Interaction effect of chronic cough and ageing on increased risk of exacerbation in patients with asthma: a prospective cohort study in a real-world setting

Background Older adults with asthma have the greatest burden and worst outcomes, and there is increasing evidence that chronic cough (CC) is associated with asthma severity and poor prognosis. However, the clinical characteristics of older adult patients with both asthma and CC remain largely unknow...

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Main Authors: Fan Ding Jin, Ji Wang, Su Jun Deng, Woo-Jung Song, Xin Zhang, Chang Yong Wang, Si Yang Gao, Kian Fan Chung, Ye Yang, Anne E. Vertigan, Feng Ming Luo, Surinder S. Birring, Wei Min Li, Dan Liu, Gang Wang
Format: Article
Language:English
Published: European Respiratory Society 2023-12-01
Series:ERJ Open Research
Online Access:http://openres.ersjournals.com/content/9/6/00461-2023.full
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author Fan Ding Jin
Ji Wang
Su Jun Deng
Woo-Jung Song
Xin Zhang
Chang Yong Wang
Si Yang Gao
Kian Fan Chung
Ye Yang
Anne E. Vertigan
Feng Ming Luo
Surinder S. Birring
Wei Min Li
Dan Liu
Gang Wang
author_facet Fan Ding Jin
Ji Wang
Su Jun Deng
Woo-Jung Song
Xin Zhang
Chang Yong Wang
Si Yang Gao
Kian Fan Chung
Ye Yang
Anne E. Vertigan
Feng Ming Luo
Surinder S. Birring
Wei Min Li
Dan Liu
Gang Wang
author_sort Fan Ding Jin
collection DOAJ
description Background Older adults with asthma have the greatest burden and worst outcomes, and there is increasing evidence that chronic cough (CC) is associated with asthma severity and poor prognosis. However, the clinical characteristics of older adult patients with both asthma and CC remain largely unknown. Methods Participants with stable asthma underwent two cough assessments within 3 months to define the presence of CC. Patients were divided into four groups based on CC and age (cut-off ≥60 years). Multidimensional assessment was performed at baseline, followed by a 12-month follow-up to investigate asthma exacerbations. Logistic regression models were used to explore the interaction effect of CC and age on asthma control and exacerbations. Results In total, 310 adult patients were prospectively recruited and divided into four groups: older CC group (n=46), older non-CC group (n=20), younger CC group (n=112) and younger non-CC group (n=132). Compared with the younger non-CC group, the older CC group had worse asthma control and quality of life and increased airflow obstruction. The older CC group showed an increase in moderate-to-severe exacerbations during the 12-month follow-up. There was a significant interaction effect of CC and ageing on the increased moderate-to-severe exacerbations (adjusted risk ratio 2.36, 95% CI 1.47–3.30). Conclusion Older asthma patients with CC have worse clinical outcomes, including worse asthma control and quality of life, increased airway obstruction and more frequent moderate-to-severe exacerbations, which can be partly explained by the interaction between CC and ageing.
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spelling doaj.art-cc1e28f6702a49e8ad72599aa52fcd192024-01-08T09:57:44ZengEuropean Respiratory SocietyERJ Open Research2312-05412023-12-019610.1183/23120541.00461-202300461-2023Interaction effect of chronic cough and ageing on increased risk of exacerbation in patients with asthma: a prospective cohort study in a real-world settingFan Ding Jin0Ji Wang1Su Jun Deng2Woo-Jung Song3Xin Zhang4Chang Yong Wang5Si Yang Gao6Kian Fan Chung7Ye Yang8Anne E. Vertigan9Feng Ming Luo10Surinder S. Birring11Wei Min Li12Dan Liu13Gang Wang14 Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China Airway Sensation and Cough Research Laboratory, Department of Allergy and Clinical Immunology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China Department of Respiratory Medicine, Royal Brompton and Harefield NHS Trust, London, UK Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China National Health and Medical Research Council Centre for Research Excellence in Severe Asthma and Treatable Traits, The University of Newcastle, Newcastle, Australia Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China Centre for Human and Applied Physiological Sciences, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, London, UK Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China Background Older adults with asthma have the greatest burden and worst outcomes, and there is increasing evidence that chronic cough (CC) is associated with asthma severity and poor prognosis. However, the clinical characteristics of older adult patients with both asthma and CC remain largely unknown. Methods Participants with stable asthma underwent two cough assessments within 3 months to define the presence of CC. Patients were divided into four groups based on CC and age (cut-off ≥60 years). Multidimensional assessment was performed at baseline, followed by a 12-month follow-up to investigate asthma exacerbations. Logistic regression models were used to explore the interaction effect of CC and age on asthma control and exacerbations. Results In total, 310 adult patients were prospectively recruited and divided into four groups: older CC group (n=46), older non-CC group (n=20), younger CC group (n=112) and younger non-CC group (n=132). Compared with the younger non-CC group, the older CC group had worse asthma control and quality of life and increased airflow obstruction. The older CC group showed an increase in moderate-to-severe exacerbations during the 12-month follow-up. There was a significant interaction effect of CC and ageing on the increased moderate-to-severe exacerbations (adjusted risk ratio 2.36, 95% CI 1.47–3.30). Conclusion Older asthma patients with CC have worse clinical outcomes, including worse asthma control and quality of life, increased airway obstruction and more frequent moderate-to-severe exacerbations, which can be partly explained by the interaction between CC and ageing.http://openres.ersjournals.com/content/9/6/00461-2023.full
spellingShingle Fan Ding Jin
Ji Wang
Su Jun Deng
Woo-Jung Song
Xin Zhang
Chang Yong Wang
Si Yang Gao
Kian Fan Chung
Ye Yang
Anne E. Vertigan
Feng Ming Luo
Surinder S. Birring
Wei Min Li
Dan Liu
Gang Wang
Interaction effect of chronic cough and ageing on increased risk of exacerbation in patients with asthma: a prospective cohort study in a real-world setting
ERJ Open Research
title Interaction effect of chronic cough and ageing on increased risk of exacerbation in patients with asthma: a prospective cohort study in a real-world setting
title_full Interaction effect of chronic cough and ageing on increased risk of exacerbation in patients with asthma: a prospective cohort study in a real-world setting
title_fullStr Interaction effect of chronic cough and ageing on increased risk of exacerbation in patients with asthma: a prospective cohort study in a real-world setting
title_full_unstemmed Interaction effect of chronic cough and ageing on increased risk of exacerbation in patients with asthma: a prospective cohort study in a real-world setting
title_short Interaction effect of chronic cough and ageing on increased risk of exacerbation in patients with asthma: a prospective cohort study in a real-world setting
title_sort interaction effect of chronic cough and ageing on increased risk of exacerbation in patients with asthma a prospective cohort study in a real world setting
url http://openres.ersjournals.com/content/9/6/00461-2023.full
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