| アブストラクト | BACKGROUND: Type 2 low-severe asthma phenotype is often a result of corticosteroid-overtreated type 2 disease owing to persistent symptoms, often unrelated to asthma and unlikely to respond to high-dose corticosteroid treatment. OBJECTIVE: This study aimed to characterize patients with severe asthma with low eosinophil counts (<300 cells/muL) and describe their disease burden and treatment across health care settings in the United Kingdom. METHODS: A retrospective cohort study of patients with severe asthma using linked Clinical Practice Research Datalink (CPRD) Aurum-Hospital Episode Statistics (HES) and UK Severe Asthma Registry (UKSAR) data indexed patients according to the latest blood eosinophil count (BEC). Clinical characteristics, treatment patterns, outcomes, and health care resource use were described by baseline BEC (</=150 and >150 to <300 cells/muL). RESULTS: Analysis included 701 (CPRD-HES) and 1,546 (UKSAR) patients; 60.5% and 59.4% had BECs 150 cells/muL or less at baseline, respectively. Across BEC groups, the proportion with uncontrolled asthma (two or more exacerbations) at follow-up (12 months after the index) was 5.4% in CPRD-HES and 45.2% in UKSAR. Maintenance oral corticosteroid use remained high across BEC groups (CPRD-HES: 29.4%; UKSAR: 51.7%), symptom control remained poor (>200 mug short-acting beta(2) agonist or >500 mug terbutaline/d in CPRD-HES: 48.8%; median Asthma Control Questionnaire-6 score in UKSAR: 2.0 [range, 1.0-3.3]). Health care resource use was similar across BEC groups. CONCLUSIONS: Most patients managed in primary care experienced infrequent exacerbations, whereas UKSAR patients had frequent exacerbations. Large proportions of both patient groups had poor symptom control and continued to receive high levels of maintenance oral corticosteroids, increasing the risk of corticosteroid-induced morbidity. These data highlight the need for rigorous assessment of underlying disease pathology to guide appropriate treatment. |
|---|
| 投稿者 | Busby, John; Menon, Shruti; Martin, Neil; Lipworth, Joe; Zhang, Ruiqi; Burhan, Hassan; Brown, Thomas; Chaudhuri, Rekha; Gore, Robin; Jackson, David J; Naveed, Shamsa; Pantin, Thomas; Pfeffer, Paul E; Patel, Mitesh; Patel, Pujan H; Rupani, Hitasha; Heaney, Liam G |
|---|
| 組織名 | Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences,;Queen's University Belfast, Belfast, United Kingdom.;Medical and Scientific Affairs, AstraZeneca UK, London, United Kingdom.;BioPharmaceuticals Medical, AstraZeneca, Cambridge, United Kingdom; University of;Leicester, Respiratory Sciences, Leicester, United Kingdom.;Respiratory Medicine, Royal Liverpool Hospital, Liverpool, United Kingdom.;Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom.;Respiratory Medicine, Gartnavel General Hospital, School of Infection & Immunity,;University of Glasgow, Glasgow, United Kingdom.;Respiratory Medicine, Addenbrookes Hospital, Cambridge, United Kingdom.;Guy's Severe Asthma Centre, King's Centre for Lung Health, King's College London,;London, United Kingdom.;University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.;Respiratory Medicine, Wythenshawe Hospital, Manchester, United Kingdom.;St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom.;Respiratory Medicine, Derriford Hospital, Plymouth, United Kingdom.;Respiratory Medicine, Royal Brompton Hospital, London, United Kingdom.;University Hospitals Southampton NHS Foundation Trust, Southampton, United;Kingdom.;Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine,;Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United;Kingdom. Electronic address: l.heaney@qub.ac.uk. |
|---|
