Source: International Congress 2016 – Asthma: mechanisms and biomarkers that promote clinical understanding
Disease area: Airway diseases

Abstract

Aim: To quantify the proportion of overlap between five asthma phenotypes in an adult population with current asthma.Methods: A total of 18,619 adults from NHANES 2007-2012 surveys were analysed and those with asthma (self-reported asthma + wheezing/asthma attack in the last year) were included. Asthma phenotypes were defined as: eosinophilic if blood eosinophils (B-Eos) ³300/mm3; asthma with obesity if BMI >30 kg/m2; asthma-COPD overlap syndrome (ACOS) if concurrent asthma and COPD (self-reported chronic bronchitis/emphysema with diagnosis ³40 years + self-reported smoking history); Th2-high if exhaled NO(FeNO) ³39 ppb; and Th2-low if FeNO <20 ppb and B-Eos <300/mm3. A proportional Venn diagram was made to illustrate the overlap between phenotypes. Data was weighted to represent the US population.Results: In 1,059 subjects with asthma, the weighted proportion of asthma with obesity, eosinophilic, Th2-low and Th2-high asthma, and ACOS were 50%, 43%, 30%, 16% and 11%, respectively. The Venn diagram shows 12 overlap categories and a non-classified sub-group (6%). A substantial overlap was observed, with patients having 2 (48%), 3 (8%) and 4 (0.6%) phenotypes. Asthma with obesity associated with Th2-low asthma was the most frequent overlap (23%).Conclusion: Most adults with asthma were classified in more than one classical phenotype, suggesting that additional approaches, e.g. unsupervised methods, are needed to define novel, more precise phenotypes enabling personalized treatment strategies.


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Rita Amaral (Porto, Portugal), Rita Amaral, João A. Fonseca, Tiago Jacinto, Ana Margarida Pereira, Andrei Malinovschi, Christer Janson, Kjell Alving. High proportion of overlap between adult asthma phenotypes in a large population-based sample. Eur Respir J 2016; 48: Suppl. 60, 568

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