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Abstract
U-BIOPRED is a European Union consortium of 20 academic institutions, 11 pharmaceutical companies and six patient organisations with the objective of improving the understanding of asthma disease mechanisms using a systems biology approach.This cross-sectional assessment of adults with severe asthma, mild/moderate asthma and healthy controls from 11 European countries consisted of analyses of patient-reported outcomes, lung function, blood and airway inflammatory measurements.Patients with severe asthma (nonsmokers, n=311; smokers/ex-smokers, n=110) had more symptoms and exacerbations compared to patients with mild/moderate disease (n=88) (2.5 exacerbations versus 0.4 in the preceding 12 months; p<0.001), with worse quality of life, and higher levels of anxiety and depression. They also had a higher incidence of nasal polyps and gastro-oesophageal reflux with lower lung function. Sputum eosinophil count was higher in severe asthma compared to mild/moderate asthma (median count 2.99% versus 1.05%; p=0.004) despite treatment with higher doses of inhaled and/or oral corticosteroids.Consistent with other severe asthma cohorts, U-BIOPRED is characterised by poor symptom control, increased comorbidity and airway inflammation, despite high levels of treatment. It is well suited to identify asthma phenotypes using the array of "omic" datasets that are at the core of this systems medicine approach.
Highlights
A substantial number of patients with asthma require systemic corticosteroids to control symptoms and/or suffer from poor control and frequent severe exacerbations despite currently available treatment [1, 2]
We present the baseline characteristics of the adult participants with severe asthma who form the majority of the U-BIOPRED cohort and compare these participants with those suffering from mild/moderate disease, in terms of their clinical, symptomatic, functional and biomarker features
The clinical characteristics of asthma were present despite higher doses of treatment that included doses of inhaled corticosteroids equal or more than 1000 μg of fluticasone, with 45% of the combined severe asthma group receiving a daily dose of prednisolone
Summary
A substantial number of patients with asthma require systemic corticosteroids to control symptoms and/or suffer from poor control and frequent severe exacerbations despite currently available treatment [1, 2]. The aim of U-BIOPRED is to identify multi-dimensional phenotypes of severe asthma and new treatment targets using a combination of state of the art “omics” (transcriptomic, proteomic, lipidomic and metabolomic) technologies applying a systems biology approach [8], thereby driving unbiased discovery in both adult and paediatric severe asthma [9]. This novel approach is designed to make drug development more effective and efficient
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