Obesity and aspirin intolerance are risk factors for difficult-to-treat asthma in Japanese non-atopic women

Fukutomi Y et al. - Significant associations of obesity and aspirin intolerance with difficult-to-treat asthma (DTA) were observed only in women and in non-atopics. These findings suggest that a phenotype-specific approach is needed to treat patients with DTA.

Methods

• The authors compared outpatients with difficult-to-treat asthma (DTA; n = 486) in a tertiary hospital for allergic diseases in central Japan with those with controlled severe asthma (n = 621) with respect to clinical factors including body mass index (BMI) and aspirin intolerance using multivariate logistic regression analysis stratified by gender and atopic phenotype.

Results

• When analysis was performed on the entire study populations, obesity (BMI ≥ 30 kg/m2; adjusted odds ratio (OR) 1.92; 95% confidence interval (95% CI: 1.07–3.43) and aspirin intolerance (OR: 2.56, 95% CI: 1.44–4.57) were found to be the significant risk factors for DTA.
• However, after the stratification by gender and atopic phenotype, the association between obesity and DTA was significant only in women (OR: 2.76, 95% CI: 1.31–5.78), but not in men (OR: 1.03, 95% CI: 0.38–2.81), and only in non-atopics (OR: 4.03, 95% CI: 1.15–14.08), but not in atopics (OR: 1.54, 95% CI: 0.79–3.02).
• The similar gender and phenotypic differences were also observed in the association between aspirin intolerance and DTA: namely, the association was significant only in women (OR: 3.96, 95% CI: 1.84–8.50), but not in men (OR: 1.19, 95% CI: 0.46–3.05); and only in non-atopics (OR: 5.49, 95% CI: 1.98–15.19), but not in atopics (OR: 1.39, 95% CI: 0.65–2.98).

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