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Asthma similarities across ProAR (Brazil) and U-BIOPRED (Europe) adult cohorts of contrasting locations, ethnicity and socioeconomic status

2019; Elsevier BV; Volume: 161; Linguagem: Inglês

10.1016/j.rmed.2019.105817

1532-3064

Álvaro A. Cruz, John Riley, Aruna T. Bansal, Eduardo Vieira Ponte, Adelmir Souza‐Machado, Paula Almeida, Valmar Bião Lima, Maggie Davis, Stewart Bates, Ian M. Adcock, Peter J. Sterk, Kian Fan Chung, Neuza Maria Alcântara‐Neves, Paula Almeida, Leila Denise Alves Ferreira Amorim, Maria Ilma Araújo, Kathleen C. Barnes, Maurício L. Barreto, Emília Maria Medeiros de Andrade Belitardo, Valmar Bião Lima, Luciana Santos Cardoso, Paulo Augusto Moreira Camargos, José Miguel Chatkin, Rosanne Costa, Ana Carla Carvalho Coelho, Philip J. Cooper, Álvaro A. Cruz, Constança Sampaio Cruz, João Pedro Arantes da Cunha, J.V. de Jesus, Jamille Souza Fernandes, Rosana Franco, Isaac Suzart Gomes‐Filho, Aline Lima-Matos, Camila Alexandrina Figueiredo, M.A. Lessa, Liliane Lins-Kusterer, Luane Marques de Mello, P. Moura-Santos, Ila Sobral Muniz, I. Paixao-Araujo, Gabriela Pimentel Pinheiro, Eduardo Vieira Ponte, Liziane Rodrigues, Cínthia Vila Nova Santana, G. Santos-Lima, T.M.O. Souza, Adelmir Souza‐Machado, Carolina Souza‐Machado, Rafaël Stelmach, Víctor Vásquez, Ian M. Adcock, Hassan Ahmed, Charles Auffray, Per Bakke, Fred Baribaud, EH Bel, Jeanette Bigler, Hans Bisgaard, Michael Boedigheimer, Klaus Bønnelykke, Joost Brandsma, Paul Brinkman, Enrica Bucchioni, Dominic Burg, Andrew Bush, Massimo Caruso, Amphun Chaiboonchoe, Pascal Chanez, C.H. Compton, Julie Corfield, A. D’Amico, Barbro Dahlén, Sven‐Erik Dahlén, Bertrand De Meulder, Ratko Djukanović, V.J. Erpenbeck, Damijan Eržen, K. Fichtner, Neil Fitch, Louise Fleming, E. Formaggio, Stephen J. Fowler, Urs Frey, Martina Gahlemann, Thomas Geiser, Victoria Goss, Yi Ke Guo, Simone Hashimoto, John Haughney, Gunilla Hedlin, Pieter‐Paul Hekking, T. W. Higenbottam, J.M. Hohlfeld, Cécile Holweg, Ildikó Horváth, Peter Howarth, A.J. James, Richard G. Knowles, Alan J. Knox, N Krug, Diane Lefaudeux, Matthew J. Loza, R. Lutter, Alexander Manta, Sarah Masefield, J.G. Matthews, Alexander Mazein, Andrea Meiser, Roelinde Middelveld, M. Miralpeix, Paolo Montuschi, Nadia Mores, Clare Murray, J. Musial, David Myles, Laurie Pahus, Ioannis Pandis, Stelios Pavlidis, Anthony D. Postle, P. Powel, G. Praticò, M. Puig Valls, Navin Rao, Amanda Roberts, Graham Roberts, Anthony Rowe, Thomas Sandström, James Schofield, Wolfgang Seibold, Anna Selby, Dominick Shaw, Ralf Sigmund, Florian Singer, Paul Skipp, Ana R. Sousa, Peter J. Sterk, Kai Sun, Bob Thornton, W. M. van Aalderen, Marleen van Geest, Jørgen Vestbo, Nadja Hawwa Vissing, Ariane H. Wagener, Scott Wagers, Z. Weiszhart, Craig E. Wheelock, Susan J. Wilson,

Delphi Technique in Research

BackgroundAsthma prevalence is 339 million globally. 'Severe asthma' (SA) comprises subjects with uncontrolled asthma despite proper management.ObjectivesTo compare asthma from diverse ethnicities and environments.MethodsA cross-sectional analysis of two adult cohorts, a Brazilian (ProAR) and a European (U-BIOPRED). U-BIOPRED comprised of 311 non-smoking with Severe Asthma (SAn), 110 smokers or ex-smokers with SA (SAs) and 88 mild to moderate asthmatics (MMA) while ProAR included 544 SA and 452 MMA. Although these projects were independent, there were similarities in objectives and methodology, with ProAR adopting operating procedures of U-BIOPRED.ResultsAmong SA subjects, age, weight, proportion of former smokers and FEV1 pre-bronchodilator were similar. The proportion of SA with a positive skin prick tests (SPT) to aeroallergens, the scores of sino-nasal symptoms and quality of life were comparable. In addition, blood eosinophil counts (EOS) and the % of subjects with EOS > 300 cells/μl were not different. The Europeans with SA however, were more severe with a greater proportion of continuous oral corticosteroids (OCS), worse symptoms and more frequent exacerbations. FEV1/FVC pre- and post-bronchodilator were lower among the Europeans. The MMA cohorts were less comparable in control and treatment, but similar in the proportion of allergic rhinitis, gastroesophageal reflux disease and EOS >3%.ConclusionsProAR and U-BIOPRED cohorts, with varying severity, ethnicity and environment have similarities, which provide the basis for global external validation of asthma phenotypes. This should stimulate collaboration between asthma consortia with the aim of understanding SA, which will lead to better management.