Effect of maintenance oral corticosteroids on risk factors for frequent exacerbations in a severe adult asthma population

Abstract

Introduction Risk factors for frequent exacerbations (FE) include poor symptom control and persistent Type 2 inflammation. The effect of maintenance oral corticosteroids (mOCS) on risk factors for FE in a real-world severe asthma population is unknown. Methods We conducted univariate and multivariate logistic regression analyses using data from the UK Severe Asthma Registry (UK-SAR) to identify risk factors for FE in patients with and without mOCS. FE was defined as ≥3 severe exacerbations in the past year. Results 1592 patients fulfilled ERS/ATS criteria for severe asthma. 833 (52%) patients were on mOCS. 1137 (71%) were frequent exacerbators. In univariate analyses, patients not on mOCS were more likely to have FE if they had an ACQ-6 score >1.5 (OR 4.70, p 50ppb (OR 1.63, p=0.02) or blood eosinophils >0.45x109/L (OR 1.66, p=0.04). In multivariate analyses, high ACQ-6 score remained a risk factor (OR 6.42, p 1.5 (OR 2.20, p Conclusion High ACQ-6 score was the strongest independent risk factor for FE in a real-world severe asthma population irrespective of mOCS status. Other FE risk factors differ in patients with and without mOCS.