Point-of-care blood eosinophil count in a severe asthma clinic setting

2017 ◽  
Vol 119 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Enrico Heffler ◽  
Giovanni Terranova ◽  
Carlo Chessari ◽  
Valentina Frazzetto ◽  
Claudia Crimi ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Eosinophil Count ◽  
Point Of Care ◽  
Blood Eosinophil ◽  
Blood Eosinophil Count ◽  
Clinic Setting

Blood eosinophil count and FeNO to predict benralizumab effectiveness in real-life severe asthma patients

2021 ◽  
pp. 1-12
Author(s):  
Hirofumi Watanabe ◽  
Toshihiro Shirai ◽  
Keita Hirai ◽  
Taisuke Akamatsu ◽  
Hiromasa Nakayasu ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Eosinophil Count ◽  
Real Life ◽  
Blood Eosinophil ◽  
Blood Eosinophil Count ◽  
Asthma Patients

scholarly journals Saudi Arabian real-life experience with biologic therapy in severe asthma

2021 ◽  
Vol 16 ◽  
Author(s):  
Safwat Eldaboussi ◽  
Ahmed Qabil ◽  
Ahmed Lotfi ◽  
Amgad Awad ◽  
Eman Abdel Salam ◽  
...  
Keyword(s):  
Observational Study ◽  
Asthma Control ◽  
Severe Asthma ◽  
Eosinophil Count ◽  
Biologic Therapy ◽  
Blood Eosinophil ◽  
Blood Eosinophil Count ◽  
Asthma Exacerbations ◽  
Percent Improvement

Background: Severe asthma (SA) is a common health problem associated with increased morbidity and mortality and high medical costs. Biological therapies have emerged in recent decades as promising treatment options for patients with high type 2 (T2) SA. This retrospective observational study from Saudi Arabia aimed to investigate the effects of additional biologics therapy on reducing oral corticosteroid (OCS) consumption, frequency of asthma exacerbations, improvement in lung function, and asthma control.Methods: This multicenter observational study enrolled a cohort of 97 patients from Mach 2019 to February 2021. Outcomes of anti-IgE, anti-IL5/IL5R, and anti-IL4R therapies in severe type 2 asthma were recorded and analyzed in terms of number of exacerbations (emergency visits or hospitalizations required), asthma symptoms, and use of oral corticosteroids, blood eosinophil count, asthma control according to GINA classification, and FEV1 before and during biologic therapy.Results:  Ninety-seven patients were included in the analysis The mean age was 46.7±14.1 years, and 69.1% of them were female. The average duration of biological treatment was 16.4±6.8 months. At the time of data collection, the four biologic therapies reduced the exacerbation rate per year from 82/97 (84.5%) to 14/97 (14.4%) with a percent improvement of 83% from 2.9 per year in the year before biologic treatment to 1.6 per year (p<0.001). OCS was reduced from 75/97 (77.3%) to 10/97 (10.3%) for a percent improvement of 86.7%, and the average OCS dose decreased from 7.12 mg to 6.8 mg. Mean blood eosinophil count also decreased after biologic therapy from 750.5±498.5 to 188.0±122.4 cells/μl, most significant result achieved with benralizumab, and mean FEV1 improved from 59.0±12.9% to 76.0±10.2%, most significant result achieved with omalizumab.  ll patients had uncontrolled asthma before biologics therapy, but asthma control improved by 91.8% after treatment.Conclusions: Biologic as add-on therapy for high T2 SA was found to reduce asthma exacerbations, systemic glucocorticoid doses, and SA symptoms.

scholarly journals Real-life effects of benralizumab on allergic chronic rhinosinusitis and nasal polyposis associated with severe asthma

2020 ◽  
Vol 34 ◽  
pp. 205873842095085 ◽  
Author(s):  
Nicola Lombardo ◽  
Corrado Pelaia ◽  
Marco Ciriolo ◽  
Marcello Della Corte ◽  
Giovanna Piazzetta ◽  
...  
Keyword(s):  
Allergic Asthma ◽  
Chronic Rhinosinusitis ◽  
Severe Asthma ◽  
Eosinophil Count ◽  
Nasal Polyposis ◽  
Rating Scale ◽  
Real Life ◽  
Blood Eosinophil ◽  
Blood Eosinophil Count ◽  
Snot 22

