Overview of asthma patients followed up in a Tertiary Clinic

Z. Çelebi Sözener, B. Özdel Öztürk, Ö. Aydın, S. Bavbek, D. Mungan dilsadmungan@gmail.com
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Doi
10.23822/EurAnnACI.1764-1489.256

Summary
Introduction. Asthma is a heterogeneous disease that combines different biological mechanisms, inflammatory pathways, and phenotypic features under the same umbrella. Our aim was to investigate the demographic and disease characteristics of our patients with asthma and to reveal the distribution of patients with different phenotypes according to endotype groups. Methods. The study was planned as a cross-sectional observational study. The Demographic and clinical data of asthmatic patients followed in our clinic for at least one year were collected from their file records. Patients were identified as eosinophilic if the absolute eosinophil count was measured at least once ≥ 300/μL during the oral corticosteroid free period or ≥ 150/μL under oral corticosteroids. Patients sensitive to at least one inhalant allergen with skin prick test and/or spIgE measurement consistent with their history and clinical features were defined as allergic. They were categorized into four main endotypes according to their eosinophilic/non-eosinophilic and allergic/non-allergic nature. Results.  Data of 405 asthma patients (79.5% female) with a median age of 50.9 years were analyzed. The prominent clinical and phenotypic characteristics of the study group were being obese (43.2%) or overweight (32%), severe asthma (49.6%), adult-onset (56.1%) or late-onset asthma (35.3%). The distribution of the four main endotypes according to eosinophilic and/or allergic status, is as follows: 22.7% allergic-eosinophilic (AE), 27.9% nonallergic-eosinophilic (NAE), 22.9% allergic-noneosinophilic (ANE), 26.4% nonallergic-noneosinophilic (NANE). While most severe asthma patients were in the AE and NAE groups, those with early-onset asthma were in AE and ANE, and those with late-onset asthma were in the NAE and NANE groups. Finally, obese patients were mostly in NANE group. The proportion of uncontrolled patients was higher in the NAE group (NAE:44.2% vs AE:31.5%, ANE:31.2%, NANE:28%, respectively). Among the severe asthma patients, the rate of uncontrolled disease was higher in those with NANE asthma (NANE:61.5%, NAE:56.6%, ANE:53.5%, AE:37.7%). Conclusions. Our study showed that different phenotypes were more closely related to some endotypes. This may allow the clinicians to identify patients and predict appropriate treatment modalities and response for individualized care.

Key words
Asthma phenotypes; asthma endotypes; asthma severity; asthma onset; obese asthma.
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