Characterization of factors associated with systemic corticosteroid use in severe asthma: Data from the Severe Asthma Research Program

摘要

Inhaled corticosteroids remain gold standard asthma therapy; however, some patients appear to require chronic systemic corticosteroids (SCSs) for optimal control. Although no previous studies have addressed factors predisposing a patient with severe asthma (SA) to require SCSs, obesity, persistent inflammation, and airway obstruction have all been associated with higher inhaled and SCS use. The study's purpose was to identify factors that could increase the likelihood for chronic SCS use in adults with SA from the Severe Asthma Research Program (SARP) to help identify high-risk patients. Biologic and clinical factors were compared between rigorously defined participants with SA who used SCSs regularly versus those who did not. Logistic regression analysis identified the most predictive factors. Cross-sectional data from participants with SA (>18 years) in the multicenter SARP population were used as previously defined.3 Participants with SA met 1 of 2 major criteria and at least 2 of 7 minor criteria as per the American Thoracic Society 2000 definition. Initial analysis included categories of demographic characteristics, smoking status, medical history, blood/ sputum analysis, fractional exhaled nitric oxide (Feno), pulmonary function, medication use, atopy, and family history. Variables were chosen on the basis of their potential as a pathophysiologic cause and clinical utility.