RT Journal Article
SR Electronic
T1 Late Breaking Abstract - Type 2 biomarker expression (FeNO and blood eosinophils) is higher in severe adult-onset than in severe early-onset asthma
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP OA2838
DO 10.1183/13993003.congress-2021.OA2838
VO 58
IS suppl 65
A1 Marek Lommatzsch
A1 Maria Klein
A1 Paul Stoll
A1 Johann Christian Virchow
YR 2021
UL http://erj.ersjournals.com/content/58/suppl_65/OA2838.abstract
AB Background: Severe asthma phenotyping is key to personalise treatment. The relevance of the age of asthma onset for type 2 biomarker expression is poorly understood.Aims and Objective: To compare type 2 biomarker expression between severe early-onset asthma (SEA) and severe adult-onset asthma (SAA).Methods: Type 2 biomarker expression was compared between SEA (age of onset <18 years of age) and SAA (age of onset ≥18 years of age), in 220 patients (not treated with biologics) routinely referred to a tertiary asthma centre (Rostock, Germany).Results: Asthma control, gender distribution, body mass index, lung function and total serum immunoglobulin E (IgE) did not differ between SEA and SAA. SAA was characterised by a higher smoking history (median pack years: 5 versus 0, p=0.03), more exacerbations (median: 4 versus 2 per year, p=0.01), a lower percentage of clinical reactions to aeroallergens (29.4% versus 80%, p<0.001), higher FeNO (median: 41 versus 20 ppb, p<0.001) and higher blood eosinophils (median: 500 versus 350 eosinophils/µl, p=0.01) than SEA. A type 2 high phenotype (≥150 eosinophils/µl blood and FeNO≥25 ppb) was more prevalent in SAA than in SEA (64.7% versus 38%, p=0.002). In SAA, the type 2 high phenotype was more prevalent among patients without allergies than those with allergies (70% versus 50%, p=0.03), despite lower total IgE (median: 152 versus 371 IU/ml, p = 0.006).Conclusion: Severe adult-onset asthma is characterised by a stronger type 2 phenotype than severe early-onset asthma, suggesting that the age of onset is a helpful clinical information for the identification of targeted treatments.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, OA2838.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.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).