Atopy Modifies the Association Between Inhaled Corticosteroid Use and Lung Function Decline in Patients with Asthma.
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Authors
Marcon, AlessandroMarchetti, Pierpaolo
Antó, Josep M
Cazzoletti, Lucia
Cerveri, Isa
Corsico, Angelo
Ferreira, Diogenes Seraphim
Garcia-Aymerich, Judith
Gislason, David
Heinrich, Joachim
Jõgi, Rain
Johannessen, Ane
Leynaert, Bénédicte
Malinovschi, Andrei
Pin, Isabelle
Probst-Hensch, Nicole
Weyler, Joost
Janson, Christer
Jarvis, Deborah
Accordini, Simone
Issue Date
2019-11-05
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Marcon A, Marchetti P, Antó JM, et al. Atopy Modifies the Association Between Inhaled Corticosteroid Use and Lung Function Decline in Patients with Asthma. J Allergy Clin Immunol Pract. 2020;8(3):980–988.e10. doi:10.1016/j.jaip.2019.10.023Abstract
Background: 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. Objective: To assess whether allergic sensitization can modify the association between ICS use and lung function decline over 20 years in adult asthma. Methods: We used data from the 3 clinical examinations of the European Community Respiratory Health Survey. We measured ICS use (no use, and use for <1.3, 1.3-8, and >8 years) and FEV1 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 FEV1 decline was modified by allergic sensitization (IgE > 0.35 kU/L for any of house-dust mite, timothy grass, cat, or Cladosporium). Results: FEV1 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 (Pinteraction = .006): in the group treated for more than 8 years, FEV1 decline was on average 27 mL/y (95% CIBonferroni-adjusted, 11-42) lower for subjects with sensitization compared with nonsensitized subjects. Conclusions: 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.Description
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Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.ae974a485f413a2113503eed53cd6c53
10.1016/j.jaip.2019.10.023
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