TY - JOUR
T1 - Impact of sex on severe asthma
T2 - a cross-sectional retrospective analysis of UK primary and specialist care
AU - On behalf of the UK Severe Asthma Registry
AU - Loewenthal, Lola
AU - Busby, John
AU - McDowell, Ronald
AU - Brown, Thomas
AU - Burhan, Hassan
AU - Chaudhuri, Rekha
AU - Dennison, Paddy
AU - Dodd, James William
AU - Doe, Simon
AU - Faruqi, Shoaib
AU - Gore, Robin
AU - Idris, Elfatih
AU - Jackson, David Joshua
AU - Patel, Mitesh
AU - Pantin, Thomas
AU - Pavord, Ian
AU - Pfeffer, Paul E.
AU - Price, David B.
AU - Rupani, Hitasha
AU - Siddiqui, Salman
AU - Heaney, Liam G.
AU - Menzies-Gow, Andrew
AU - Higbee, Daniel
AU - Morgan, Caitlin
AU - Nava, George
AU - O'Brien, John
AU - Shrimanker, Rahul
AU - Butler, Claire
AU - McCullough, Nuala
AU - Sweeney, Joan
AU - Bawler, Kaylee
AU - Castell, Beverley
AU - Hayes, Gemma
AU - Symes, Mickey
AU - Wells, Charlotte
AU - Willis-Chan, Jane
AU - Logan, Jennifer
AU - Nixon, Julie
AU - Slater, Diane
AU - Boddy, Clare
AU - Dhariwal, Jaideep
AU - Lam, Jodie
AU - Nanzer, Alexandra
AU - Roxas, Cris
AU - Cumming, Helena
AU - Fergusson, Jackie
AU - Smith, Catherine
AU - Borg, Katie
AU - Connelly, Clare
AU - Burton, Rachel
PY - 2024/5/1
Y1 - 2024/5/1
N2 - Introduction After puberty, females are more likely to develop asthma and in a more severe form than males. The associations between asthma and sex are complex with multiple intrinsic and external factors. Aim To evaluate the sex differences in the characteristics and treatment of patients with severe asthma (SA) in a real-world setting. Methods Demographic, clinical and treatment characteristics for patients with SA in the UK Severe Asthma Registry (UKSAR) and Optimum Patient Care Research Database (OPCRD) were retrospectively analysed by sex using univariable and multivariable logistic regression analyses adjusted for year, age and hospital/practice. results 3679 (60.9% female) patients from UKSAR and 18 369 patients (67.9% female) from OPCRD with SA were included. Females were more likely to be symptomatic with increased Asthma Control Questionnaire-6 (UKSAR adjusted OR (aOR) 1.14, 95% CI 1.09 to 1.18) and Royal College of Physicians-3 Question scores (OPCRD aOR 1.29, 95% CI 1.13 to 1.47). However, they had a higher forced expiratory volume in 1 second per cent (FEV1%) predicted (UKSAR 68.7% vs 64.8%, p<0.001) with no significant difference in peak expiratory flow. Type 2 biomarkers IgE (UKSAR 129 IU/mL vs 208 IU/mL, p<0.001) and FeNO (UKSAR 36ppb vs 46ppb, p<0.001) were lower in females with no significant difference in blood eosinophils or biological therapy. Females were less likely to be on maintenance oral corticosteroids (UKSAR aOR 0.86, 95% CI 0.75 to 0.99) but more likely to be obese (UKSAR aOR 1.67, 95% CI 145 to 1.93; OPCRD SA aOR 1.46, 95% CI 1.34 to 1.58). Conclusions Females had increased symptoms and were more likely to be obese despite higher FEV1% predicted and lower type 2 biomarkers with consistent and clinically important differences across both datasets.
AB - Introduction After puberty, females are more likely to develop asthma and in a more severe form than males. The associations between asthma and sex are complex with multiple intrinsic and external factors. Aim To evaluate the sex differences in the characteristics and treatment of patients with severe asthma (SA) in a real-world setting. Methods Demographic, clinical and treatment characteristics for patients with SA in the UK Severe Asthma Registry (UKSAR) and Optimum Patient Care Research Database (OPCRD) were retrospectively analysed by sex using univariable and multivariable logistic regression analyses adjusted for year, age and hospital/practice. results 3679 (60.9% female) patients from UKSAR and 18 369 patients (67.9% female) from OPCRD with SA were included. Females were more likely to be symptomatic with increased Asthma Control Questionnaire-6 (UKSAR adjusted OR (aOR) 1.14, 95% CI 1.09 to 1.18) and Royal College of Physicians-3 Question scores (OPCRD aOR 1.29, 95% CI 1.13 to 1.47). However, they had a higher forced expiratory volume in 1 second per cent (FEV1%) predicted (UKSAR 68.7% vs 64.8%, p<0.001) with no significant difference in peak expiratory flow. Type 2 biomarkers IgE (UKSAR 129 IU/mL vs 208 IU/mL, p<0.001) and FeNO (UKSAR 36ppb vs 46ppb, p<0.001) were lower in females with no significant difference in blood eosinophils or biological therapy. Females were less likely to be on maintenance oral corticosteroids (UKSAR aOR 0.86, 95% CI 0.75 to 0.99) but more likely to be obese (UKSAR aOR 1.67, 95% CI 145 to 1.93; OPCRD SA aOR 1.46, 95% CI 1.34 to 1.58). Conclusions Females had increased symptoms and were more likely to be obese despite higher FEV1% predicted and lower type 2 biomarkers with consistent and clinically important differences across both datasets.
U2 - 10.1136/thorax-2023-220512
DO - 10.1136/thorax-2023-220512
M3 - Article
C2 - 38124220
AN - SCOPUS:85180458099
SN - 0040-6376
VL - 79
SP - 403
EP - 411
JO - Thorax
JF - Thorax
IS - 5
ER -