Comorbidities Are Common Among Patients With Uncontrolled Asthma

The prevalence of comorbidities is high among patients with difficult-to-control asthma, according to a recent study. Comorbidities are especially common among older women, former smokers, and patients who are dependent on prednisone.

Patients with difficult-to-control asthma tend to face a significantly greater medical and financial burden than patients whose asthma is not difficult to control. Additionally, previous research has shown that comorbidities contribute to uncontrolled asthma. According to the researchers, these burdens may be decreased with better treatment strategies and greater insight into the prevalence, nature, and risk factors of comorbidities among this patient population.

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To explore this further, the researchers administered questionnaires to 5002 adult patients with asthma who had a prescription for high-dose (more than 1000 μg) fluticasone or oral corticosteroids. Additionally, each patient was assessed for comorbidities like gastroesophageal reflux, nasal polyps, cardiovascular disease, anxiety/depression, obesity, and diabetes.

A total of 2312 patients returned the questionnaire. Of these, 914 were diagnosed with difficult-to-treat asthma. Comorbidities were diagnosed according to treatment prescriptions or responses to the questionnaire. Associations between patient characteristics and comorbidities were evaluated via multivariable logistic regression analyses.

Results indicated that 92% of patients with difficult-to-control asthma had at least 1 comorbidity. Patients with difficult-to-control asthma had more comorbidities and a significantly higher prevalence of most comorbidities, vs patients whose asthma was not difficult to control. Exceptions included diabetes and nasal polyposis.

Additionally, the researchers found that comorbidities were most common among patients who were older, female, and had a history of smoking and chronic prednisone use.

“Almost all patients with difficult-to-control asthma have comorbidities, in particular asthmatic women of older age, former smokers, and asthmatics who are prednisone dependent,” the researchers concluded. “Recognition of these typical characteristics can help physicians in the diagnostic workup, so that adequate preventive measures can be taken.”

—Christina Vogt


Hekking PPW, Amelink M, Wener RR, Bouvy ML, Bel EH. Comorbidities in difficult-to-control asthma. J Allergy Clin Immunol Pract. 2017;2198(17):30473-30477.