| Popis: |
Laurent Portel,1 Caroline Fabry-Vendrand,2 Nathalie Texier,3 Déborah Schwartz,3 Audrey Capdepon,2 Gabriel Thabut,2 Didier Debieuvre4 1Service de Pneumologie, Centre Hospitalier Robert Boulin, Libourne, France; 2Astra Zeneca, Courbevoie, France; 3Kappa Santé, Paris, France; 4Service de Pneumologie, Hôpital Émile Muller, Groupe Hospitalier de la Région Mulhouse Sud-Alsace (GHRMSA), Mulhouse, FranceCorrespondence: Laurent Portel, Service de Pneumologie, Centre Hospitalier Robert Boulin, 112 Avenue de la Marne, BP 199, Libourne, 33505, France, Tel +33 557 553 560, Fax +33 557 553 431, Email laurent.portel@ch-libourne.frPurpose: Data on severe non-eosinophilic asthma are scarce. Moreover, as compared with eosinophilic asthma, non-eosinophilic asthma less frequently benefits from the latest therapeutic advances. This study aimed to highlight differences between non-eosinophilic and eosinophilic asthma as they may help the development of new therapeutic agents.Patients and Methods: Data from 1075 adult patients with severe asthma (GINA treatment: 4/5) collected during the cross-sectional non-interventional FASE-CPHG study were analyzed. Two groups of patients (EOS-/EOS+) were constituted based on blood eosinophil counts (cutoff value: 300 G/l). Characteristics of EOS- (N = 500) and EOS+ (N = 575) patients were described; EOS- patients were also described according to their allergic profile based on skin allergy or allergen-specific immunoglobulin E (IgE) assays (cutoff value: 150 IU/mL).Results: Percentages of patients with obesity (29%), allergen sensitization (57%), or ≥ 2 annual exacerbations in the last 12 months (68%) were similar in both groups. As compared with EOS+ patients, EOS- patients less frequently reported chronic rhinitis (41.1% vs 50.5%, p < 0.01) or nasal polyposis (13.6% vs 27.5%, p < 0.01), and more frequently reported GERD (45.2% vs 37.1%, p < 0.01), anxiety (45.5% vs 38.1%, p = 0.01), or depression (18.3% vs 13.3%, p = 0.02). EOS- patients had lower serum total IgE levels (median: 158 vs 319 IU/mL, p < 0.01) and were less frequently treated with long-term oral corticosteroid therapy (16.0% vs 23.7%; p < 0.01). Their asthma was more frequently uncontrolled (48% vs 40%, p < 0.01). Similar results were found with a cutoff value for blood eosinophil counts at 150 G/l. EOS- patients with allergic profile less frequently reported high serum IgE levels (35.6% vs 57.9%, p < 0.01). EOS- and EOS+ patients treated with long-term oral corticosteroids had similar profiles.Conclusion: In our patients with severe asthma, EOS- asthma was approximately as frequent as EOS+ asthma; EOS- asthma was frequently poorly controlled or uncontrolled, confirming the need for a better management. Allergy did not appear to worsen clinical profile.Keywords: asthma, eosinophils, France, hospital, observational study |
