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Impact of sex on severe asthma: a cross-sectional retrospective analysis of UK primary and specialist care

Lookup NU author(s): Dr Simon Doe

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Abstract

© 2023 Author(s) (or their employer(s)).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.


Publication metadata

Author(s): Loewenthal L, Busby J, Mcdowell R, Brown T, Burhan H, Chaudhuri R, Dennison P, Dodd JW, Doe S, Faruqi S, Gore R, Idris E, Jackson DJ, Patel M, Pantin T, Pavord I, Pfeffer PE, Price DB, Rupani H, Siddiqui S, Heaney LG, Menzies-Gow A

Publication type: Article

Publication status: Published

Journal: Thorax

Year: 2024

Volume: 79

Issue: 5

Pages: 403-411

Online publication date: 16/12/2023

Acceptance date: 20/11/2023

ISSN (print): 0040-6376

ISSN (electronic): 1468-3296

Publisher: BMJ Publishing Group

URL: https://doi.org/10.1136/thorax-2023-220512

DOI: 10.1136/thorax-2023-220512

PubMed id: 38124220


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