Marcon, AlessandroAntó i Boqué, Josep MariaGarcía Aymerich, JudithAccordini, Simone2019-12-162019-12-162020Marcon 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.2019.10.0232213-2198http://hdl.handle.net/10230/43169Background: 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.application/pdfeng© 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/)info:eu-repo/semantics/articlehttp://dx.doi.org/10.1016/j.jaip.2019.10.023Allergic sensitizationAsthmaAtopyCohort studyEpidemiologyIgEInhaled corticosteroidsLung function declinePrecision medicineResponse to corticosteroidsinfo:eu-repo/semantics/openAccess