D2.124 - Clinical Characteristics and Predictors in Patients with Difficult-to-Treat Asthma

Difficult-to-treat asthma is a complex chronic respiratory disease influenced by demographic characteristics, environmental exposures, lifestyle habits, and medication use. It significantly impacts patients’ quality of life (AQLQ) and medication adherence (AAAQ), yet systematic analysis, particularly age-specific differences, remains limited.

This study was a cross-sectional study. We analyzed data from 1,336 asthma patients at Kaohsiung Chang Gung Memorial Hospital (2012–2024), including questionnaires, blood tests, and pulmonary function measurements. Patients with incomplete data were excluded.

Univariate analysis showed significant differences between difficult-to-treat (N=794)and non-difficult asthma (N=542) groups. The difficult-to-treat group had lower height and weight (p < 0.05), a lower proportion of university-level education (p = 0.0048), and increased IgE (p = 0.0419), eosinophil (p = 0.0455), and decreased neutrophil levels (p = 0.0090). Secondhand smoke exposure, especially from spouse and parent (p <0.05), was more common. Age-stratified analysis revealed distinct patterns. In the ≤60 years group, smoking started earlier (p = 0.0167), and environmental exposures (e.g., musty smell, incense burning) were significant. Pulmonary function indicators (FEV1/FVC, PEF) were markedly reduced (p < 0.05). In the >60 years group, IgE, monocyte, neutrophil, and total WBC levels showed significant difference (p < 0.05), with severe airway obstruction evident. Both groups had high ICS,OCS and LTRA usage rates (p < 0.05), indicating severe disease requiring intensive treatment.

Difficult-to-treat asthma patients show significant differences in environmental exposures, pulmonary function, and inflammatory markers, with distinct age-specific features. Tailored interventions targeting age and patient-specific factors are essential to improve disease control and quality of life.