Capital Allergy & Respiratory Disease Center, Sacramento, California.
AllerVie Health-Alabama Allergy & Asthma Center Health, Birmingham, Alabama.
Ann Allergy Asthma Immunol. 2023 Jun;130(6):784-790.e5. doi: 10.1016/j.anai.2023.03.001. Epub 2023 Mar 10.
Patients with severe asthma (SA) experience a high disease burden, often precipitated by exposure to disease triggers.
To evaluate the prevalence and effects of patient-reported triggers on asthma disease burden in a cohort of subspecialist-treated patients with SA in the United States.
CHRONICLE is an observational study of adults with SA receiving biologics or maintenance systemic corticosteroids or whose disease is uncontrolled on high-dosage inhaled corticosteroids and additional controllers. Data were analyzed for patients enrolled between February 2018 and February 2021. This analysis evaluated patient-reported triggers from a 17-category survey and associations with multiple measures of disease burden.
Among 2793 enrolled patients, 1434 (51%) completed the trigger questionnaire. The median trigger number per patient was 8 (interquartile range, 5-10). The most frequent triggers were weather or air changes, viral infections, seasonal allergies, perennial allergies, and exercise. Patients reporting more triggers experienced more poorly controlled disease, worse quality of life, and reduced work productivity. The annualized rates of exacerbations and asthma hospitalizations increased by 7% and 17%, respectively, for each additional trigger (both P < .001). For all measures, trigger number was a stronger predictor of disease burden than blood eosinophil count.
Among US specialist-treated patients with SA, asthma trigger number was positively and significantly associated with greater uncontrolled disease burden across multiple measures, which highlights the importance of understanding patient-reported triggers in SA.
ClinicalTrials.gov Identifier: NCT03373045.
严重哮喘（SA）患者疾病负担高，常因暴露于疾病诱因而加重。
评估美国专科治疗的 SA 患者中，患者报告的诱因对哮喘疾病负担的患病率和影响。
CHRONICLE 是一项观察性研究，纳入接受生物制剂或维持性全身皮质类固醇治疗的成人 SA 患者，或高剂量吸入皮质类固醇和其他控制药物治疗控制不佳的患者。数据分析纳入 2018 年 2 月至 2021 年 2 月间入组的患者。该分析评估了来自 17 类调查的患者报告的诱因，以及与多种疾病负担指标的关联。
在 2793 名入组患者中，有 1434 名（51%）完成了诱因问卷。每位患者的中位数诱因数为 8（四分位距，5-10）。最常见的诱因是天气或空气变化、病毒感染、季节性过敏、常年过敏和运动。报告更多诱因的患者疾病控制更差，生活质量更差，工作生产力降低。每次额外诱因发生哮喘加重和住院的年化率分别增加 7%和 17%（均 P<0.001）。对于所有指标，诱因数量是疾病负担的更强预测因素，优于血嗜酸性粒细胞计数。
在美国专科治疗的 SA 患者中，哮喘诱因数量与多项措施中未得到良好控制的疾病负担呈正相关且具有显著意义，这凸显了了解 SA 患者报告的诱因的重要性。
ClinicalTrials.gov 标识符：NCT03373045。
