Comorbidities In Asthma: Not A Numbers Game

Studies investigating influence of the quantity of comorbidities on asthma control in real-world populations have been sparse. Herein, we analyze the influence of comorbidities and multi-morbidity on asthma control in a real-world population. A regression analysis of the Asthma IQ dataset was performed to determine the influence of individual comorbidities and multi-morbidity on asthma control. ACT score was used to define uncontrolled (<20) and poorly controlled asthma (£15). Adult comorbidities included were eczema, rhinitis/sinusitis, gastroesophageal reflux disease (GERD), current/past tobacco use, second-hand smoke exposure, obstructive sleep apnea (OSA), depression and overweight (BMI³25)/obesity (BMI³30). Pediatric comorbidities included were eczema, OSA, rhinitis/sinusitis, and second-hand smoke exposure. A history of tobacco use (OR=1.58, 95% CI 1.11-2.23) and obesity (OR=1.73, 95% CI 1.22-2.44) were significantly associated with poorly controlled asthma in adults. Being overweight (1.50, 95% CI 1.24-1.82), obese (1.78, 95% CI 1.47-2.14), or having a history of tobacco use (1.77, 95% CI 1.44-2.18) was associated with uncontrolled asthma in adults. In adults and children, eczema was significantly associated with uncontrolled asthma (Adults: 1.80, 95% CI [1.20-2.70], children: 1.44, 95% CI 1.00-2.06). Second-hand smoke was significantly associated with both uncontrolled (1.41, 95% CI [1.05-1.88]) and poorly controlled (1.70, 95% CI [1.03-2.83]) asthma in children. The number of comorbidities was not significantly associated with uncontrolled/poorly controlled asthma. We identified specific comorbidities in a real-world asthma population that physicians should address when treating asthma patients to assess their risk of poor control. Future studies should investigate relationships between treatment of comorbidities with asthma control and severity.