[en] BACKGROUND: Longitudinal trials have suggested that asthma control may be influenced by fluctuations in eosinophilic inflammation. This association has however never been confirmed in daily practice. OBJECTIVE: To investigate the relationship between asthma control and sputum eosinophils in clinical practice. METHODS: A retrospective longitudinal study was conducted on 187 patients with asthma with at least 2 successful sputum inductions at our Asthma Clinic. Linear mixed models were used to assess the relationship between asthma control and individual changes in sputum eosinophils. Receiver-operating characteristic curves were constructed to define minimal important differences (MIDs) of sputum eosinophils associated with a change of at least 0.5 in Asthma Control Questionnaire (ACQ) score. Then, a validation cohort of 79 patients with asthma was recruited to reassess this relationship and the accuracy of the MID values. RESULTS: A multivariate analysis showed that asthma control was independently associated with individual fluctuations in sputum eosinophil count (P < .001). In patients with intermittent/persistently eosinophilic asthma, we calculated a minimal important decrease of 4.3% in the percentage of sputum eosinophils (area under the curve [AUC], 0.69; P < .001) or 3.4-fold (AUC, 0.65; P = .003) for a significant improvement in asthma control and a minimal important increase of 3.5% (AUC, 0.67; P = .004) or 1.8-fold (AUC, 0.63; P = .02) for a significant worsening in asthma control. The association between asthma control and sputum eosinophils and the accuracy of the MIDs of sputum eosinophils were confirmed in the validation cohort. CONCLUSIONS: At the individual level, asthma control was associated with fluctuations in sputum eosinophil count over time.
Disciplines :
Pharmacy, pharmacology & toxicology
Author, co-author :
Demarche, Sophie ; Université de Liège > Département de pharmacie > Pharmacie clinique et pharmacie hospitalière
SCHLEICH, FLorence ; Centre Hospitalier Universitaire de Liège - CHU > Service de pneumologie - allergologie
PAULUS, Virginie ; Centre Hospitalier Universitaire de Liège - CHU > Service de pneumologie - allergologie
HENKET, Monique ; Centre Hospitalier Universitaire de Liège - CHU > Service de pneumologie - allergologie
Van Hees, Thierry ; Université de Liège > Département de pharmacie > Pharmacie clinique et pharmacie hospitalière
Louis, Renaud ; Université de Liège > Département des sciences cliniques > Pneumologie - Allergologie
Language :
English
Title :
Asthma Control and Sputum Eosinophils: A Longitudinal Study in Daily Practice.
Publication date :
2017
Journal title :
Journal of Allergy and Clinical Immunology: In Practice
ISSN :
2213-2198
eISSN :
2213-2201
Publisher :
Elsevier, Amsterdam, Netherlands
Volume :
5
Issue :
5
Pages :
1335-1343.e5
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright (c) 2017 The Authors. Published by Elsevier Inc. All rights reserved.
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