RT Journal Article
SR Electronic
T1 Identification of asthma phenotypes based on extrapulmonary treatable traits
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 2000240
DO 10.1183/13993003.00240-2020
A1 Freitas, Patricia Duarte
A1 Xavier, Rafaella França
A1 McDonald, Vanessa Marie
A1 Gibson, Peter Gerard
A1 Cordova-Rivera, Laura
A1 Furlanetto, Karina Couto
A1 de Oliveira, Joice Mara
A1 Carvalho-Pinto, Regina Maria
A1 Cukier, Alberto
A1 Stelmach, Rafael
A1 Carvalho, Celso Ricardo Fernandes
YR 2020
UL http://erj.ersjournals.com/content/early/2020/07/09/13993003.00240-2020.abstract
AB Background Asthma is a heterogeneous and complex disease, and the description of asthma phenotypes based on extrapulmonary treatable traits has not been previously reported.Objective to identify and characterise clusters based on clinical, functional, anthropometrical, and psychological characteristics in participants with moderate-to-severe asthma.Methods This is a cross-sectional multicentre study involving centres from Brazil and Australia. Participants (N=296) with moderate-to-severe asthma were consecutively recruited. Physical activity and sedentary time, clinical asthma control, anthropometric data, pulmonary function, psychological, and health-status were evaluated. Participants were classified by hierarchical cluster analysis and the clusters compared using ANOVA, Kruskal-Wallis, and Chi-square tests. Multiple logistic and linear regression models were performed to evaluate the association between variables.Results We identified four clusters: (1)controlled asthma who were physically active, (2)uncontrolled asthma who were physically inactive and more sedentary, (3)uncontrolled asthma with low physical activity, who were also obese and experienced anxiety and/or depression symptoms (4)very uncontrolled asthma, who were physically inactive, more sedentary, obese and experienced anxiety and/or depression symptoms. Higher levels of sedentary time, female sex, and anxiety symptoms were associated with increased odds of exacerbation risk while being more active showed a protective factor for hospitalisation. Asthma control was associated with sex, the occurrence of exacerbation, physical activity, and health-status.Conclusion Traits such as physical inactivity, obesity, and symptoms of anxiety and/or depression were associated with worse asthma outcomes, and closely and inextricably with asthma control. This cluster analysis supports the importance of assessing extrapulmonary traits to improve personalised management and outcomes for people with moderate and severe asthma.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. López-Abente has nothing to disclose.Conflict of interest: Dr. Freitas has nothing to disclose.Conflict of interest: Dr. Xavier has nothing to disclose.Conflict of interest: Dr. McDonald has nothing to disclose.Conflict of interest: Dr. Gibson has nothing to disclose.Conflict of interest: Dr. Codorva-Rivera has nothing to disclose.Conflict of interest: Dr. Furlanetto has nothing to disclose.Conflict of interest: Dr. Oliveira has nothing to disclose.Conflict of interest: Dr. Carvalho-Pinto has nothing to disclose.Conflict of interest: Dr. Cukier has nothing to disclose.Conflict of interest: Dr. Stelmach has nothing to disclose.Conflict of interest: Dr. Carvalho has nothing to disclose.