Abstract
Background: In patients with severe uncontrolled asthma, it is important to identify the T2-high and T2-low endotype and stratify the treatment approach.
Aims: We clarify the prevalence and clinical characteristics of T2-high and T2-low endotype of severe uncontrolled asthma distinguished by combining popular type-2 biomarkers in practice.
Methods: This retrospective study examined clinical data of 161 patients with severe uncontrolled asthma defined by ERS/ATS guidelines. T2-high was determined by the presence of atopy (RAST +) and/or FeNO > 25 ppb and/or B-Eos > 300 /μL, while T2-low was determined by the absence of all these characteristics. Moreover, patients were divided into following uncontrolled features subtypes; Exacerbation (EXA), Poor symptom control (SYM), and Airflow limitation (AFL).
Results: The prevalence of T2-high patients was 89%, while that of T2-low patients was 11%. The majority (47%) of patients overlapped to all three type-2 biomarkers. By contrast, overlapped patients in all three uncontrolled features were classified in only 6%, while patients in AFL alone features accounted for the most (31%). Although the prevalence of patients with EXA or SYM showed no significant differences between T2-high and T2-low group, the presence of AFL in the T2-high group had higher than that in the T2-low group (65% vs 24%). Regardless of whether Atopy or high B-Eos exists, high FeNO were found to be the risk factor of AFL according to the multivariate analysis.
Conclusions: Most patients were classified into the T2-high endotype. The T2-high endotype group had the feature of AFL. Among them, high FeNO had a large impact on AFL.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA2749.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019