High BMI, comorbid rhinitis factor in asthma exacerbations

The risk of having exacerbations in patients with asthma is high in the presence of high body mass index (BMI) and comorbid rhinitis, although attacks cause no further reduction in quality of life (QoL), according to a recent study.

The study included 3,227 patients, among whom 1,207 suffered asthmatic attacks within 4 weeks after enrolment. Compared with those who did not, patients who had attacks were more likely to be older and female, had higher BMI, had poorer respiratory function, and were more likely to be smokers.

Researchers matched patients with and without exacerbations using propensity scores to identify risk factors for asthma exacerbations and the effect of these attacks on QoL. The final sample included 1,522 patients, with 761 in each group.

Multivariate logistic regression analysis revealed asthma exacerbation to be associated with the following factors: high BMI (odds ratio [OR], 1.05; p=0.002), low forced expiratory flow 75% of forced vital capacity (FEF75%; OR, 0.997; p=0.039), and severe rhinitis as determined based on Allergic Rhinitis and its Impact on Asthma (OR, 1.12; p=0.032).

Moreover, asthma exacerbations were associated with frequent unscheduled hospital or clinic visits or absence from work or school, suggesting an increase in healthcare resource utilization and loss of productivity, the researchers noted.

Patients with vs without exacerbations had markedly lower QoL at baseline, scoring worse on scales such as emotion, social activities, worsening factors, daily activity and economics. However, asthma exacerbations had no further impact on QoL.