A retrospective cohort study in severe asthma describing commonly measured biomarkers: Eosinophil count and IgE levels.

Haughney, J., Morice, A., Blyth, K. G. , Lee, A. J., Coutts, A., McKnight, E. and Pavord, I. (2018) A retrospective cohort study in severe asthma describing commonly measured biomarkers: Eosinophil count and IgE levels. Respiratory Medicine, 134, pp. 117-123. (doi:10.1016/j.rmed.2017.12.001) (PMID:29413497)

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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.

Item Type:Articles
Keywords:Biologic therapy, Eosinophils, IgE, Severe asthma
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Blyth, Dr Kevin
Authors: Haughney, J., Morice, A., Blyth, K. G., Lee, A. J., Coutts, A., McKnight, E., and Pavord, I.
College/School:College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
Journal Name:Respiratory Medicine
Publisher:Elsevier Ltd
ISSN:0954-6111
ISSN (Online):1532-3064
Published Online:05 December 2017
Copyright Holders:Copyright © 2017 Elsevier
First Published:First published in Respiratory Medicine 134:117-123
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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