Klinická farmakologie a farmacie – 3/2018

www.klinickafarmakologie.cz  / Klin Farmakol Farm 2019; 33(3): 11–16 / KLINICKÁ FARMAKOLOGIE A FARMACIE 13 ORIGINÁLNÍ PRÁCE Targeting asthma control in real‑life clinical practice by using ICS/LABA combination t‑test, analysis of variance or Chi‑square test of inde­ pendence. The dependence of qualitative variables wasmeasuredusing a Spearman correlation coeffi­ cient, with an appropriate test of significance of the coefficient being calculated as well. Multivariable logistic regression was used to calculate the odds ratio (OR), with a 95%Confidence Interval (CI), and by a test of significance for specified parameters. The significance level was set at the level α = 0.05. For the subsequent logistic regression analysis, we used the parameters from the baseline logistic regression with a significance of p < 0.1. Results Four hundred and ninety‑four adult ast­ hma patients were enrolled in the study with a nearly equal proportion of males and fema­ les. Baseline characteristics of the subjects are shown in Table 2. The mean age at the time of asthma diagnosis was 32.5 (SD 16.6) years. The mean disease duration was 6.3 years (SD 7.5, median 4 years). There were no significant differences in age at diagnosis or the duration of the disease (p = 0.379, p = 0.418, respecti­ vely) between males and females. Over a half of the patients (52%) had a positive family his­ tory of asthma, particularly the younger ones. However, their proportion decreased with increasing age (ρ = -0.197, p < 0.001). Of the 494 patients, 74 (15 %) were active smokers irrespective of gender (p = 0.271). With increa­ sing age, an increasing proportion of smokers was observed (ρ = 0.101, p = 0.028). We assessed comorbidities according to avai­ lablemedical records with a focus on ten diseases: allergic rhinitis; either chronic bronchitis or chronic obstructive pulmonary disease (COPD); cardiovas­ cular diseases; atopic dermatitis; gastrointestinal and metabolic diseases; thyroid gland disorders; rheumatic diseases; depression; and chronic idi­ opathic urticaria. Themajority of patients suffered from at least one comorbid condition, with 27% having no recorded comorbidity, 49% having at least one, and 25%at least two comorbidities. The most frequent comorbidities were allergic rhinitis (38%) and chronic bronchitis or COPD (29%). The impact of therapy and education on asthma control Day‑time and night‑time asthma symptoms At the baseline visit, 93% of the patients re­ ported day‑time symptoms related to asthma and 81 % reported night‑time symptoms. Over the study treatment period, the occurrence of day and night symptoms decreased markedly (p < 0.001) (Fig. 1). Tab. 2.  Baseline characteristics of subjects (n = 494) Characteristic Sex (n, %) Male 238 (48%) Female 256 (52%) Mean Age, years (SD; median) All 39 (16; 37) Male 37.9 (16.5; 37) Female 40.1 (15.9; 37.5) Mean age at the time of asthma diagnosis, years (SD; median) All 32.5 (16.6; 31) Male 31.8 (17.1; 29) Female 33.2 (16.2; 32) Mean asthma duration, years (SD; median) All 6.3 (7.3; 4) Male 6.0 (6.5; 4) Female 6.6 (7.9; 4) Active smokers (n, %) 72 (14.6%) Family history of asthma occurrence (n, %) 256 (51.8%) Positive allergic status (n, %) Inhaled allergens 165 (33.4%) Drugs/medication 58 (11.7%) Food 37 (7.5%) Insect bite 5 (1%) Occurrence of day-time symptoms at baseline (n, %) 459 (93%) Occurrence of night-time symptoms at baseline (n, %) 401 (81%) Limitation of daily activities (n, %) 330 (67%) Pulmonary function testing at baseline (n, %) Mean prebronchodilator FEV1 (l) 2.4 % predicted 77 Without ventilatory disorder 105 (21%) Mild obstructive ventilatory disorder 184 (37%) Moderate obstructive ventilatory disorder 156 (32%) Severe or very severe obstructive ventilatory disorder 31 (6%) Combined ventilatory disorder 18 (4%) Asthma medication at baseline (n, %) ICS alone 58 (11.7%) ICS + LABA 416 (84.2%) Montelukast 31 (6.3%) Tiotropium bromide 5 (1%) Theophylline 34 (6.8%) Systemic corticosteroids 9 (1.8%) Antihistamines 215 (4.4.%) Comorbidities Allergic rhinitis 38% Chronic bronchitis or chronic obstructive pulmonary disease 29% Cardiovascular disease 16% Atopic dermatitis 9% Gastrointestinal and metabolic disorders 7% Thyroid gland disorders 2% Tuberculosis 1% Rheumatologic disorders 1% Depression 0.6% Chronic idiopathic urticaria 0.2% Other 9% ICS = inhaled corticosteroids LABA = long-acting β2-adrenoreceptor agonist FEV1 = forced expiratory volume at first second