Disease burden and eosinophilic phenotype in Chinese patients with moderate-to-severe asthma: Baseline analysis of a...

BackgroundAsthma is a common respiratory disease with a high disease burden in China. The patient population with severe asthma remains largely unexplored.ObjectivesTo describe the disease burden, treatment pattern and eosinophilic phenotype of Chinese patients with moderate-to-severe asthma.DesignThis is a retrospective baseline analysis of the real-world, observational, multicenter PRESENT study (NCT06422663).MethodsPatients receiving Global Initiative for Asthma Step 3-5 treatment were categorized into protocol-specified severe asthma (uncontrolled asthma with medium-dose inhaled corticosteroids [ICS], or asthma with high-dose ICS) and moderate asthma subgroups. This baseline analysis reported patient characteristics, disease burden, treatment patterns, eosinophilic phenotype and testing rates of biomarkers at enrolment. Disease burden was assessed by historical asthma exacerbation rate within the past year, Asthma Control Test (ACT) score and lung function.ResultsOf the 498 patients included, 203 (40.8%) were identified as having protocol-specified severe asthma. Notable disease burden was observed, as reflected by the high proportion of patients experiencing asthma exacerbation (severe asthma: 35.0%; moderate asthma: 14.6%), low ACT score (mean [SD]: severe asthma: 17.4 [3.8]; moderate asthma: 20.6 [3.7]) and declined pre-bronchodilator forced expiratory volume in one second (pre-BD FEV₁; median [interquartile range]: severe asthma: 2.0 [1.5, 2.5]; moderate asthma: 2.2 [1.7, 2.8]). Overall, testing rates of blood eosinophil (EOS) were 25.3% (in the past seven days), 49.0% (in the past three months) and 68.9% (in the past one year). Among patients who tested EOS once and twice in the past one year, 62.5% (180/288) and 76.4% (42/55) had blood EOS counts ≥150 cells/μL, respectively. Testing rates of different biomarkers varied but were generally low.ConclusionNotable disease burden and sub-optimal management were observed in Chinese patients with moderate-to-severe asthma. Biomarker-based phenotyping of severe asthma was unsatisfactory. Treatment escalation and routine monitoring of blood EOS level might be considered.RegistrationClinicalTrials.gov, NCT06422663, registered on March 19, 2024, https://clinicaltrials.gov/study/NCT06422663.