Abstract

Background

Patients with non-eosinophilic asthma are reported to be less responsive to treatment compared with those with eosinophilic asthma, but little prospective evidence is available from real life populations.

Aim

To compare the clinical outcomes in patients with non-eosinophilic asthma (NEA) versus eosinophilic asthma (EA) after 12 months asthma management in a specialist setting.

Methods

Patients with asthma referred to a specialist outpatient clinic at a Danish university hospital were enrolled consecutively. FeNO, asthma control (ACQ score) and airway hyperresponsiveness (AHR) to mannitol were assessed at baseline and at 12 months follow-up. NEA was defined as a FeNO < 25 ppb, and EA as a FeNO > 25 ppb at inclusion.

Results.

Ninety-six asthma patients (Females: 55%, age: 33 years (15-63)) were followed. Sixty-two (65%) had NEA, and 34 (35%) had EA. At baseline, ACQ score and AHR were comparable in the two groups.

At follow-up, both patients with NEA and EA reported significant improvements in ACQ (NEA: 1.17 (±0.74) to 0.92 (±0.90), p= 0.01 and EA: 1.31 (±1.2) to 0.85 (±0.90), p=0.03). Further, AHR decreased significantly in both groups (RDR: NEA: 0.17 (±0.85) to 0.03 (±0.07), p<0.001 and EA: 0.26 (±0.91) to 0.02 (±0.059), p < 0.001). There were no significant differences in improvement in ACQ and AHR between the two groups.

Conclusion

Patients with non-eosinophilic asthma experience an improvement in asthma control and airway hyperresponsiveness after 12 months of specialist management that is comparable with patients with eosinophilic asthma, indicating that in a real-life setting NEA and EA are equally responsive to available treatment.