Impact of Age and Gender on Response to Asthma Therapy.

Am J Respir Crit Care Med. 2015 Jun 11;

Authors: Dunn RM, Lehman E, Chinchilli VM, Martin RJ, Boushey HA, Israel E, Kraft M, Lazarus SC, Lemanske RF, Lugogo NL, Peters SP, Sorkness CA, Szefler S, Wechsler ME, NHLBI Asthma Clinical Research Network.

Abstract
RATIONALE: Age and gender are associated with differences in asthma prevalence and morbidity.
OBJECTIVES: Determine if age and gender associate with distinct phenotypes and a variable response to therapy in mild-moderate asthmatics.
METHODS: We utilized Asthma Clinical Research Network data to determine the impact of age and gender on phenotypes and treatment failures among subjects participating in 10 trials from 1993 to 2003.
MEASUREMENTS AND MAIN RESULTS: 1,200 subjects were identified [median age = 30.4 years, male = 520 (43.3%), female = 680(56.7%)] and analyzed. A higher proportion of subjects ≥30 years old experienced treatment failures (17.3% vs. 10.3%; OR=1.82, CI=1.30-2.54; P < 0.001); and rates increased proportionally with increasing age above 30 across the cohort [OR per year = 1.02, CI=1.01-1.04), OR per 5-year = 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 failure. A higher proportion of subjects ≥30 years old receiving controller therapy experienced treatment failures. When stratified by specific therapy, treatment failures increased consistently for every year above 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).
CONCLUSION: 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 genders.

PMID: 26068329 [PubMed - as supplied by publisher]