Page 44 - ADULT-ONSET ASTHMA PREDICTORS OF CLINICAL COURSE AND SEVERITY

ADULT-ONSET ASTHMA – PREDICTORS OF CLINICAL COURSE AND SEVERITY
ABSTRACT
BACKGROUND: Several biomarkers have been used to assess sputum eosinophilia in asthma. It has been suggested that the diagnos c accuracy of these biomarkers might di er between asthma phenotypes. We inves gated the accuracy of biomarkers in detec ng sputum eosinophilia (≥3%) in di erent adult asthma phenotypes.
METHODS: Levels of eosinophils in blood and sputum, FeNO and total IgE from 336 adult patients, enrolled in 3 prospective observational clinical trials and recruited at five pulmonology outpatient departments, were analyzed. Area’s under the receiver operating characteristics curves (AUC) for detecting sputum eosinophilia were calculated, and compared between severe and mild, obese and non-obese, atopic and non-atopic, and (ex-)smoking and never-smoking asthma patients.
RESULTS: Sputum eosinophilia was present in 116 pa ents (35%). In the total group the AUC was 0.83 (95%CI 0.78-0.87) for blood eosinophils, 0.82 for FeNO (0.77-0.87) and 0.69 (0.63- 0.75) for total IgE. AUC’s were similar for blood eosinophils and FeNO between di erent phenotypes. Total IgE was less accurate to detect sputum eosinophilia in atopic and obese pa ents than in non-atopic and non-obese pa ents.
CONCLUSION: Blood eosinophils and FeNO had comparable diagnos c accuracy (superior to total IgE) to iden fy sputum eosinophilia in adult asthma pa ents irrespec ve of asthma phenotype such as severe, non-atopic, obese and smoking-related asthma.
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