Persistent airway inflammation and high exacerbation rate in asthma that starts at menopause

Giovanni Balzano, S. Fuschillo, E. De Angelis, C. Gaudiosi, A. Mancini, M. Caputi

Research output: Contribution to journalArticlepeer-review

Abstract

Background and Aim. Asthma that begins around the time of menopause is frequently characterised by marked clinical severity and poor response to treatment. We sought to assess the clinical characteristics, bronchial responsiveness, perception of induced bronchoconstriction and airway inflammation in women with menopausal asthma, as compared to women of a similar age with pre-existing asthma. Methods. Nine women with pre-existing asthma were selected for clinical severity (symptoms, lung function and medication requirements) similar to that in 11 women with menopausal asthma. Anti-asthmatic treatment in all of the study patients included high dose inhaled (with or without oral) corticosteroids. Results. The women with menopausal asthma demonstrated less atopy, more chronic recurrent sinusitis, similar airway responsiveness, and similar perception of induced bronchoconstriction, but a significantly higher sputum eosinophil count (19.5 ± 10.8 versus 3.3 + 43%; p <0.001) and a higher severe exacerbation rate during the 1-year follow-up period (5.09 ± 4.85 versus 0.78 + 0.97; p <0.05). Sputum eosinophil count and severe asthma exacerbation rate correlated well in both groups considered as a whole (r = 0.65; p <0.005). Conclusion. The eosinophilic airway inflammation present in women with menopausal asthma is poorly responsive to anti-inflammatory treatment with corticosteroids and predisposes to frequent severe exacerbations. Airway inflammation should be monitored in women with menopausal asthma.

Original languageEnglish
Pages (from-to)135-141
Number of pages7
JournalMonaldi Archives for Chest Disease - Cardiac Series
Volume67
Issue number3
Publication statusPublished - Sep 2007

Keywords

  • Airway inflammation
  • Asthma
  • Asthma perception
  • Asthma severity
  • Menopause

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine

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