Clinical outcomes in non-eosinophilic versus eosinophilic asthma after 12 months specialist management

Abstract

Background Non-eosinophilic asthma is reported to be less responsive to steroid treatment than eosinophilic asthma, but little prospective evidence is available from real life populations. Aim: To compare the clinical outcomes in patients with non-eosinophilic asthma (NEA) versus eosinophilic asthma (EA), after 12 months asthma management in a specialist setting. Methods: Asthma patients referred to a specialist outpatient clinic at a university hospital were consecutively enrolled, and FeNO, asthma control (ACQ score), and airway hyperresponsiveness to mannitol (AHR) were assessed at baseline and after 12 months follow-up. NEA was defined as a FeNO 25 ppb at inclusion. Results: A total of 96 asthma patients (Females: 57%, age: 28 years (15-63)) were followed, of whom 62 (65%) had NEA, and 34 (35%) had EA. At baseline, the level of asthma control and AHR to mannitol was comparable in the two groups. At follow-up, both patients with NEA and EA reported significant improvements in ACQ score (NEA: 1.17 (±0.74) to 0.92 (±0.90), p= 0.01, EA: 1.31 (±1.2) to 0.85 (±0.90), p=0.03). Furthermore, AHR to mannitol decreased significantly in both groups (RDR: NEA: 0.17 (±0.85) to 0.03 (±0.07), p Conclusion: Patients with non-eosinophilic asthma experience an improvement in asthma control and airway hyperresponsiveness after 12 months of specialist management that is comparable to patients with eosinophilic asthma, indicating that NEA and EA are equally responsive to treatment in a real-life setting.