Clinical and inflammatory characteristics of the European U-BIOPRED adult severe asthma cohort

Abstract

U-BIOPRED is a European Union consortium of 20 academic institutions, 11 pharmaceutical companies and six patient organisations with the objective of improving the understanding of asthma disease mechanisms using a systems biology approach.This cross-sectional assessment of adults with severe asthma, mild/moderate asthma and healthy controls from 11 European countries consisted of analyses of patient-reported outcomes, lung function, blood and airway inflammatory measurements.Patients with severe asthma (nonsmokers, n=311; smokers/ex-smokers, n=110) had more symptoms and exacerbations compared to patients with mild/moderate disease (n=88) (2.5 exacerbations versus 0.4 in the preceding 12 months; p<0.001), with worse quality of life, and higher levels of anxiety and depression. They also had a higher incidence of nasal polyps and gastro-oesophageal reflux with lower lung function. Sputum eosinophil count was higher in severe asthma compared to mild/moderate asthma (median count 2.99% versus 1.05%; p=0.004) despite treatment with higher doses of inhaled and/or oral corticosteroids.Consistent with other severe asthma cohorts, U-BIOPRED is characterised by poor symptom control, increased comorbidity and airway inflammation, despite high levels of treatment. It is well suited to identify asthma phenotypes using the array of "omic" datasets that are at the core of this systems medicine approach. @ERSpublications Severe asthma results in more airway inflammation, worse symptoms and lower lung function, despite increased therapy http://ow.ly/QznR3

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

“…Phenotypes may be based on the presence and level of inflammation, which may be termed inflammatory phenotypes [16], or based on a combination of clinical characteristics, physiological, and inflammatory markers, which may be termed clinical phenotypes [17–22]. …”

Small Airways Disease and Asthma Management: Is there a Connection?

“…The recent European U-BIOPRED adult severe asthma cohort, including more than 400 severe asthmatic patients, has shown that the majority of severe asthmatics had sputum eosinophils > 3%. Interestingly, those with a current or a past history of smoking did not have less sputum eosinophils, clearly indicating that smoking history in asthmatics does not preclude the presence of eosinophilic inflammation 59 . In the same study, there is clearly no link between asthma severity and sputum neutrophil counts.…”

Phenotyping Asthma: Linking Clinical Features to Biomolecular Pathways

“…The EU-funded Unbiased Biomarkers for the Prediction of Respiratory Disease Outcomes (U-BIOPRED) project has just published details of their paediatric and adult severe asthma cohorts 31,32 . This cross-sectional assessment of adults with severe asthma, mild/ moderate asthma, and healthy controls from 11 European countries showed that patients with severe asthma had more symptoms and exacerbations (2.5 exacerbations versus 0.4 in the preceding 12 months) compared to patients with mild/moderate disease, with worse quality of life and higher levels of anxiety and depression.…”