PUB - Publikationen an der Universität Bielefeld

Background: Little is known about how smoking affects asthma patients’ characteristics, and therefore may impact treatment choices regarding biologic therapy (BT) and its therapy response Objective: Our aim was to evaluate the impact of smoking on baseline data in patients with severe asthma. Methods: We analysed patients’ characteristics including pulmonary function tests, asthma control, exacerbation rate and biomarkers. We performed linear models comparing smokers vs. never-smokers, and three pre-defined groups stratified by smoking history (<10 pack-years (py), 10-20 py, >20 py). Data was obtained from GAN. Results: We included 2.478 patients: 65 (2.6%) active smokers, 1.005 (40.6%) ex-smokers and 1.408 (56.8%) never-smokers. 529 patients (21.3%) had <10 py, 304 (12.3%) 10-20 py and 237 (9.6%) >20 py. Smoking was associated with worse asthma control (>20 py: ACT -1.77 points (p <.001); mini-AQLQ -4.88 (p=.004)), while exacerbation rate and oral corticosteroid doses were similar. Smoking was associated with worse lung function indicating smoking-related lung injury e.g. DLCO (0.85-fold lower with 10-20 py (p<.001) resp. 0.82 fold lower with >20 py (p<.001)). Smokers had greater signs of hyperinflation (higher RV (p<.001) and TLC (p<.008)). Regarding biomarkers smoking was associated with 1.58-fold higher IgE levels (>20 py: p=.002), 0.84-fold lower FeNO concentrations (p=.001) and 2.12-fold higher blood eosinophil count (BEC, p=.045). Conclusion: Smoking history in patients with severe asthma significantly affects baseline characteristics, such as IgE levels, FeNO, BEC and pulmonary functionthereby impacting treatment choices regarding BT and possibly response to therapy.