AI Article Synopsis

  • This study followed 223 asthma patients over 36 months after they reduced their inhaled corticosteroid (ICS) dose by 50% to assess the long-term effects on asthma control.
  • Key predictive factors for maintaining asthma control included low serum levels of IL-33, low week-to-week variability in peak expiratory flows (PEFs), childhood onset of asthma, and high serum IL-10 levels at the time of dose reduction.
  • Ultimately, 59.6% of the patients maintained asthma control, showing that specific biological and clinical markers can help predict patient outcomes after ICS dose reduction.

Article Abstract

Background: The prognosis for patients beyond 1 year after reduction of their inhaled corticosteroid (ICS) dose remains unknown. Predictive factors that can be evaluated before the initiation of asthma treatment or at ICS dose reduction are unknown.

Methods: We prospectively studied 223 patients in 6 hospitals in the National Hospital Organization of Japan during the 36 months after 50% reduction of their daily ICS dose. All patients recorded their morning and evening peak expiratory flows (PEFs) in their diaries. Lung function, bronchial hyperresponsiveness, fractional nitric oxide levels, number of eosinophils in sputum, and serum IgE levels were measured in most patients. Serum levels of IL-10, IL-33, and thymic stromal lymphopoietin before ICS dose reduction were measured in all patients.

Results: During the 36-month study period, asthma control was retained in 127 (59.6%) of the 213 enrolled patients who underwent ICS dose reduction. Multivariate logistic regression analysis revealed that, at the initiation of dose reduction, the factors most predictive of maintenance of asthma control after ICS dose reduction were a low serum IL-33 level (P < .01), low PEF variability over 1 week (P = .014), childhood onset of asthma (at age <10 years) (P = .03), and high serum IL-10 level (P = .035).

Conclusions: We demonstrated that low PEF variability over 1 week, high serum IL-10 level, and low serum IL-33 concentration were useful factors for predicting that an adult's asthma will remain in control for months to years after a 50% reduction in the daily ICS dose.

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Source
http://dx.doi.org/10.1016/j.jaip.2017.10.036DOI Listing

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