Respiratory Research volume 22 , Article number: Cite this article. Metrics details. In France, data regarding epidemiology and management of severe asthma are scarce. The objective of this study was to describe asthma phenotypes using a cluster analysis in severe asthmatics recruited in a real world setting.
The study design was prospective, observational and multicentric. One hundred and seven physicians included patients. Both sociodemographic and clinical variables were collected. Hierarchical cluster analysis was performed by the Ward method followed by k-means cluster analysis on a population of patients.
In our population of adults with severe asthma followed by pulmonologists, five distinct phenotypes were identified and are quite different from those mentioned in previous studies. Asthma is a heterogeneous disease that presents with a variety of symptoms and variable response to medication. Management of mild to moderate asthma is based on the same treatment for each patient, variable according to asthma control and exacerbations risk [ 1 ] GINA By contrast, as patients with difficult-to-treat asthma or severe asthma had a high rate of exacerbations and poor asthma control and poor quality of life despite management, improvement in therapeutic management had leaded to better understanding in asthma phenotypes.
A decade ago, asthma phenotypes were defined by two criteria i. Since then, Enfumosa Network [ 2 ] identified that patients with chronic severe asthma were more likely to be female, overweighted, less atopic and pointed out exposure to aspirin for some subjects. The SARP consortium in USA identified three clusters in adult patients with severe asthma [ 3 ]: early onset allergic asthma, late onset non-atopic asthma, severe asthma with fixed airflow.
Interestingly, associations were made between asthma phenotypes and asthma-related health outcomes i. In these phenotypes, atopic status but also non-white race were distinguishing variables for both children and adolescents.
