High ACT score is not sufficient to reduce the risk of asthma exacerbations in asthma with low lung function

COREA investigators

doi:10.1016/j.rmed.2019.02.010

High ACT score is not sufficient to reduce the risk of asthma exacerbations in asthma with low lung function

COREA investigators

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

Background: Low forced expiratory volume in 1 s (FEV ₁ ) is a risk factor for asthma exacerbations (AEs). We aimed to determine if asthma control could reduce the future risk of AEs in patients with low FEV ₁ . This study was conducted to evaluate the future risks of AEs within six months according to Asthma Control Test™ (ACT) score and FEV ₁ . Methods: A total of 565 patients with asthma were enrolled from the COREA cohort. The ACT score, lung function test, and number of AEs were assessed at baseline, three-month follow-up, and six-month follow-up with conventional asthma treatments by asthma specialists in real clinical settings. Results: Female sex, low ACT score, low FEV ₁ , low FVC, and AE history in the previous three months were related with increased AEs within six months. AEs during six-month follow-up occurred in 24% of patients with ACT <20 and FEV ₁ < 60% at baseline. Among patients with an ACT score ≥20, 3.4% of patients with an FEV ₁ < 2.16 L and 9.8% of patients with FEV ₁ ≥ 2.16 L had experienced AEs (P = 0.01), although no differences were observed in the presence of AEs within six months according to the predicted FEV ₁ (FEV ₁ ≥ 60% vs. FEV ₁ < 60%, 5.66% vs. 8.51%, P = 0.65). Conclusion: Patient with low FEV ₁ seemed to show higher risk of AEs than those with near-normal FEV ₁ despite ACT score ≥20 and asthma treatments. Therefore, treatment strategies that prevent AEs are needed in high-risk asthmatic patients.

Original language	English
Pages (from-to)	38-44
Number of pages	7
Journal	Respiratory Medicine
Volume	150
DOIs	https://doi.org/10.1016/j.rmed.2019.02.010
Publication status	Published - 2019 Apr

Bibliographical note

Funding Information:
This research was supported by a grant awarded to the Korea Health Technology R&D Project via the Korea Health Industry Development Institute , which is funded by the Ministry of Health & Welfare, Republic of Korea (Grant No. HC15C1335 ). This research was also supported by the Basic Science Research Program via the National Research Foundation of Korea (NRF) , which is funded by the Ministry of Education ( 2017R1D1A3B03034684 ). Appendix A

Publisher Copyright:
© 2019 Elsevier Ltd

All Science Journal Classification (ASJC) codes

Pulmonary and Respiratory Medicine

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10.1016/j.rmed.2019.02.010

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@article{169e883b1af146b6b5156ef2a2892220,

title = "High ACT score is not sufficient to reduce the risk of asthma exacerbations in asthma with low lung function",

abstract = " Background: Low forced expiratory volume in 1 s (FEV 1 ) is a risk factor for asthma exacerbations (AEs). We aimed to determine if asthma control could reduce the future risk of AEs in patients with low FEV 1 . This study was conducted to evaluate the future risks of AEs within six months according to Asthma Control Test{\texttrademark} (ACT) score and FEV 1 . Methods: A total of 565 patients with asthma were enrolled from the COREA cohort. The ACT score, lung function test, and number of AEs were assessed at baseline, three-month follow-up, and six-month follow-up with conventional asthma treatments by asthma specialists in real clinical settings. Results: Female sex, low ACT score, low FEV 1 , low FVC, and AE history in the previous three months were related with increased AEs within six months. AEs during six-month follow-up occurred in 24% of patients with ACT <20 and FEV 1 < 60% at baseline. Among patients with an ACT score ≥20, 3.4% of patients with an FEV 1 < 2.16 L and 9.8% of patients with FEV 1 ≥ 2.16 L had experienced AEs (P = 0.01), although no differences were observed in the presence of AEs within six months according to the predicted FEV 1 (FEV 1 ≥ 60% vs. FEV 1 < 60%, 5.66% vs. 8.51%, P = 0.65). Conclusion: Patient with low FEV 1 seemed to show higher risk of AEs than those with near-normal FEV 1 despite ACT score ≥20 and asthma treatments. Therefore, treatment strategies that prevent AEs are needed in high-risk asthmatic patients. ",

author = "{COREA investigators} and Kwon, {Jae Woo} and Heewon Jung and Kim, {Sae Hoon} and Chang, {Yoon Seok} and Cho, {You Sook} and Nahm, {Dong Ho} and Jang, {An Soo} and Park, {Jung Won} and Yoon, {Ho Joo} and Cho, {Sang Heon} and Cho, {Young Joo} and Choi, {Byoung Whui} and Moon, {Hee Bom} and Kim, {Tae Bum}",

note = "Funding Information: This research was supported by a grant awarded to the Korea Health Technology R&D Project via the Korea Health Industry Development Institute , which is funded by the Ministry of Health & Welfare, Republic of Korea (Grant No. HC15C1335 ). This research was also supported by the Basic Science Research Program via the National Research Foundation of Korea (NRF) , which is funded by the Ministry of Education ( 2017R1D1A3B03034684 ). Appendix A Publisher Copyright: {\textcopyright} 2019 Elsevier Ltd",

year = "2019",

month = apr,

doi = "10.1016/j.rmed.2019.02.010",

language = "English",

volume = "150",

pages = "38--44",

journal = "British Journal of Tuberculosis and Diseases of the Chest",

issn = "0954-6111",

publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - High ACT score is not sufficient to reduce the risk of asthma exacerbations in asthma with low lung function

