Asthma Exacerbation Severity Is Greater for Women than for Men Interview with:
astrazenecaOlga Ryan, DrPH, MPH, MBA

Regional Clinical Account Director, Southwest
AstraZeneca What is the background for this study? What are the main findings?

Response: Asthma is common and imparts a substantial societal burden. It is well documented that asthma prevalence varies between males and females. Before puberty, more boys have asthma.  Following puberty, a greater proportion of women suffer with asthma. We also have observed that women experience greater morbidity from the illness, greater healthcare resource utilization and suboptimal response for guideline recommended therapies (ICS, ICS/LABA).

Rationale for this study focused on describing asthma related outcomes between a well characterized severe asthma cohort, with intent in delineating differences among the sexes. With the advent of targeted biological medicines for severe asthma, as well as apparent gaps in knowledge, we wanted to understand potential sex-specific disease indicators in a well characterized severe asthma cohort. What are the main findings? Why might women have a worse course than men?

Response: Totality of the work has been presented by 2 posters at AAAAI 2019 and 2020. Aggregate learnings suggest that baseline eosinophil counts are similar between the sexes; however, women have lower IgE, lesser prevalence of atopy and nasal polyps.

We also noted that a great proportion of women were exacerbating more frequently (greater than 3x/year) at baseline. In addition, when looking specifically into asthma exacerbations, interesting nuances are apparent. A greater proportion of women experience severe exacerbations—specifically, those leading to Emergency Room utilization and mechanical ventilation. So, with  blood eosinophils being similar between the sexes, IgE was a poor predictor in the number of and severity of exacerbations at baseline. Response to Benralizumab was similar in both men and women. What should readers take away from your report?

Response: Clinical and biological differences are observed between asthmatic men and women. Understanding these key differences is critical in recognizing disease severity and risk, thereby contributing to personalization and optimization of disease management. What recommendations do you have for future research as a result of this study?

Response: Future research should continue exploring biological, clinical and social differences in experience with asthma between men and women. This is important across all levels of evidence generation—starting at the bench side and into the clinical and real world patterns. Is there anything else you would like to add?

Response:  Thank you for highlighting this necessary work—with ongoing advocacy and dialogue, we stand the capabilities to make a meaningful contribution to medicine and patients collectively severed.

Citation: AAAAI 2020 Abstract

ABSTRACT ONLY| VOLUME 145, ISSUE 2, SUPPLEMENT , AB206, FEBRUARY 01, 2020 Asthma Exacerbation Severity Is Greater for Women than for Men
Olga Ryan, Rohit Katial, MD FAAAAI, Ian Hirsch, James Kreindler

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Last Updated on May 1, 2020 by Marie Benz MD FAAD