Abstract
Background Identifying asthma patients suitable for biologic therapy includes the assessment of blood biomarkers (IgE and eosinophils (EOS)). How they relate to each other is unclear. Methods This retrospective, database study used routinely collected clinical data to identify and evaluate an asthma cohort (classification code for asthma; ≥ 18 years; ≥1 prescription for asthma; ≥1 estimation of serum IgE, in 2 years prior to index date). Distribution into high and low IgE and EOS groups (IgE cut-point: > or ≤75 kU/L; EOS cut point: >or ≤400 μ/L), and characteristics by group are described. Findings In patients with severe asthma (British Thoracic Society Step (BTS) ≥4; N = 884), using maximum recorded IgE/EOS, 33% had high IgE/high EOS, 28% low IgE/low EOS and approximately a fifth each had high IgE/low EOS or low IgE/high EOS. Proportions were similar when EOS values measured 2 or 4 weeks before an exacerbation were excluded. Using EOS/IgE ′same day’ measurements (N = 578) only identified half of the high EOS group. Patients in high IgE groups were more likely to be younger males without comorbid COPD; those in high EOS groups were more likely to be on BTS treatment Step 5 vs 4. The low IgE/low EOS group had the lowest incidence of asthma-related hospital attendances, the highest incidence was observed in the high EOS groups. Conclusion Maximum available EOS measurement irrespective of exacerbations may be relevant when considering therapy. These data showed low IgE/Low EOS to be more benign and high EOS groups at increased risk of frequent, severe exacerbations.
| Original language | English |
|---|---|
| Pages (from-to) | 117-123 |
| Number of pages | 7 |
| Journal | Respiratory Medicine |
| Volume | 134 |
| Early online date | 5 Dec 2017 |
| DOIs | |
| Publication status | Published - 1 Jan 2018 |
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Keywords
- Biologic therapy
- Eosinophils
- IgE
- Severe asthma
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
Cite this
A retrospective cohort study in severe asthma describing commonly measured biomarkers : Eosinophil count and IgE levels. / Haughney, John; Morice, Alyn; Blyth, Kevin G.; Lee, Amanda J.; Coutts, Alasdair; McKnight, Eddie; Pavord, Ian.
In: Respiratory Medicine, Vol. 134, 01.01.2018, p. 117-123.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A retrospective cohort study in severe asthma describing commonly measured biomarkers
T2 - Eosinophil count and IgE levels
AU - Haughney, John
AU - Morice, Alyn
AU - Blyth, Kevin G.
AU - Lee, Amanda J.
AU - Coutts, Alasdair
AU - McKnight, Eddie
AU - Pavord, Ian
N1 - Acknowledgements: The authors acknowledge editorial support in the form of assistance in the development of manuscript drafts, collating author comments and copyediting, which was provided by Kate Hollingworth of Continuous Improvement Ltd. This support was funded by NSHI.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background Identifying asthma patients suitable for biologic therapy includes the assessment of blood biomarkers (IgE and eosinophils (EOS)). How they relate to each other is unclear. Methods This retrospective, database study used routinely collected clinical data to identify and evaluate an asthma cohort (classification code for asthma; ≥ 18 years; ≥1 prescription for asthma; ≥1 estimation of serum IgE, in 2 years prior to index date). Distribution into high and low IgE and EOS groups (IgE cut-point: > or ≤75 kU/L; EOS cut point: >or ≤400 μ/L), and characteristics by group are described. Findings In patients with severe asthma (British Thoracic Society Step (BTS) ≥4; N = 884), using maximum recorded IgE/EOS, 33% had high IgE/high EOS, 28% low IgE/low EOS and approximately a fifth each had high IgE/low EOS or low IgE/high EOS. Proportions were similar when EOS values measured 2 or 4 weeks before an exacerbation were excluded. Using EOS/IgE ′same day’ measurements (N = 578) only identified half of the high EOS group. Patients in high IgE groups were more likely to be younger males without comorbid COPD; those in high EOS groups were more likely to be on BTS treatment Step 5 vs 4. The low IgE/low EOS group had the lowest incidence of asthma-related hospital attendances, the highest incidence was observed in the high EOS groups. Conclusion Maximum available EOS measurement irrespective of exacerbations may be relevant when considering therapy. These data showed low IgE/Low EOS to be more benign and high EOS groups at increased risk of frequent, severe exacerbations.
AB - Background Identifying asthma patients suitable for biologic therapy includes the assessment of blood biomarkers (IgE and eosinophils (EOS)). How they relate to each other is unclear. Methods This retrospective, database study used routinely collected clinical data to identify and evaluate an asthma cohort (classification code for asthma; ≥ 18 years; ≥1 prescription for asthma; ≥1 estimation of serum IgE, in 2 years prior to index date). Distribution into high and low IgE and EOS groups (IgE cut-point: > or ≤75 kU/L; EOS cut point: >or ≤400 μ/L), and characteristics by group are described. Findings In patients with severe asthma (British Thoracic Society Step (BTS) ≥4; N = 884), using maximum recorded IgE/EOS, 33% had high IgE/high EOS, 28% low IgE/low EOS and approximately a fifth each had high IgE/low EOS or low IgE/high EOS. Proportions were similar when EOS values measured 2 or 4 weeks before an exacerbation were excluded. Using EOS/IgE ′same day’ measurements (N = 578) only identified half of the high EOS group. Patients in high IgE groups were more likely to be younger males without comorbid COPD; those in high EOS groups were more likely to be on BTS treatment Step 5 vs 4. The low IgE/low EOS group had the lowest incidence of asthma-related hospital attendances, the highest incidence was observed in the high EOS groups. Conclusion Maximum available EOS measurement irrespective of exacerbations may be relevant when considering therapy. These data showed low IgE/Low EOS to be more benign and high EOS groups at increased risk of frequent, severe exacerbations.
KW - Biologic therapy
KW - Eosinophils
KW - IgE
KW - Severe asthma
UR - http://www.scopus.com/inward/record.url?scp=85037645205&partnerID=8YFLogxK
U2 - 10.1016/j.rmed.2017.12.001
DO - 10.1016/j.rmed.2017.12.001
M3 - Article
VL - 134
SP - 117
EP - 123
JO - Respiratory Medicine
JF - Respiratory Medicine
SN - 0954-6111
ER -