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Background: Severe asthma is a disabling and costly disease, often poorly controlled despite high dosage of controller medication. Aims To characterize a severe asthma cohort by cell phenotypes, derived from a large-scale population survey in northern Sweden. Methods: Severe asthma was defined by the US SARP criteria. High dosage ICS was defined by the GINA 2014 criteria. The cohort was divided into four cell phenotype groups: high eosinophils (≥300/mm3) and normal/low neutrophils (HE); high neutrophils (≥5000/mm3) and normal/low eosinophils (HN); high eosinophils and high neutrophils (HEN); or both low (LEN). These groups were analyzed by degree of asthma control measured by Asthma Control Test and by lung function. Results: Overall, 32 patients with severe asthma were identified (severe asthma prevalence 4%) — 11, 7, 3, and 11 patients in the HE, HN, HEN, and LEN groups, respectively. Uncontrolled asthma was reported for 58% of the patients, 35% were partly controlled and 6% were controlled. Neutrophil count ≥5000 was reported for 31% of the patients, 44% had eosinophil counts ≥300. The greatest percentage of uncontrolled patients was found in the HE group (70%), followed by HEN group (67%) and the HN group (57%). FEV1/FVC Conclusions In this severe asthma population, the majority of patients were uncontrolled, had increased concentrations of eosinophils and/or neutrophils, and airway obstruction despite treatment with high dosage controller medication. Study sponsor: AstraZeneca. |