The aim of this study has been to evaluate the efficacy of the IL-5 receptor blocker benralizumab on chronic rhinosinusitis with nasal polyposis (CRSwNP), associated with severe eosinophilic allergic asthma. Ten patients with severe eosinophilic allergic asthma and CRSwNP were enrolled. Sino-nasal outcome test (SNOT-22), numerical rating scale (NRS), endoscopic nasal polyp score, Lund Mackey CT (computed tomography) score, and blood eosinophil count were measured at baseline and after 24 weeks of treatment with benralizumab. All the above clinical, endoscopic, imaging, and hematological parameters significantly improved after 24 weeks of treatment with benralizumab. In particular, SNOT-22 decreased from 61.10 ± 17.20 to 26.30 ± 19.74 ( P < 0.001), NRS decreased from 7.20 ± 1.55 to 3.40 ± 2.22 ( P < 0.001), the endoscopic polyp nasal score decreased from 4.20 ± 1.32 to 2.50 ± 1.78 ( P < 0.001), the Lund-Mackay CT score decreased from 16.60 ± 5.50 to 6.90 ± 5.99 ( P < 0.001), and blood eosinophil count decreased from 807.3 ± 271.1 cells/μL to 0 cells/μL ( P < 0.0001). These results strongly suggest that benralizumab exerted a very effective therapeutic action on CRSwNP associated with severe asthma, thus improving nasal symptoms and decreasing polyp size.

Prevalence of Asthma-COPD Overlap in COPD and Severe Asthma Cohorts

2021 ◽  
Author(s):  
Hyonsoo Joo ◽  
So-Young Park ◽  
So Young Park ◽  
Seo Young Park ◽  
Sang-Heon Kim ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Eosinophil Count ◽  
Clinical Manifestations ◽  
Forced Expiratory Volume ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Obstructive Pulmonary Disease ◽  
Blood Eosinophil Count ◽  
Bronchodilator Response

Abstract Background: Asthma and chronic obstructive pulmonary disease (COPD) are airway diseases with similar clinical manifestations, despite differences in pathophysiology. Asthma-COPD overlap (ACO) is a condition characterized by overlapping clinical features of both diseases. There have been few reports regarding the prevalence of ACO in COPD and severe asthma cohorts. ACO is heterogeneous; patients can be classified on the basis of phenotype differences. This study was performed to analyze the prevalence of ACO in COPD and severe asthma cohorts. In addition, this study compared baseline characteristics among ACO patients according to phenotype.Methods: Patients with COPD were prospectively enrolled into the Korean COPD subgroup study (KOCOSS) cohort. Patients with severe asthma were prospectively enrolled into the Korean Severe Asthma Registry (KoSAR). ACO was defined in accordance with the updated Spanish criteria. In the COPD cohort, ACO was defined as bronchodilator response (BDR) ≥ 15% and ≥ 400 mL from baseline or blood eosinophil count ≥ 300 cells/μL. In the severe asthma cohort, ACO was defined as age ≥ 35 years, smoking ≥ 10 pack-years, and post-bronchodilator forced expiratory volume in 1 s/forced vital capacity < 0.7. Patients with ACO were divided into four groups according to smoking history (threshold: 20 pack-years) and blood eosinophil count (threshold: 300 cells/μL).Results: The prevalence of ACO significantly differed between the COPD and severe asthma cohorts (19.8% [365/1839] vs. 12.5% [104/832], respectively, P < 0.001). The numbers of patients in each group were as follows: Group A (smoking 10–20 pack-years and blood eosinophil count ≥ 300 cells/μL), 42 (9.1%); Group B (smoking 10–20 pack-years and eosinophil count < 300 cells/μL), 17 (3.7%); Group C (smoking ≥ 20 pack-years and eosinophil count ≥ 300 cells/μL), 341 (73.8%); and Group D (smoking ≥ 20 pack-years and eosinophil count < 300 cells/μL), 62 (13.4%). Age, sex, BDR, comorbidities, and medications significantly differed among the four groups.Conclusion: The prevalence of ACO differed between COPD and severe asthma cohorts. ACO patients can be classified into four phenotype groups, such that each phenotype exhibits distinct characteristics.

scholarly journals Eosinophils Target Therapy for Severe Asthma: Critical Points

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
L. Brussino ◽  
E. Heffler ◽  
C. Bucca ◽  
S. Nicola ◽  
G. Rolla
Keyword(s):  
Severe Asthma ◽  
Eosinophil Count ◽  
Inhaled Corticosteroids ◽  
Response To Treatment ◽  
High Dose ◽  
Blood Eosinophil ◽  
Moderate Increase ◽  
Eosinophilic Asthma ◽  
Peripheral Blood Eosinophil ◽  
Blood Eosinophil Count

