Eosinophilic and Noneosinophilic Asthma : An Expert Consensus Framework to Characterize Phenotypes in a Global Real-Life Severe Asthma Cohort

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Eosinophilic and Noneosinophilic Asthma : An Expert Consensus Framework to Characterize Phenotypes in a Global Real-Life Severe Asthma Cohort

Heaney, Liam G. (författare): Queen's University Belfast

Perez de Llano, Luis (författare): University Hospital Lucus Augusti

Al-Ahmad, Mona (författare): Kuwait University

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Backer, Vibeke (författare): University of Copenhagen

Busby, John (författare): Queen's University Belfast

Canonica, Giorgio Walter (författare): Humanitas Research Hospital,Humanitas University

Christoff, George C. (författare): Medical University of Sofia

Cosio, Borja G. (författare): Hospital Universitario Son Espases

FitzGerald, J. Mark (författare): Centre for Lung Health, Vancouver

Heffler, Enrico (författare): Humanitas University,Humanitas Research Hospital

Iwanaga, Takashi (författare): Kindai University Hospital

Jackson, David J. (författare): King's College London,Guy's and St Thomas' NHS Foundation Trust

Menzies-Gow, Andrew N. (författare): Royal Brompton and Harefield NHS Foundation Trust

Papadopoulos, Nikolaos G. (författare): National and Kapodistrian University of Athens

Papaioannou, Andriana I. (författare): National and Kapodistrian University of Athens

Pfeffer, Paul E. (författare): Queen Mary University

Popov, Todor A. (författare)

Porsbjerg, Celeste M. (författare): Bispebjerg Hospital

Rhee, Chin Kook (författare)

Sadatsafavi, Mohsen (författare): University of British Columbia

Tohda, Yuji (författare)

Wang, Eileen (författare): University of Colorado School of Medicine,National Jewish Health

Wechsler, Michael E. (författare): National Jewish Health

Alacqua, Marianna (författare): AstraZeneca, UK

Altraja, Alan (författare): University of Tartu

Bjermer, Leif (författare): Lund University,Lunds universitet,Klinisk lungmedicin,Forskargrupper vid Lunds universitet,Clinical Respiratory Medicine,Lund University Research Groups,Skåne University Hospital

Björnsdóttir, Unnur S. (författare): National University Hospital of Iceland

Bourdin, Arnaud (författare): University of Montpellier

Brusselle, Guy G. (författare): Erasmus University Medical Center,Ghent University Hospital

Buhl, Roland (författare): Universitätsmedizin Mainz

Costello, Richard W. (författare): Beaumont Hospital, Dublin

Hew, Mark (författare): Monash University

Koh, Mariko Siyue (författare): Duke–NUS Medical School,Singapore General Hospital

Lehmann, Sverre (författare): University of Bergen

Lehtimäki, Lauri (författare): Tampere University Hospital

Peters, Matthew (författare): Concord Repatriation General Hospital

Taillé, Camille (författare): Paris Diderot University

Taube, Christian (författare): University Hospital Essen

Tran, Trung N. (författare): AstraZeneca, UK

Zangrilli, James (författare): AstraZeneca, UK

Bulathsinhala, Lakmini (författare): Optimum Patient Care Ltd

Carter, Victoria A. (författare): Optimum Patient Care Ltd

Chaudhry, Isha (författare): Optimum Patient Care Ltd

Eleangovan, Neva (författare): Optimum Patient Care Ltd

Hosseini, Naeimeh (författare): Optimum Patient Care Ltd

Kerkhof, Marjan (författare): Optimum Patient Care Ltd

Murray, Ruth B. (författare): Optimum Patient Care Ltd

Price, Chris A. (författare): Optimum Patient Care Ltd

Price, David B. (författare): University of Aberdeen,Optimum Patient Care Ltd,Observational and Pragmatic Research Institute Pte Ltd

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Elsevier BV, 2021
2021
Engelska 17 s.
Ingår i: Chest. - : Elsevier BV. - 0012-3692. ; 160:3, s. 814-830

Relaterad länk:: http://dx.doi.org/10... (free); visa fler...; http://journal.chest...; https://lup.lub.lu.s...; https://doi.org/10.1...; visa färre...

