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- Title
Clusters of Severe Eosinophilic Asthma in a Korean Asthma Cohort.
- Authors
Lee, Ji-Hyang; An, Jin; Won, Ha-Kyeong; Seo, Bomi; Kim, Jung-Hyun; Park, So-Young; Kim, Min-Hye; Shin, Yoo Seob; Jung, Jae-Woo; Song, Woo-Jung; Lee, Taehoon; Kwon, Hyouk-Soo; Lee, Jae Hyun; Kim, Joo-Hee; Kim, Sae-Hoon; Chang, Yoon-Seok; Cho, You Sook; Nahm, Dong-Ho; Jang, An-Soo; Park, Jung-Won
- Abstract
Background: Targeted therapies have broadened the available treatment options for patients with severe eosinophilic asthma (SEA). However, differences in the magnitude of treatment responses among patients indicate the presence of various underlying pathophysiological processes and patient subgroups. Objectives: We aimed to describe the characteristics of SEA and identify its patient subgroups. Methods: Clinical data from the Cohort for Reality and Evolution of Adult Asthma in Korea were analyzed. Cluster analysis was performed among those with SEA using 5 variables, namely, prebronchodilator forced expiratory volume in 1 s, body mass index, age at symptom onset, smoking amount, and blood eosinophil counts. Results: Patients with SEA showed prevalent sensitization to aeroallergens, decreased lung function, and poor asthma control status. Cluster analysis revealed 3 distinctive subgroups among patients with SEA. Cluster 1 (n = 177) consisted of patients reporting the lowest blood eosinophils (median, 346.8 cells/μL) and modest severe asthma with preserved lung function during the 12-month treatment period. Cluster 2 (n = 42) predominantly included smoking males with severe persistent airway obstruction and moderate eosinophilia (median, 451.8 cells/μL). Lastly, cluster 3 (n = 95) included patients with the most severe asthma, the highest eosinophil levels (median, 817.5 cells/μL), and good treatment response in terms of improved lung function and control status. Conclusions: Three subgroups were identified in SEA through the cluster analysis. The distinctive features of each cluster may help physicians predict patients who will respond to biologics with greater magnitude of clinical improvement. Further research regarding the underlying pathophysiology and clinical importance of each subgroup is warranted.
- Subjects
SOUTH Korea; LUNG physiology; EOSINOPHILS; ASTHMA; BIOLOGICAL products; FORCED expiratory volume; AGE factors in disease; DESCRIPTIVE statistics; PULMONARY eosinophilia; CLUSTER analysis (Statistics); BODY mass index; SMOKING
- Publication
Respiration, 2022, Vol 101, Issue 5, p465
- ISSN
0025-7931
- Publication type
Article
- DOI
10.1159/000520492