Factors associated with asthma control in patients with aspirin-exacerbated respiratory disease

Background: Effective control of asthma is the primary goal of its treatment. Despite an improved understanding of asthma pathogenesis and accessibility of novel therapies, the rate of uncontrolled asthma remains high. Objective: To find potential factors associated with asthma control in patients with aspirin-exacerbated respiratory disease (AERD). Methods:Clinical data were collected from a specifically structured questionnaire. Demographics, a history of upper airway symptoms, asthma course, exacerbations expressed as emergency department (ED) visits/hospitalizations, and asthma treatment were considered. Spirometry, skin prick tests, total IgE concentration, and blood eosinophil count were evaluated. Asthma control was assessed through the Asthma Control Test (ACT). Results: Out of 201 AERD patients, 41 (20.4%), 69 (34.3%), and 91 (45.3%) had controlled, partially controlled, and uncontrolled asthma, respectively. A multivariate ordered logistic regression analysis revealed that hospitalizations for asthma in the previous 12 months (OR 2.88; 95%CI, 1.117.46), ED visits for asthma throughout its duration (OR 1.05; 95%CI, 1.0041.10), and total IgE concentration (OR 1.28; 95%CI, 1.021.60) were positively associated with poor asthma control, whereas FEV1 values (OR 0.98; 95%CI, 0.960.99) and medical care at a referential specialty clinic (OR 0.50; 95%CI, 0.270.95) were positively associated with good asthma control. Conclusions: The prevalence of uncontrolled asthma in AERD patients is high and similar to that observed in different asthmatic populations. Owing both to the specificity and complexity of the disease, AERD patients should stay under regular care of well experienced referential medical centers to ensure that this asthma phenotype is dealt with effectively.