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Factors associated with uncontrolled severe asthma in the biologic era
Hideki Yasui1, Kyohei Oishi2, Fumiya Nihashi3
1Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan; Center for Clinical Research, Hamamatsu University Hospital, Hamamatsu, Japan.
Respiratory Medicine
|November 23, 2024
Summary
Even with biologics, severe asthma remains uncontrolled for many. Elevated blood neutrophil counts and frequent exacerbations are key factors, with neutrophils showing promise as a biomarker.
Area of Science:
- Pulmonology
- Immunology
- Clinical Medicine
Background:
- Severe asthma affects many despite biologic therapies, creating a significant social burden.
- Identifying factors contributing to uncontrolled severe asthma is crucial in the current treatment landscape.
Purpose of the Study:
- To identify factors associated with uncontrolled severe asthma in the biologic era.
- To assess the role of elevated blood neutrophil counts and exacerbation frequency in severe asthma control.
Main Methods:
- A multicenter prospective study enrolled 154 patients with severe asthma.
- Asthma control was assessed using the Asthma Control Questionnaire (ACQ-5).
- Logistic regression analysis identified factors linked to uncontrolled asthma (ACQ-5 ≥1.5).
Main Results:
- 36.4% of patients had uncontrolled severe asthma.
- Uncontrolled asthma was linked to frequent exacerbations (≥2/year) and elevated blood neutrophil counts.
- Elevated neutrophils were associated with uncontrolled asthma regardless of biologic use.
Conclusions:
- Frequent exacerbations and elevated blood neutrophil counts are independent predictors of uncontrolled severe asthma.
- Elevated blood neutrophil counts may serve as a valuable biomarker for severe asthma, even with biologic treatment.
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