Stability of phenotypes defined by physiological variables and biomarkers in adults with asthma

Kupczyk, Maciej; Dahlén, Barbro; Sterk, PJ; Niżankowska‐Mogilnicka, Ewa; Papi, Alberto; Bel, EH; Chanez, Pascal; Howarth, PH; Holgate, S. T.; Brusselle, Guy; Siafakas, NM; Gjomarkaj, Mark; Dahlén, SE

doi:10.1111/all.12445

Cited by 94 publications

(88 citation statements)

References 23 publications

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“…In this group, 34% of patients were also on OCS therapy (7.3% of the total asthmatic population), with a mean daily dose of 22 mg oral prednisone. Together, these observations indicate that the patients with severe asthma included in the COBRA cohort are among the most severe cases currently described in the literature [11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 77%

“…Some European and US cohorts have already provided insights into novel asthma phenotypes, and have improved our understanding of the underlying pathological processes [12][13][14][15][16]. However, most studies conducted with these cohorts were cross-sectional or, when longitudinal, they included low numbers of patients in the cohort or limited numbers of examinations during follow-up [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

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Clinical and biological characteristics of the French COBRA cohort of adult subjects with asthma

et al. 2017

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The COhort of BRonchial obstruction and Asthma (COBRA) is a longitudinal cohort that involves 12 French academic institutions. DNA, serum samples and clinical data are collected at entry and every 6 months thereafter.Of 1080 patients with asthma recruited between 2007 and 2015, 401 had mild/moderate and 613 had severe asthma. In cross-sectional analyses, compared with patients with milder disease, patients with severe asthma had more symptoms, exacerbations, hospitalisations and visits to the emergency department during the preceding 12 months, higher numbers of blood eosinophils, and more comorbidities. More than 60% of patients with severe asthma were therapy-uncontrolled at entry, and 152 of them were being treated with omalizumab. In addition, patients with asthma who had the highest eosinophilia levels (>300/mm3) had shorter asthma duration, lower lung function, and higher rates of severe exacerbations and unacceptable asthma control than patients with lower eosinophil counts.Longitudinal analyses performed in 427 patients with asthma with at least three differential blood cell counts demonstrated that both eosinophil numbers and eosinophil increase over time were associated with the number of exacerbations occurring until the next visit and with Juniper score.Studies with the COBRA cohort will help to improve knowledge concerning the risk and biological factors associated with asthma severity and to better understand their influence on the disease trajectory.

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Section: Discussionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Clinical and biological characteristics of the French COBRA cohort of adult subjects with asthma

et al. 2017

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“…After withdrawal from ICSs, 67% of patients had eosinophilic asthma, whereas after treatment with ICSs, only 39% had eosinophilic asthma [12]. This and other factors may explain why the eosinophilic phenotype is not consistent over time in some studies [13].…”

Section: How Is Eosinophilic Asthma Defined?mentioning

confidence: 99%

“…This was illustrated in the 328 patients of the severe asthma research programme (SARP) showing that the accuracy of blood eosinophils to predict sputum eosinophilia was low, leading to considerable misclassification of patients with eosinophilic or non-eosinophilic asthma. This low accuracy might be due to the high variability of blood eosinophil counts in patients with asthma, both in the short (24 h) and in the long (1 year) run [13,27]. So, merely for the diagnosis of 'eosinophilic asthma,' one single measurement of blood eosinophils does not seem to be of great value.…”

Section: Blood Eosinophilsmentioning

confidence: 99%

Improving the diagnosis of eosinophilic asthma

Coumou

Bel

2016

Expert Review of Respiratory Medicine

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“…Furthermore, it is important to mention that the phenotyping, endotyping, and selecting biomarkers for the personalized approach do not necessarily include single biomolecules, but rather be composed of properly selected constellations or signatures of proteins and other peptides, transcriptomes, genes, microRNAs [164] and metabolites [165,166]. Finally, there is a need for more evidence on the consistency of severe asthma phenotypes, throughout the clinical course of severe asthma [23,159,163,167–169]. …”

Section: Management Of Severe Asthmamentioning

confidence: 99%

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

Porsbjerg

Ulrik

Skjold

et al. 2018

European Clinical Respiratory Journal

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Although a minority of asthma patients suffer from severe asthma, they represent a major clinical challenge in terms of poor symptom control despite high-dose treatment, risk of exacerbations, and side effects. Novel biological treatments may benefit patients with severe asthma, but are expensive, and are only effective in appropriately targeted patients. In some patients, symptoms are driven by other factors than asthma, and all patients with suspected severe asthma (‘difficult asthma’) should undergo systematic assessment, in order to differentiate between true severe asthma, and ‘difficult-to-treat’ patients, in whom poor control is related to factors such as poor adherence or co-morbidities. The Nordic Consensus Statement on severe asthma was developed by the Nordic Severe Asthma Network, consisting of members from Norway, Sweden, Finland, Denmark, Iceland and Estonia, including representatives from the respective national respiratory scientific societies with the aim to provide an overview and recommendations regarding the diagnosis, systematic assessment and management of severe asthma. Furthermore, the Consensus Statement proposes recommendations for the organization of severe asthma management in primary, secondary, and tertiary care.

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Stability of phenotypes defined by physiological variables and biomarkers in adults with asthma

Cited by 94 publications

References 23 publications

Clinical and biological characteristics of the French COBRA cohort of adult subjects with asthma

Clinical and biological characteristics of the French COBRA cohort of adult subjects with asthma

Improving the diagnosis of eosinophilic asthma

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

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