RT Journal Article
SR Electronic
T1 Intermediate-onset asthma: similarities and differences with early and late-onset
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA3110
DO 10.1183/13993003.congress-2021.PA3110
VO 58
IS suppl 65
A1 Martina Turrin
A1 Michele Rizzo
A1 Silvia Tonin
A1 Kim Lokar Oliani
A1 Matteo Bonato
A1 Manuel Cosio
A1 Marina Saetta
A1 Simonetta Baraldo
YR 2021
UL http://erj.ersjournals.com/content/58/suppl_65/PA3110.abstract
AB Background: Age of asthma onset may have significant pathogenetic implications. While early and late phenotypes have been well studied, intermediate onset-asthma is not well understood.Aim: To investigate the impact of comorbidities, smoking history and inflammatory phenotypes on asthma control (GINA) in patients stratified by age of onset.Methods: In a cohort of 250 patients(54±16 yr) followed at the asthma clinic 3 clusters were defined: early-onset asthma(EA)<12 yr; intermediate asthma(IA) 12-40 yr; late-onset asthma(LA)>40 yr.Results: 77/250 (30%) subjects had EA, 76 (30%) IA and 98 (39%) LA. EA was different from LA, with more rhinitis (76vs53%, p=0.02) which was associated to worse asthma control (p=0.01) and lower FEV1/FVC (74±10vs83±7%;p=0.01); EA also had more eosinophils (0.36±0.3 vs 0.14±0.1 x109/L;p<0.01) and IgE (441±635vs71±76KU/L;p<0.01). LA patients had more neutrophils (4.2±1.5vs3.3±1.1x109/L;p=0.01) particularly when obese. Obesity in LA was associated to worse control (p=0.009) and lower FEV1/FVC (73±9vs80±10;p=0.009). IA was an intermediate phenotype, with both eosinophilic (0.31±0.3x109/L) and neutrophilic (4±1.4x109/L) patterns. In IA obesity, but not rhinitis, was associated to worse control (p=0.003), lower FEV1/FVC (71±10vs79±10; p=0.03) and neutrophilic inflammation. Of note, smoking history and environmental exposure were associated to worse control in IA (p<0.001, p=0.04) but not in EA and LA.Conclusions: Early, intermediate and late-onset asthma are distinct phenotypes. In our population IA showed a combination of EA and LA features and a mixed eosinophilic/neutrophilic pattern. Differently from EA and LA, in IA asthma control is influenced by smoking and environmental exposure.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3110.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.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).