Impact of Sex on Prediction of Asthma Attacks by Clinical Risk Factors and Type 2 Biomarkers.

However, the impact of sex on their prognostic value is unclear.

然而，性别对它们预后价值的影响尚不清楚。

research_question

Does sex modify prognostic values of clinical characteristics, BEC, and Feno for severe asthma attacks?

性别是否改变了临床特征、呼出气冷凝液（BEC）和呼出气一氧化氮（Feno）对严重哮喘发作的预后价值？

study_design_and_methods

We conducted a patient-level meta-analysisof the control arms of 22 randomized asthma trials (Oxford Asthma Attack Risk Scale Meta-Analysis[ORACLE2], N = 6,510).

我们对22项随机哮喘试验的对照组进行了患者级荟萃分析（牛津哮喘发作风险量表荟萃分析[ORACLE2]，N = 6,510）。

Annualized severe asthma attack rates and (adjusted) rate ratios (aRRs) (95% CI) were estimated with sex-specific multivariable negative binomial models, adjusting for baseline demographics, clinical characteristics, and type 2 biomarkers (BEC and Feno).

使用性别特异性的多变量负二项模型估计了年度严重哮喘发作率和（调整后的）发作率比值（aRRs）及其95%置信区间，同时调整了基线人口统计学特征、临床特征和2型生物标志物（BEC和Feno）。

Interaction tests evaluated the influence of sex on other prognostic factors.

交互作用检验评估了性别对其他预后因素的影响。

Results

Among 4,140 female and 2,370 male patients, crude attack rates were higher in female patients than in male patients (0.90 vs 0.74 attacks/patient-year).

在4140名女性和2370名男性患者中，女性患者的粗略发病率高于男性患者（每患者年0.90次对比0.74次）。

Prior asthma attacks were the strongest predictor of future attacks in both sexes but with a higher aRR in male individuals (aRR [95%CI], 2.76 [1.97-3.88]) than in female individuals (1.66 [1.33-2.06]; interaction P = .03).

既往哮喘发作是两性未来发作的最强预测因素，但在男性中相对风险更高（aRR [95%置信区间]，2.76 [1.97-3.88]）相比于女性（1.66 [1.33-2.06]；交互作用P = .03）。

In contrast, the prognostic utility of treatment intensity, BMI, lung function, smoking status, comorbidities, and type 2 biomarkers was similar in male and female individuals.

相比之下，治疗强度、体质指数（BMI）、肺功能、吸烟状况、合并症和2型生物标志物的预后效用在男性和女性个体中是相似的。

The highest risk was seen in the combined high-BEC/high- Feno groups for both sexes.

在两性中，高呼出气一氧化氮（BEC）和高呼出气一氧化氮（Feno）组合的最高风险均被观察到。

interpretation

To our knowledge, this study is the first patient-level meta-analysisof prospectively collected clinical trial data to evaluate sex as a modifier of prognostic factors for asthma attacks.

据我们所知，本研究是首个对前瞻性收集的临床试验数据进行的患者水平荟萃分析，旨在评估性别作为哮喘发作预后因素的修饰因子。

The overall annualized asthma attack rate was higher in female than male individuals.

女性个体的整体年化哮喘发作率高于男性。

Prior attack history had stronger prognostic value for future attacks in male individuals, whereas other clinical risk factors and type 2 biomarkers (blood eosinophils and Feno) showed no major sex differences.

先前发作史对于男性个体未来发作的预后价值更强，而其他临床风险因素和2型生物标志物（血嗜酸性粒细胞和Feno）未显示出主要的性别差异。

These findings highlight that female individuals without prior attacks may face increased risk, and they have important implications for clinical research and practice.

这些发现强调了没有先前发作的女性个体可能面临更高的风险，这对临床研究和实践具有重要意义。