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Identification of asthma phenotypes based on extrapulmonary treatable traits
Patricia Duarte Freitas1, Rafaella França Xavier1, Vanessa Marie McDonald2,3,4
1Dept of Physical Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
The European Respiratory Journal
|August 1, 2020
Summary
Asthma phenotypes are linked to physical activity, obesity, and mental health. Identifying these extrapulmonary traits can personalize treatment for moderate-to-severe asthma, improving patient outcomes.
Area of Science:
- Pulmonary Medicine
- Clinical Psychology
Background:
- Asthma is a complex, heterogeneous respiratory condition.
- Asthma phenotypes based on extrapulmonary treatable traits remain underexplored.
Purpose of the Study:
- To identify and characterize asthma patient clusters based on clinical, functional, anthropometric, and psychological factors.
- To investigate the relationship between extrapulmonary traits and asthma control and exacerbation risk.
Main Methods:
- Cross-sectional, multicenter study of 296 participants with moderate-to-severe asthma.
- Hierarchical cluster analysis to group participants based on physical activity, sedentary time, asthma control, anthropometrics, pulmonary function, and psychological status.
- Statistical analysis including ANOVA, Kruskal-Wallis, Chi-squared, logistic, and linear regression models.
Main Results:
- Four distinct asthma clusters were identified: 1) controlled, active; 2) uncontrolled, inactive/sedentary; 3) uncontrolled, inactive/sedentary, obese, with anxiety/depression; 4) very uncontrolled, inactive/sedentary, obese, with anxiety/depression.
- Sedentary time, female sex, and anxiety symptoms increased exacerbation risk.
- Physical activity was protective against hospitalization; asthma control correlated with sex, exacerbations, activity, and health status.
Conclusions:
- Physical inactivity, obesity, and anxiety/depression symptoms are linked to poorer asthma outcomes and control.
- Assessing extrapulmonary traits is crucial for personalized management and improved outcomes in moderate-to-severe asthma.
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