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Effects of Asthma Medication Type on Asthma Exacerbation in a Real-World Setting

Authors
 Yong Jun Choi  ;  Chang-Hwa Kim  ;  Jaeuk Lee  ;  Min Kwang Byun  ;  Jae Hwa Cho  ;  Hye Jung Park 
Citation
 YONSEI MEDICAL JOURNAL, Vol.63(7) : 603-610, 2022-07 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2022-07
MeSH
Administration, Inhalation ; Adrenal Cortex Hormones / adverse effects ; Asthma* / drug therapy ; Drug Therapy, Combination ; Hospitals ; Humans ; Retrospective Studies
Keywords
Asthma ; exacerbation ; medication ; prognosis
Abstract
Purpose: Currently, there are multiple options for the pharmacological treatment of asthma. This study aimed to compare the effects of different asthma medications on exacerbation in a real-world setting.

Materials and methods: We retrospectively reviewed electronic medical records of asthma patients who visited the hospital from November 1, 2016 to October 31, 2019. The number of asthma exacerbations requiring administration of systemic steroids was the primary outcome. A time-varying Cox regression analysis was used to reflect the real-world setting: variable usage times, discontinuation, and switching of medication.

Results: Among 937 patients with asthma, 228 (24.3%) experienced asthma exacerbation during the study period. Asthma exacerbation was observed in patients using short-acting β2-agonists (SABA) alone (50.4% vs. 28.6%, p<0.001) as well as in patients not using inhaled corticosteroids (ICS) (58.8% vs. 40.3%, p<0.001), long-acting β2-agonists (LABA) (54.8% vs. 36.1%, p<0.001), and leukotriene receptor antagonists (71.5% vs. 50.8%, p<0.001). A time-varying Cox regression analysis of asthma exacerbations according to the duration of asthma medication showed that SABA alone increased the risk of asthma exacerbation [hazard ratio (HR), 1.834; 95% confidence interval (CI), 1.299-2.588; p=0.001], whereas ICS-LABA decreased the risk (HR, 0.733; 95% CI, 0.538-0.997; p=0.048). However, in the subgroup analysis according to medication type, specific ingredients showed no significant differences.

Conclusion: In the real world, asthma medications affect asthma exacerbation variably according to the medication type.
Files in This Item:
T202202869.pdf Download
DOI
10.3349/ymj.2022.63.7.603
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Hye Jung(박혜정) ORCID logo https://orcid.org/0000-0002-1862-1003
Byun, Min Kwang(변민광) ORCID logo https://orcid.org/0000-0003-1525-1745
Lee, Jaeuk(이재욱)
Cho, Jaehwa(조재화) ORCID logo https://orcid.org/0000-0002-3432-3997
Choi, Yong Jun(최용준) ORCID logo https://orcid.org/0000-0002-6114-2059
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/189522
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