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Published on: February 12, 2015
Smoking and Lung Function Response to Inhaled Glucocorticoids in Adult-Onset Asthma
Karoliina Lehtola1, Minna Tommola2, Iida Vähätalo1,3
1Tampere University Respiratory Research Group, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Introduction:
Tobacco smoking has been associated with reduced response to inhaled corticosteroids (ICS). However, little is known about how smoking affects lung function response to ICS treatment in new-onset asthma.
Aims And Objectives:
To evaluate the sub-acute ICS response on lung function in new adult-onset asthma in steroid-naïve patients classified according to smoking status in a real-life longitudinal cohort.
Methods:
In the Seinäjoki Adult Asthma Study, 203 patients with new adult-onset asthma were followed for 12 years. Patients who were dispensed ICS during the first two years of the follow-up were included (n=174). Lung function was evaluated at baseline, and the maximum lung function point was determined during the first 2.5 years (Max0-2.5). Patients were divided into groups by smoking status (never/ex/current smokers) and smoking history (never vs ever or <10 vs ≥10 smoked pack-years).
Results:
At asthma diagnosis 50% (n=90) were ex- or current smokers. The increase of forced vital capacity % predicted from baseline to Max0-2.5 was higher (p=0.025) in current smokers compared to never- and ex-smokers. No differences in lung function change between never vs ever smokers or in patients with <10 vs ≥10 pack-years smoked were found after ICS initiation, even after adjusting for individual ICS dose.
Conclusion:
Although the harmful effects of smoking on asthma control and long-term lung function decline have been well established, sub-acute lung function response to ICS in adult-onset asthma seems not to differ according to smoking status. The result suggests that patients should have similar ICS therapy initiation regardless of their smoking history.
Clinical Trial Registration:
This study is registered at www.ClinicalTrials.gov with identifier number NCT02733016.
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