title: Predictors of future exacerbation risk in patients with asthma.
abstract: OBJECTIVE
  Although modern treatment of asthma improves asthma control, some patients still experience exacerbations. The aim of the present study was to detect predictors of asthmatic exacerbations Methods: We included patients with asthma followed up in asthma clinics of 2 tertiary University hospitals. Demographic and functional characteristics, levels of exhaled NO, and inflammatory biomarkers (IL-13, ΕCP και IL-8) and cell counts in induced sputum were recorded at baseline. Measurements were performed with the patients in stability and were considered as their personal best. Patients received optimal treatment with good compliance and were followed up for 1 year for asthma exacerbations occurrence. Evaluation of the effect of recorded parameters on asthma exacerbations was performed with univariate and multivariate Poisson regression analysis.
  
  
  RESULTS
  171 patients (118 female) with bronchial asthma (mean age 51.6 ± 13.2 years) were included in the study. The mean number of exacerbations in 1 year of follow up was 0.4 ± 0.8 while the majority of patients (71.9%) did not experience any exacerbation. In multivariate Poisson Regression analysis only 3 characteristics were predictors of future exacerbations: FEV1 [IRR(95% CI)], [0.970(0.954-0.987)], p = 0.001, high BMI [1.078(1.030-1.129)], p = 0.001, and the need for permanent treatment with oral corticosteroids for asthma control maintenance [2.542(1.083-5.964)], p = 0.032 CONCLUSION: Optimal guideline-based asthma management results in minimal occurrence of exacerbations in the majority of patients. Predictors of exacerbations are low FEV1 levels in stability, high BMI and the need for permanent treatment with oral corticosteroids.
authors: a 2nd Respiratory Medicine Department, Attikon Hospital , University of Athens , Athens , Greece.
authors: Andriana I
authors: AI
authors: Papaioannou
authors: a 2nd Respiratory Medicine Department, Attikon Hospital , University of Athens , Athens , Greece.
authors: Konstantinos
authors: K
authors: Kostikas
authors: b 1st Respiratory Medicine Department, Sotiria Hospital , University of Athens , Athens , Greece.
authors: Petros
authors: P
authors: Bakakos
authors: b 1st Respiratory Medicine Department, Sotiria Hospital , University of Athens , Athens , Greece.
authors: Anastasia
authors: A
authors: Papaporfyriou
authors: b 1st Respiratory Medicine Department, Sotiria Hospital , University of Athens , Athens , Greece.
authors: Elissavet
authors: E
authors: Konstantellou
authors: c Respiratory Medicine Department , Evagelismos Hospital , Athens , Greece.
authors: Georgios
authors: G
authors: Hillas
authors: d Clinical Research unit , Athens Army General Hospital , Athens , Greece.
authors: Georgios
authors: G
authors: Papatheodorou
authors: b 1st Respiratory Medicine Department, Sotiria Hospital , University of Athens , Athens , Greece.
authors: Nikolaos G
authors: NG
authors: Koulouris
authors: a 2nd Respiratory Medicine Department, Attikon Hospital , University of Athens , Athens , Greece.
authors: Spyridon
authors: S
authors: Papiris
authors: a 2nd Respiratory Medicine Department, Attikon Hospital , University of Athens , Athens , Greece.
authors: Stelios
authors: S
authors: Loukides
mesh_terms: D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D015415:Biomarkers / Q000378:metabolism; D018450:Disease Progression; D047150:Eosinophil Cationic Protein / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D006115:Greece / Q000453:epidemiology; D006801:Humans; D018793:Interleukin-13 / Q000378:metabolism*; D016209:Interleukin-8 / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests / Q000379:methods; D018570:Risk Assessment / Q000379:methods; D013183:Sputum / Q000378:metabolism; D000067251:Symptom Flare Up
chemical_list: D018927:Anti-Asthmatic Agents; D015415:Biomarkers; D005938:Glucocorticoids; D018793:Interleukin-13; D016209:Interleukin-8; D047150:Eosinophil Cationic Protein
keywords: Asthma; biomarkers; body mass index; exacerbations; exhaled nitric oxide; pulmonary function