TY - JOUR
T1 - Stability of phenotypes defined by physiological variables and biomarkers in adults with asthma
AU - Kupczyk, M.
AU - Dahlén, B.
AU - Sterk, P. J.
AU - Nizankowska-Mogilnicka, E.
AU - Papi, A.
AU - Bel, E. H.
AU - Chanez, P.
AU - Howarth, P. H.
AU - Holgate, S. T.
AU - Brusselle, G.
AU - Siafakas, N. M.
AU - Gjomarkaj, M.
AU - Dahlén, S.-E.
AU - AUTHOR GROUP
AU - Weersink, Els
AU - Gaga, Mina
AU - Papadopoulos, Nikos
AU - Oikonomidou, Erasmia
AU - Zervas, Eleftherios
AU - Contoli, Marco
AU - Pauwels, Romain A.
AU - Joos, Guy F.
AU - de Rudder, Isabelle
AU - Schelfhout, Vanessa
AU - Richter, Kai
AU - Gerding, Daisy
AU - Magnussen, Helgo
AU - Samara, Katerina
AU - Plataki, Maria
AU - Papadopouli, Eva
AU - Szczeklik, Andrzej
AU - Ziolkowska- Graca, Bozena
AU - Kania, Aleksander
AU - Gawlewicz-Mroczka, Agnieszka
AU - Duplaga, Mariusz
AU - Figiel, Ewa
AU - Rabe, Klaus F.
AU - Gauw, Stefanie
AU - van Veen, Ilonka
AU - Kips, Johan C.
AU - Johnston, Sebastian L.
AU - Mallia, Patrick
AU - Campbell, Deborah A.
AU - Robinson, Douglas S.
AU - Kanniess, Frank
AU - Fabbri, Leo M.
AU - Romagnoli, Micaela
AU - Vachier, Isabelle
AU - Devautour, Catherine
AU - Meziane, Lahouari
AU - Vignola, A. Maurizio
PY - 2014
Y1 - 2014
N2 - Although asthma is characterized by variable airways obstruction, most studies of asthma phenotypes are cross-sectional. The stability of phenotypes defined either by biomarkers or by physiological variables was assessed by repeated measures over 1 year in the Pan-European BIOAIR cohort of adult asthmatics. A total of 169 patients, 93 with severe asthma (SA) and 76 with mild-to-moderate asthma (MA), were examined at six or more visits during 1 year. Asthma phenotype clusters were defined by physiological variables (lung function, reversibility and age of onset of the disease) or by biomarkers (eosinophils and neutrophils in induced sputum). After 1 year of follow-up, the allocation to clusters was changed in 23.6% of all asthma patients when defined by physiological phenotypes and, remarkably, in 42.3% of the patients when stratified according to sputum cellularity (P = 0.034). In the SA cohort, 30% and 48.6% of the patients changed allocation according to physiological and biomarker clustering, respectively. Variability of phenotypes was not influenced by change in oral or inhaled corticosteroid dose, nor by the number of exacerbations. Lower stability of single and repeated measure was found for all evaluated biomarkers (eosinophils, neutrophils and FeNO) in contrast to good stability of physiological variables (FEV1 ), quality of life and asthma control. Phenotypes determined by biomarkers are less stable than those defined by physiological variables, especially in severe asthmatics. The data also imply that definition of asthma phenotypes is improved by repeated measures to account for fluctuations in lung function, biomarkers and asthma control
AB - Although asthma is characterized by variable airways obstruction, most studies of asthma phenotypes are cross-sectional. The stability of phenotypes defined either by biomarkers or by physiological variables was assessed by repeated measures over 1 year in the Pan-European BIOAIR cohort of adult asthmatics. A total of 169 patients, 93 with severe asthma (SA) and 76 with mild-to-moderate asthma (MA), were examined at six or more visits during 1 year. Asthma phenotype clusters were defined by physiological variables (lung function, reversibility and age of onset of the disease) or by biomarkers (eosinophils and neutrophils in induced sputum). After 1 year of follow-up, the allocation to clusters was changed in 23.6% of all asthma patients when defined by physiological phenotypes and, remarkably, in 42.3% of the patients when stratified according to sputum cellularity (P = 0.034). In the SA cohort, 30% and 48.6% of the patients changed allocation according to physiological and biomarker clustering, respectively. Variability of phenotypes was not influenced by change in oral or inhaled corticosteroid dose, nor by the number of exacerbations. Lower stability of single and repeated measure was found for all evaluated biomarkers (eosinophils, neutrophils and FeNO) in contrast to good stability of physiological variables (FEV1 ), quality of life and asthma control. Phenotypes determined by biomarkers are less stable than those defined by physiological variables, especially in severe asthmatics. The data also imply that definition of asthma phenotypes is improved by repeated measures to account for fluctuations in lung function, biomarkers and asthma control
U2 - https://doi.org/10.1111/all.12445
DO - https://doi.org/10.1111/all.12445
M3 - Article
C2 - 25039610
SN - 0105-4538
VL - 69
SP - 1198
EP - 1204
JO - Allergy
JF - Allergy
IS - 9
ER -