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Phenotype Classification Based on Risk Factors for Asthma Exacerbation Factors in Japanese Patients with Severe Asthma
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A1900 - Phenotype Classification Based on Risk Factors for Asthma Exacerbation Factors in Japanese Patients with Severe Asthma
Author Block: M. Kuwae1, K. Fukunaga1, T. Kamatani1, R. Watanabe1, S. Okuzumi1, R. Baba1, T. Tanosaki1, M. Matsuzaka1, T. Mochimaru1, S. Ueda1, Y. Suzuki2, K. Asano3, T. Betsuyaku1; 1Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan, 2Division of Pulmonary Medicine, Kitasato University Kitasato Institute Hospital, Tokyo, Japan, 3Division of Pulmonary Medicine, Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan.
Introduction In recent years, asthma has been considered as a disease with diverse pathologies. Phenotype classification is a useful method to represent the underlying endotype. However, only few reports have described phenotype classification based on exacerbation factors. Objective This study aimed to classify phenotypes observed in Japanese patients with severe asthma on the basis on asthma exacerbation factors and to clarify the characteristics of each cluster. Methods Among the asthma patients registered at Keio University Hospital and related facilities between April 2010 and March 2016, 197 patients aged >20 years who needed step 4 or 5 treatment as defined by the Gold Initiative for Asthma 2017 were defined as having severe asthma. These patients were clustered using the k-means method based on the 19 asthma exacerbation factors reported previously. Results On the basis on the cluster analysis results, we classified the patients into three groups. The first group consisting of those who developed asthma in their youth. These patients exhibited atopic dermatitis and low eosinophil level in serum. They had normal FEV1(forced expiratory volume in 1 second) levels, but a high frequency of asthma attacks, alcohol-induced asthma, and low adherence to medication. The second group consisting of those who developed asthma in old age. This group had a higher prevalence of ex-smokers than the other groups. Patients in this group had a low frequency of asthma attacks, but showed decreasing FEV1 levels over time. The third group consisting of those who developed asthma in adulthood and exhibited low FEV1 levels, high frequency of asthma attacks, and high airway reversibility and activity restriction according to the questionnaire surveys. Conclusion Phenotype classification based on asthma exacerbation risk factors revealed some new clusters in patients with severe asthma.
Author Block: M. Kuwae1, K. Fukunaga1, T. Kamatani1, R. Watanabe1, S. Okuzumi1, R. Baba1, T. Tanosaki1, M. Matsuzaka1, T. Mochimaru1, S. Ueda1, Y. Suzuki2, K. Asano3, T. Betsuyaku1; 1Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan, 2Division of Pulmonary Medicine, Kitasato University Kitasato Institute Hospital, Tokyo, Japan, 3Division of Pulmonary Medicine, Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan.
Introduction In recent years, asthma has been considered as a disease with diverse pathologies. Phenotype classification is a useful method to represent the underlying endotype. However, only few reports have described phenotype classification based on exacerbation factors. Objective This study aimed to classify phenotypes observed in Japanese patients with severe asthma on the basis on asthma exacerbation factors and to clarify the characteristics of each cluster. Methods Among the asthma patients registered at Keio University Hospital and related facilities between April 2010 and March 2016, 197 patients aged >20 years who needed step 4 or 5 treatment as defined by the Gold Initiative for Asthma 2017 were defined as having severe asthma. These patients were clustered using the k-means method based on the 19 asthma exacerbation factors reported previously. Results On the basis on the cluster analysis results, we classified the patients into three groups. The first group consisting of those who developed asthma in their youth. These patients exhibited atopic dermatitis and low eosinophil level in serum. They had normal FEV1(forced expiratory volume in 1 second) levels, but a high frequency of asthma attacks, alcohol-induced asthma, and low adherence to medication. The second group consisting of those who developed asthma in old age. This group had a higher prevalence of ex-smokers than the other groups. Patients in this group had a low frequency of asthma attacks, but showed decreasing FEV1 levels over time. The third group consisting of those who developed asthma in adulthood and exhibited low FEV1 levels, high frequency of asthma attacks, and high airway reversibility and activity restriction according to the questionnaire surveys. Conclusion Phenotype classification based on asthma exacerbation risk factors revealed some new clusters in patients with severe asthma.
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