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Effects of older age and age of asthma onset on clinical and inflammatory variables in severe refractory asthma.

Chaudhuri, Rekha and McSharry, Charles and Heaney, Liam G and Niven, Robert and Brightling, Christopher E and Menzies-Gow, Andrew N and Bucknall, Christine and Mansur, Adel H and Lee, Waiting and Shepherd, Malcolm and Spears, Mark and Cowan, Douglas C and Husi, Holger and Thomson, Neil C (2016) Effects of older age and age of asthma onset on clinical and inflammatory variables in severe refractory asthma. Respiratory medicine, 118. pp. 46-52. ISSN 1532-3064. This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs

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Official URL: http://www.resmedjournal.com/article/S0954-6111(16...

Abstract

BACKGROUND

Asthma in the elderly as well as asthma of adult-onset has been associated with increased morbidity, but little is known specifically about the effects of age on clinical and inflammatory outcomes in severe refractory asthma. The aims of the study were to examine the effects of age [<65 versus ≥65 years] and age of onset of asthma [childhood-onset, <18 versus adult-onset, ≥18 years] on clinical and inflammatory variables in patients with severe asthma.

METHODS

In 1042 subjects with refractory asthma recruited to the British Thoracic Society Severe Asthma Registry, we compared patient demographics, disease characteristics and biomarkers of inflammation in patients aged <65 years (n = 896) versus ≥65 years (n = 146) and onset at age <18 years (n = 430) versus ≥18 years (n = 526).

RESULTS

Severe asthma patients aged ≥65 years had improved symptom control, better asthma quality of life and in the last year, less emergency visits and rescue oral steroid courses [3 (1-6) versus 5 (2-7), p < 0.001] than severe asthmatics aged <65 years. Blood eosinophils were lower in the elderly group. Patients with severe adult-onset asthma had similar symptom control, lung function and health-care utilization compared to severe childhood-onset asthma. Adult-onset asthmatics had higher blood eosinophils and were less atopic.

CONCLUSIONS

Patients with severe refractory asthma aged ≥65 years exhibit better clinical and health care outcomes and have lower blood eosinophils compared to those aged <65 years. Severe refractory adult-onset asthma is associated with similar levels of asthma control, higher blood eosinophils and less atopy than severe refractory childhood-onset asthma.

Item Type: Article
Additional Information: This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs
Subjects: WF Respiratory system. Respiratory medicine
Divisions: Emergency Services > Acute Medicine and AMU
Related URLs:
Depositing User: Preeti Puligari
Date Deposited: 30 Mar 2017 11:41
Last Modified: 30 Mar 2017 11:41
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1314

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