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.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.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.doi http://dx.doi.org/10.1016/j.jaip.2019.10.023
- dc.identifier.issn 2213-2198
- dc.identifier.uri http://hdl.handle.net/10230/43169
- 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.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
- 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.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.type.version info:eu-repo/semantics/publishedVersion