The Journal of Allergy and Clinical Immunology
Volume 124, Issue 2 , Pages 213-221.e1 , August 2009

Asthma morbidity among inner-city adolescents receiving guidelines-based therapy: Role of predictors in the setting of high adherence

  • Rebecca S. Gruchalla, MD, PhD

      Affiliations

    • University of Texas Southwestern Medical Center, Dallas, Tex
    • Corresponding Author InformationReprint requests: Rebecca S. Gruchalla, MD, PhD, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8859.
    • ,
  • Hugh A. Sampson, MD

      Affiliations

    • Mount Sinai School of Medicine, New York, NY
    • ,
  • Elizabeth Matsui, MD

      Affiliations

    • Johns Hopkins University School of Medicine, Baltimore, Md
    • ,
  • Gloria David, PhD, MHSc

      Affiliations

    • Rho, Inc, Chapel Hill, NC
    • ,
  • Peter J. Gergen, MD, MPH

      Affiliations

    • Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
    • ,
  • Agustin Calatroni, MA, MS

      Affiliations

    • Rho, Inc, Chapel Hill, NC
    • ,
  • Mark Brown, MD

      Affiliations

    • University of Arizona College of Medicine, Tucson, Ariz
    • ,
  • Andrew H. Liu, MD

      Affiliations

    • National Jewish Health, Denver, Colo
    • University of Colorado Health Science Center, Denver, Colo
    • ,
  • Gordon R. Bloomberg, MD

      Affiliations

    • Washington University, St Louis, Mo
    • ,
  • James F. Chmiel, MD

      Affiliations

    • Case Western Reserve University School of Medicine, Cleveland, Ohio
    • ,
  • Rajesh Kumar, MD

      Affiliations

    • Children's Memorial Hospital, Chicago, Ill
    • ,
  • Carin Lamm, MD

      Affiliations

    • Columbia University College of Physicians and Surgeons, New York, NY
    • ,
  • Ernestine Smartt, RN

      Affiliations

    • Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
    • ,
  • Christine A. Sorkness, PharmD

      Affiliations

    • University of Wisconsin School of Medicine and Public Health, Madison, Wis
    • ,
  • Suzanne F. Steinbach, MD

      Affiliations

    • Boston University School of Medicine, Boston, Mass
    • ,
  • Kelly D. Stone, MD, PhD

      Affiliations

    • Children's National Medical Center, Washington, DC
    • ,
  • Stanley J. Szefler, MD

      Affiliations

    • National Jewish Health, Denver, Colo
    • University of Colorado Denver School of Medicine, Denver, Colo
    • ,
  • William W. Busse, MD

      Affiliations

    • University of Wisconsin School of Medicine and Public Health, Madison, Wis

Received 18 November 2008 ,Revised 21 April 2009 ,Accepted 26 May 2009.

  • Image Result

    Relative importance of baseline characteristics for predicting maximum symptom days (A) and exacerbations (B) during follow-up (visits 3-8). Combined, these baseline characteristics explain 11.4% and

    Relative importance of baseline characteristics for predicting maximum symptom days (A) and exacerbations (B) during follow-up (visits 3-8). Combined, these baseline characteristics explain 11.4% and 12.6% of the variation for maximum symptom days and exacerbations, respectively.

  • Image Result
    Relative importance of baseline characteristics for predicting baseline FENO. A, Individual variables. B, Variables combined into specific domains with 95% CI. Domains are defined as lung function (me

    Relative importance of baseline characteristics for predicting baseline FENO. A, Individual variables. B, Variables combined into specific domains with 95% CI. Domains are defined as lung function (methacholine PC20, FEV1/FVC, FEV1% predicted, and postbronchodilator percent change in FEV1), inflammation (blood and sputum eosinophils), atopy (number of positive skin tests, total IgE, and sum of the 5 allergen-specific IgEs), and symptoms (maximum symptom days, days of albuterol use, nights of albuterol use, and exacerbations). Combined, these baseline characteristics explain 50.3% of the variation in FENO.

 Supported in whole or in part with federal funds from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, under contracts NO1-AI-25496 and NO1-AI-25482 and from the National Center for Research Resources, National Institutes of Health, under grants RR00052, M01 RR00533, M01RR0071, 5UL1RR024992-02, and 5M01RR020359-04.

 Disclosure of potential conflict of interest: R. S. Gruchalla receives consulting fees from GlaxoSmithKline, research support from the National Institute of Allergy and Infectious Diseases/National Institutes of Health, Novartis, and ExxonMobil, and is a board member of the American Board of Allergy and Immunology. H. A. Sampson is a consultant for and 4% shareholder in Allertein Pharmaceuticals, LLC; is on the advisory board for Schering-Plough; receives grants from the Food Allergy Initiative and the National Institute of Allergy and Infectious Diseases/National Institutes of Health; is a consultant and scientific advisor for the Food Allergy Initiative; is 45% owner of Herbal Springs, LLC; and is a board member of the American Academy of Allergy, Asthma, and Immunology. E. Matsui receives research support from the National Institutes of Health. M. Brown is a speaker for GlaxoSmithKline and AstraZeneca and a consultant for Novartis. A. H. Liu is a speaker/consultant for GlaxoSmithKline, Merck, and AstraZeneca and receives research support from GlaxoSmithKline. G. R. Bloomberg receives research support from the National Institute of Allergy and Infectious Diseases/National Institutes of Health. J. F. Chmiel is a consultant for MyCysticFibrosis.com, receives honoraria from the France Foundation, and receives grant support from Cystic Fibrosis Foundation Therapeutics, Inc, and the National Institutes of Health. R. Kumar receives grant support from the National Heart, Lung, and Blood Institute/National Institutes of Health, is a member of the American Thoracic Society, and is vice president of the Illinois Society of Allergy and Immunology. C. A. Sorkness receives consulting fees and speaker honoraria from GlaxoSmithKline and receives research support from Pharmaxis and Schering-Plough. S. F. Steinbach receives research support from the National Institute of Allergy and Infectious Diseases/National Institutes of Health and is on the speakers bureau for Merck and GlaxoSmithKline. K. D. Stone receives research support from the National Institute of Allergy and Infectious Diseases/National Institutes of Health. S. J. Szefler is a consultant for GlaxoSmithKline, Genentech, and Merck and receives research support from the National Heart, Lung, and Blood Institute/National Institutes of Health, the National Institute of Allergy and Infectious Diseases/National Institutes of Health, Ross Pharmaceuticals, and GlaxoSmithKline. W. W. Busse is a consultant for Altair, GlaxoSmithKline, Merck, Wyeth, Pfizer, Centocor, Amgen, UCB, Johnson & Johnson, Novartis, AstraZeneca, Eisai, TEVA, CompleWare, KaloBios, and Boehringer Ingelheim Sandoz and receives research support from the National Heart, Lung, and Blood Institute/National Institutes of Health, the National Institute of Allergy and Infectious Diseases/National Institutes of Health, Novartis, Centocor, GlaxoSmithKline, MedImmune, and Ception. The rest of the authors have declared that they have no conflict of interest.

PII: S0091-6749(09)00860-4

doi: 10.1016/j.jaci.2009.05.036

The Journal of Allergy and Clinical Immunology
Volume 124, Issue 2 , Pages 213-221.e1 , August 2009

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