Abstract
The aim of this study was to identify asthma phenotypes through cluster analysis. Cluster analysis was performed using self-reported characteristics from a cohort of 1291 Swedish asthma patients. Disease burden was measured using the Asthma Control Test (ACT), the mini Asthma Quality of Life Questionnaire (mini-AQLQ), exacerbation frequency and asthma severity. Validation was performed in 748 individuals from the same geographical region. Three clusters; early onset predominantly female, adult onset predominantly female and adult onset predominantly male, were identified. Early onset predominantly female asthma had a higher burden of disease, the highest exacerbation frequency and use of inhaled corticosteroids. Adult onset predominantly male asthma had the highest mean score of ACT and mini-AQLQ, the lowest exacerbation frequency and higher proportion of subjects with mild asthma. These clusters, based on information from clinical questionnaire data, might be useful in primary care settings where the access to spirometry and biomarkers is limited.
Highlights
Despite progress in asthma treatment, the number of patients with poorly controlled disease remains high[1]
Two-thirds of all patients with asthma were under the care of a primary care physician
Cluster analysis in discovery cohort The cluster analysis of the discovery cohort resulted in identification of three clusters, as three clusters gave the highest silhouette distance
Summary
Despite progress in asthma treatment, the number of patients with poorly controlled disease remains high[1] One reason for this is the heterogeneous character of the disease, involving complex pathophysiological processes[2]. The majority of previous research has been conducted using multiple measurements such as sputum, serum and bronchoalveolar lavage fluid cell counts and biomarkers, exhaled nitric oxide (FENO), pulmonary function tests and genetic data[5,6]. The majority of those phenotypes have been studied in patients severe asthma and have not been validated in an independent cohort. The majority of patients with asthma are detected, treated and followed-up in primary care where there usually is no access to complex data[3,7]
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