SESSION TYPE: Asthma Predictors and Outcomes
PRESENTED ON: Wednesday, October 24, 2012 at 02:45 PM - 04:15 PM
PURPOSE: Short-term exposure to marijuana causes bronchodilatation, whereas long-term exposure increases respiratory symptoms. However, the impact of marijuana smoking on subsequent outcomes for subjects presenting to the emergency department (ED) with a severe asthma exacerbation is not well known. We describe the clinical characteristics and impact on outcomes in subjects with asthma and a history of marijuana smoking who presented to the ED with an asthma exacerbation.
METHODS: Methods We analyzed data from a multicenter study of subjects presenting to the ED with an asthma exacerbation, an FEV1 <70% predicted following bronchodilator therapy, and that had ≥ 1 exacerbations within the previous year. Entry criteria allowed for active tobacco or marijuana smokers. At discharge from the ED, subjects received a course of systemic corticosteroids and were provided a prescription for 12 weeks of inhaled corticosteroids. Measures at baseline and 12 weeks following treatment included number of asthma exacerbations, pulmonary function, Asthma Control Questionnaire, Asthma Quality of Life Questionnaire, and selected biomarkers.
RESULTS: Data were available for 108 subjects at baseline. Twenty-two subjects (20.4%) were marijuana smokers, 84 (77.8%) were not marijuana smokers, and 2 were unknown. Marijuana smokers were younger (31.3 vs. 37.6 years, P=.01) and predominantly male (13/22 vs. 20/84, P<.01). Marijuana smokers reported similar symptoms, asthma control, ED visits, and hospitalizations as compared to non-marijuana smokers at baseline; however, marijuana smokers reported more steroid bursts over the preceding 3 months (P=.03). Over the subsequent 12 weeks, marijuana smokers were more likely to experience one or more exacerbations than non-marijuana smokers (59% vs. 29%, P=.01), and had a higher exacerbation rate (3.98/year vs. 1.96/year; P=.02). The impact of marijuana on exacerbations remained significant even after adjustment for treatment status.
CONCLUSIONS: Marijuana smoking was associated with an increase in the number of asthma exacerbations over the subsequent 12 weeks following an ED visit for asthma.
CLINICAL IMPLICATIONS: Marijuana smoking history may help assess the risk of recurrent asthma exacerbations following an ED visit.
DISCLOSURE: Joseph Parker: Employee: Salaried employee of MedImmune LLC
Keunpyo Kim: Employee: Employee of MedImmune LLC
Robert Silverman: Other: Principal investigator in clinical trial
Kimmie McLaurin: Employee: Employee of MedImmune LLC
Xiao Tu: Employee: Employee of MedImmune LLC
Nestor Molfino: Employee: Employee of MedImmune LLC
The data from this trial was obtained from a randomized controlled clinical trial of an investigation product. No information regarding the investigational product is contained in this abstract.MedImmune, LLC, Gaithersburg, MD