AU - COREA investigators

AU - Kwon, Jae Woo

AU - Jung, Heewon

AU - Kim, Sae Hoon

AU - Chang, Yoon Seok

AU - Cho, You Sook

AU - Nahm, Dong Ho

AU - Jang, An Soo

AU - Park, Jung Won

AU - Yoon, Ho Joo

AU - Cho, Sang Heon

AU - Cho, Young Joo

AU - Choi, Byoung Whui

AU - Moon, Hee Bom

AU - Kim, Tae Bum

N1 - Funding Information: This research was supported by a grant awarded to the Korea Health Technology R&D Project via the Korea Health Industry Development Institute , which is funded by the Ministry of Health & Welfare, Republic of Korea (Grant No. HC15C1335 ). This research was also supported by the Basic Science Research Program via the National Research Foundation of Korea (NRF) , which is funded by the Ministry of Education ( 2017R1D1A3B03034684 ). Appendix A Publisher Copyright: © 2019 Elsevier Ltd

PY - 2019/4

Y1 - 2019/4

N2 - Background: Low forced expiratory volume in 1 s (FEV 1 ) is a risk factor for asthma exacerbations (AEs). We aimed to determine if asthma control could reduce the future risk of AEs in patients with low FEV 1 . This study was conducted to evaluate the future risks of AEs within six months according to Asthma Control Test™ (ACT) score and FEV 1 . Methods: A total of 565 patients with asthma were enrolled from the COREA cohort. The ACT score, lung function test, and number of AEs were assessed at baseline, three-month follow-up, and six-month follow-up with conventional asthma treatments by asthma specialists in real clinical settings. Results: Female sex, low ACT score, low FEV 1 , low FVC, and AE history in the previous three months were related with increased AEs within six months. AEs during six-month follow-up occurred in 24% of patients with ACT <20 and FEV 1 < 60% at baseline. Among patients with an ACT score ≥20, 3.4% of patients with an FEV 1 < 2.16 L and 9.8% of patients with FEV 1 ≥ 2.16 L had experienced AEs (P = 0.01), although no differences were observed in the presence of AEs within six months according to the predicted FEV 1 (FEV 1 ≥ 60% vs. FEV 1 < 60%, 5.66% vs. 8.51%, P = 0.65). Conclusion: Patient with low FEV 1 seemed to show higher risk of AEs than those with near-normal FEV 1 despite ACT score ≥20 and asthma treatments. Therefore, treatment strategies that prevent AEs are needed in high-risk asthmatic patients.

AB - Background: Low forced expiratory volume in 1 s (FEV 1 ) is a risk factor for asthma exacerbations (AEs). We aimed to determine if asthma control could reduce the future risk of AEs in patients with low FEV 1 . This study was conducted to evaluate the future risks of AEs within six months according to Asthma Control Test™ (ACT) score and FEV 1 . Methods: A total of 565 patients with asthma were enrolled from the COREA cohort. The ACT score, lung function test, and number of AEs were assessed at baseline, three-month follow-up, and six-month follow-up with conventional asthma treatments by asthma specialists in real clinical settings. Results: Female sex, low ACT score, low FEV 1 , low FVC, and AE history in the previous three months were related with increased AEs within six months. AEs during six-month follow-up occurred in 24% of patients with ACT <20 and FEV 1 < 60% at baseline. Among patients with an ACT score ≥20, 3.4% of patients with an FEV 1 < 2.16 L and 9.8% of patients with FEV 1 ≥ 2.16 L had experienced AEs (P = 0.01), although no differences were observed in the presence of AEs within six months according to the predicted FEV 1 (FEV 1 ≥ 60% vs. FEV 1 < 60%, 5.66% vs. 8.51%, P = 0.65). Conclusion: Patient with low FEV 1 seemed to show higher risk of AEs than those with near-normal FEV 1 despite ACT score ≥20 and asthma treatments. Therefore, treatment strategies that prevent AEs are needed in high-risk asthmatic patients.

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U2 - 10.1016/j.rmed.2019.02.010

DO - 10.1016/j.rmed.2019.02.010

M3 - Article

C2 - 30961949

AN - SCOPUS:85061669728

VL - 150

SP - 38

EP - 44

JO - British Journal of Tuberculosis and Diseases of the Chest

JF - British Journal of Tuberculosis and Diseases of the Chest

SN - 0954-6111

ER -

High ACT score is not sufficient to reduce the risk of asthma exacerbations in asthma with low lung function

Abstract

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