Abstract
Background: Bronchial asthma can present with different features depending on the age of onset. While early and late onset asthma are well documented, intermediate-onset asthma is much less studied.
Aim: To investigate the impact of clinical characteristics and risk factors on asthma control in persistent asthma with a focus on intermediate-onset asthma.
Methods: In a cohort of 250 patients with persistent asthma (age: 54±16yrs) 3 clusters were defined: EA(early-onset asthma ≤12yr);IA (intermediate-onset asthma 12-40yr);LA (late-onset asthma >40yr). Medical history, smoking and occupational exposure, lung function, blood cell counts, body mass index (BMI), comorbidities, and level of asthma control were recorded.
Results: Among 250 patients 78(31%) had EA, 75(30%) IA and 98(39%) LA. Occupational exposure was significatively higher in IA than in EA and LA (62vs20vs39%;p=0.002) while smoking (39vs32vs37%), outdoor pollution (42vs44vs47%) and obesity (20vs17vs21%) were similar among groups. IA had more blood eosinophils than LA (4.5±3.5vs2.7±1.9%;p=0.005) and more neutrophils than EA (56±11vs 50±9%;p=0.04). In IA poor asthma control (ACT<20) was associated to occupational exposure (59vs25%;p=0.0004), smoking (66vs13%;p<0.0001) and obesity (53vs25%;p=0.003). Occupationally 82% were exposed to chemical dusts/vapour, 23% to metals, 17% to organic dusts, 13% to textiles with no gender differences. Poor symptom control was more frequent in subjects exposed to chemicals than in others (77%vs 50%;p=0.003).
Conclusions: Intermediate-onset asthma is a different phenotype in which obesity, occupational exposure, especially to chemical dusts, and smoke could have an important influence on disease mechanisms and symptom control.
Footnotes
Cite this article as Eur Respir J 2022; 60: Suppl. 66, 3012.
This article was presented at the 2022 ERS International Congress, in session “-”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
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