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

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dc.contributor.author Marcon, Alessandro
dc.contributor.author Antó i Boqué, Josep Maria
dc.contributor.author García Aymerich, Judith
dc.contributor.author Accordini, Simone
dc.date.accessioned 2019-12-16T08:27:27Z
dc.date.available 2019-12-16T08:27:27Z
dc.date.issued 2020
dc.identifier.citation Marcon A, Marchetti P, Antó JM, Cazzoletti L, Cerveri I, Corsico A 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):980-8. DOI: 10.1016/j.jaip.2019.10.023
dc.identifier.issn 2213-2198
dc.identifier.uri http://hdl.handle.net/10230/43169
dc.description.abstract 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.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartof Journal of Allergy and Clinical Immunology. 2020;8(3):980-8
dc.rights © 2020 Alessandro Marcon et al. Published by Elsevier Inc. on behalf of the American Academyof Allergy, Asthma & Immunology. This is an open access article under the CCBY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.title Atopy modifies the association between inhaled corticosteroid use and lung function decline in patients with asthma
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1016/j.jaip.2019.10.023
dc.subject.keyword Allergic sensitization
dc.subject.keyword Asthma
dc.subject.keyword Atopy
dc.subject.keyword Cohort study
dc.subject.keyword Epidemiology
dc.subject.keyword IgE
dc.subject.keyword Inhaled corticosteroids
dc.subject.keyword Lung function decline
dc.subject.keyword Precision medicine
dc.subject.keyword Response to corticosteroids
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion


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