. 980-988.e10.

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Abstract

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.; To assess whether allergic sensitization can modify the association between ICS use and lung function decline over 20 years in adult asthma.; We used data from the 3 clinical examinations of the European Community Respiratory Health Survey. We measured ICS use (no use, and use for 8 years) and FEV; 1; 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 FEV; 1; decline was modified by allergic sensitization (IgE > 0.35 kU/L for any of house-dust mite, timothy grass, cat, or Cladosporium).; FEV; 1; 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, FEV; 1; decline was on average 27 mL/y (95% CI; Bonferroni-adjusted; , 11-42) lower for subjects with sensitization compared with nonsensitized subjects.; 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.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Chronic Disease Epidemiology > Genetic Epidemiology of Non-Communicable Diseases (Probst-Hensch)
03 Faculty of Medicine > Departement Public Health > Sozial- und Präventivmedizin > Genetic Epidemiology of Non-Communicable Diseases (Probst-Hensch)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
UniBasel Contributors:Probst Hensch, Nicole
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Elsevier
ISSN:2213-2201
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
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Last Modified:27 Mar 2020 08:45
Deposited On:27 Mar 2020 08:45

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