Tidskriftsartikel (refereegranskat)

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Background: Phenotypic characteristics of patients with eosinophilic and noneosinophilic asthma are not well characterized in global, real-life severe asthma cohorts. Research Question: What is the prevalence of eosinophilic and noneosinophilic phenotypes in the population with severe asthma, and can these phenotypes be differentiated by clinical and biomarker variables? Study Design and Methods: This was an historical registry study. Adult patients with severe asthma and available blood eosinophil count (BEC) from 11 countries enrolled in the International Severe Asthma Registry (January 1, 2015-September 30, 2019) were categorized according to likelihood of eosinophilic phenotype using a predefined gradient eosinophilic algorithm based on highest BEC, long-term oral corticosteroid use, elevated fractional exhaled nitric oxide, nasal polyps, and adult-onset asthma. Demographic and clinical characteristics were defined at baseline (ie, 1 year before or closest to date of BEC). Results: One thousand seven hundred sixteen patients with prospective data were included; 83.8% were identified as most likely (grade 3), 8.3% were identified as likely (grade 2), and 6.3% identified as least likely (grade 1) to have an eosinophilic phenotype, and 1.6% of patients showed a noneosinophilic phenotype (grade 0). Eosinophilic phenotype patients (ie, grades 2 or 3) showed later asthma onset (29.1 years vs 6.7 years; P < .001) and worse lung function (postbronchodilator % predicted FEV1, 76.1% vs 89.3%; P = .027) than those with a noneosinophilic phenotype. Patients with noneosinophilic phenotypes were more likely to be women (81.5% vs 62.9%; P = .047), to have eczema (20.8% vs 8.5%; P = .003), and to use anti-IgE (32.1% vs 13.4%; P = .004) and leukotriene receptor antagonists (50.0% vs 28.0%; P = .011) add-on therapy. Interpretation: According to this multicomponent, consensus-driven, and evidence-based eosinophil gradient algorithm (using variables readily accessible in real life), the severe asthma eosinophilic phenotype was more prevalent than previously identified and was phenotypically distinct. This pragmatic gradient algorithm uses variables readily accessible in primary and specialist care, addressing inherent issues of phenotype heterogeneity and phenotype instability. Identification of treatable traits across phenotypes should improve therapeutic precision.

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Av författaren/redakt...: Heaney, Liam G.; Perez de Llano, ...; Al-Ahmad, Mona; Backer, Vibeke; Busby, John; Canonica, Giorgi ...; visa fler...; Christoff, Georg ...; Cosio, Borja G.; FitzGerald, J. M ...; Heffler, Enrico; Iwanaga, Takashi; Jackson, David J ...; Menzies-Gow, And ...; Papadopoulos, Ni ...; Papaioannou, And ...; Pfeffer, Paul E.; Popov, Todor A.; Porsbjerg, Celes ...; Rhee, Chin Kook; Sadatsafavi, Moh ...; Tohda, Yuji; Wang, Eileen; Wechsler, Michae ...; Alacqua, Mariann ...; Altraja, Alan; Bjermer, Leif; Björnsdóttir, Un ...; Bourdin, Arnaud; Brusselle, Guy G ...; Buhl, Roland; Costello, Richar ...; Hew, Mark; Koh, Mariko Siyu ...; Lehmann, Sverre; Lehtimäki, Lauri; Peters, Matthew; Taillé, Camille; Taube, Christian; Tran, Trung N.; Zangrilli, James; Bulathsinhala, L ...; Carter, Victoria ...; Chaudhry, Isha; Eleangovan, Neva; Hosseini, Naeime ...; Kerkhof, Marjan; Murray, Ruth B.; Price, Chris A.; Price, David B.; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Lungmedicin och ...

Artiklar i publikationen: Chest

Av lärosätet: Lunds universitet

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Eosinophilic and Noneosinophilic Asthma : An Expert Consensus Framework to Characterize Phenotypes in a Global Real-Life Severe Asthma Cohort

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