
Having concomitant asthma phenotypes is common and independently relates to poor lung function in NHANES 2007–2012
Author(s) -
Amaral Rita,
Fonseca João A.,
Jacinto Tiago,
Pereira Ana M.,
Malinovschi Andrei,
Janson Christer,
Alving Kjell
Publication year - 2018
Publication title -
clinical and translational allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.979
H-Index - 37
ISSN - 2045-7022
DOI - 10.1186/s13601-018-0201-3
Subject(s) - medicine , asthma , national health and nutrition examination survey , concomitant , confounding , population , pulmonary function testing , pediatrics , environmental health
Background Evidence for distinct asthma phenotypes and their overlap is becoming increasingly relevant to identify personalized and targeted therapeutic strategies. In this study, we aimed to describe the overlap of five commonly reported asthma phenotypes in US adults with current asthma and assess its association with asthma outcomes. Methods Data from the National Health and Nutrition Examination Surveys (NHANES) 2007–2012 were used (n = 30,442). Adults with current asthma were selected. Asthma phenotypes were: B‐Eos‐high [if blood eosinophils (B‐Eos) ≥ 300/mm 3 ]; FeNO‐high (FeNO ≥ 35 ppb); B‐Eos&FeNO‐low (B‐Eos < 150/mm 3 and FeNO < 20 ppb); asthma with obesity (AwObesity) (BMI ≥ 30 kg/m 2 ); and asthma with concurrent COPD. Data were weighted for the US population and analyses were stratified by age (< 40 and ≥ 40 years old). Results Of the 18,619 adults included, 1059 (5.6% [95% CI 5.1–5.9]) had current asthma. A substantial overlap was observed both in subjects aged < 40 years (44%) and ≥ 40 years (54%). The more prevalent specific overlaps in both age groups were AwObesity associated with either B‐Eos‐high (15 and 12%, respectively) or B‐Eos&FeNO‐low asthma (13 and 11%, respectively). About 14% of the current asthma patients were “non‐classified”. Regardless of phenotype classification, having concomitant phenotypes was significantly associated with (adjusted OR, 95% CI) ≥ 2 controller medications (2.03, 1.16–3.57), and FEV 1 < LLN (3.21, 1.74–5.94), adjusted for confounding variables. Conclusions A prevalent overlap of commonly reported asthma phenotypes was observed among asthma patients from the general population, with implications for objective asthma outcomes. A broader approach may be required to better characterize asthma patients and prevent poor asthma outcomes.