title: Impact of Age and Sex on Response to Asthma Therapy.
abstract: BACKGROUND
  Age and sex are associated with differences in asthma prevalence and morbidity.
  
  
  OBJECTIVE
  To determine if age and sex associate with distinct phenotypes and a variable response to therapy in subjects with mild to moderate asthma.
  
  
  METHODS
  We used Asthma Clinical Research Network data to determine the impact of age and sex on phenotypes and treatment failures among subjects participating in 10 trials from 1993 to 2003.
  
  
  RESULTS
  A total of 1,200 subjects were identified (median age, 30.4 yr; male, 520 [43.3%]; female, 680 [56.7%]) and analyzed. A higher proportion of subjects greater than or equal to 30 years old experienced treatment failures (17.3% vs. 10.3%; odds ratio [OR], 1.82; confidence interval [CI], 1.30-2.54; P < 0.001), and rates increased proportionally with increasing age older than 30 across the cohort (OR per yr, 1.02 [CI, 1.01-1.04]; OR per 5 yr, 1.13 [CI, 1.04-1.22]; P < 0.001). Lower lung function and longer duration of asthma were associated with a higher risk of treatment failures. A higher proportion of subjects greater than or equal to 30 years old receiving controller therapy experienced treatment failures. When stratified by specific therapy, treatment failures increased consistently for every year older than age 30 in subjects on inhaled corticosteroids (OR per year, 1.03; CI, 1.01-1.07). Females had a slightly higher FEV1 % predicted (84.5% vs. 81.1%; P < 0.001) but similar asthma control measures. There was not a statistically significant difference in treatment failures between females and males (15.2% vs. 11.7%; P = 0.088).
  
  
  CONCLUSIONS
  Older age is associated with an increased risk of treatment failure, particularly in subjects taking inhaled corticosteroids. There was no significant difference in treatment failures between sexes.
authors.affiliation: 1 National Jewish, Denver, Denver, Colorado.
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Dunn
authors.affiliation: 2 Penn State University, Hershey, Pennsylvania.
authors.forename: Erik
authors.initials: E
authors.lastname: Lehman
authors.affiliation: 2 Penn State University, Hershey, Pennsylvania.
authors.forename: Vernon M
authors.initials: VM
authors.lastname: Chinchilli
authors.affiliation: 1 National Jewish, Denver, Denver, Colorado.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Martin
authors.affiliation: 3 University of California-San Francisco, San Francisco, California.
authors.forename: Homer A
authors.initials: HA
authors.lastname: Boushey
authors.affiliation: 4 Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Elliot
authors.initials: E
authors.lastname: Israel
authors.affiliation: 5 Duke University, Durham, North Carolina.
authors.forename: Monica
authors.initials: M
authors.lastname: Kraft
authors.affiliation: 3 University of California-San Francisco, San Francisco, California.
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Lazarus
authors.affiliation: 6 University of Wisconsin-Madison, Madison, Wisconsin.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Lemanske
authors.affiliation: 5 Duke University, Durham, North Carolina.
authors.forename: Njira L
authors.initials: NL
authors.lastname: Lugogo
authors.affiliation: 7 Wake Forest University, Winston-Salem, North Carolina; and.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Peters
authors.affiliation: 6 University of Wisconsin-Madison, Madison, Wisconsin.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Sorkness
authors.affiliation: 8 Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado.
authors.forename: Stanley
authors.initials: S
authors.lastname: Szefler
authors.affiliation: 1 National Jewish, Denver, Denver, Colorado.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Wechsler
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000367:Age Factors; D001249:Asthma / Q000188:drug therapy*; D001507:Beclomethasone / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D019819:Budesonide / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D010641:Phenotype; D012189:Retrospective Studies; D012737:Sex Factors; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents; D005938:Glucocorticoids; D020024:Leukotriene Antagonists; D019819:Budesonide; D001507:Beclomethasone
keywords: age; asthma; inhaled corticosteroid; sex; treatment failure