Asthma is a chronic and heterogeneous disease, which is defined as severe disease whenever it requires treatment with a high dose of inhaled corticosteroids plus a second controller and/or systemic corticosteroids to prevent it from becoming ‘‘uncontrolled’’ or if it remains ‘‘uncontrolled’’ despite this therapy. Severe asthma is a heterogeneous condition consisting of phenotypes such as eosinophilic asthma, which is characterized by sputum eosinophilia, associated with mild to moderate increase in blood eosinophil count, frequently adult-onset, and associated with chronic rhinosinusitis with nasal polyps in half of the cases. Eosinophilic asthma is driven by T2 inflammation, characterized, among the others, by interleukin-5 production. IL-5 plays a key role in the differentiation, survival, migration, and activation of eosinophils, and it has become an appealing therapeutic target for eosinophilic asthma. In recent years two monoclonal antibodies (mepolizumab and reslizumab) directed against IL-5 and one monoclonal antibody directed against the alpha-subunit of the IL-5 receptor (benralizumab) have been developed. All these IL-5 target drugs have been shown to reduce the number of exacerbation in patients with severe asthma selected on the basis of peripheral blood eosinophil count. There are still a number of unresolved issues related to the anti-IL5 strategy in eosinophilic asthma, which are here reviewed. These issues include the effects of such therapy on airway obstruction and asthmatic symptoms, the level of baseline eosinophils that predicts a response to treatment, the relationship between blood and airway eosinophilia, and, perhaps most importantly, how to elucidate the pathogenetic role played by eosinophils in the individual patient with severe eosinophilic asthma.

scholarly journals Xenon ventilation MRI in difficult asthma; initial experience in a clinical setting

2021 ◽  
pp. 00785-2020
Author(s):  
Grace T. Mussell ◽  
Helen Marshall ◽  
Laurie J. Smith ◽  
Alberto M. Biancardi ◽  
Paul J.C. Hughes ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Clinical Setting ◽  
Eosinophil Count ◽  
Pulmonary Function Tests ◽  
Clinical Care ◽  
Quantitative Mri ◽  
Blood Eosinophil ◽  
Mri Imaging ◽  
Blood Eosinophil Count ◽  
Complementary Method

BackgroundHyperpolarised gas MRI can be used to assess ventilation patterns. Previous studies have shown the image derived metric of ventilation defect percent (VDP) to correlate with FEV1/FVC and FEV1 in asthma.ObjectivesTo explore the utility of hyperpolarised xenon-129 (129Xe) ventilation MRI in clinical care and examine its relationship with spirometry and other clinical metrics in people seen in a severe asthma service.Methods26 people referred from a severe asthma clinic for MRI scanning were assessed by contemporaneous 129Xe MRI and spirometry. A sub-group of 18 patients also underwent reversibility testing with spirometry and MRI. Quantitative MRI measures of ventilation were calculated; VDP and the ventilation heterogeneity index (VHI), and compared to spirometry, ACQ7 and blood eosinophil count. Images were reviewed by a multidisciplinary team.ResultsVDP and VHI correlated with FEV1, FEV1/FVC and FEF25–75% but not with ACQ7 or blood eosinophil count. Discordance of MRI imaging and symptoms and/or pulmonary function tests also occurred, prompting diagnostic re-evaluation in some cases.ConclusionHyperpolarised gas MRI provides a complementary method of assessment in people with difficult to manage asthma in a clinical setting. When used as a tool supporting clinical care in a severe asthma service, occurrences of discordance between symptoms, spirometry and MRI scanning indicate how MRI scanning may add to a management pathway.

scholarly journals Implication of fraction of exhaled nitric oxide and blood eosinophil count in severe asthma

2018 ◽  
Vol 67 ◽  
pp. S3-S11 ◽  
Author(s):  
Tomoyuki Soma ◽  
Hidetoshi Iemura ◽  
Erika Naito ◽  
Sachiko Miyauchi ◽  
Yoshitaka Uchida ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Severe Asthma ◽  
Eosinophil Count ◽  
Exhaled Nitric Oxide ◽  
Blood Eosinophil ◽  
Blood Eosinophil Count
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