Disease burden of people with uncontrolled severe asthma with and without biomarkers of inflammation

What is it about?

Asthma is a long-term condition that affects the lungs. People with asthma can be grouped based on whether their doctor thinks their asthma is mild, moderate, or severe. They can also be grouped based on whether their asthma symptoms are uncontrolled or controlled. This can be assessed by filling in a questionnaire about how their asthma has been in the past 4 weeks, and by counting the number of severe asthma flare-ups in the previous year. Most people with asthma have biological markers of inflammation, known as biomarkers, including history of allergy, high levels of white blood cells, known as eosinophils, and high levels of nitric oxide in their exhaled breath. In this study, people with uncontrolled severe asthma were grouped by the presence or absence of these biomarkers. We found that people with uncontrolled severe asthma with low levels of eosinophils or with no biomarkers had a similar burden of disease as people with one or more of these biomarkers.

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Why is it important?

Our findings show that uncontrolled severe asthma has a heavy burden on people, regardless of their biomarkers, with people experiencing more asthma-related flare-ups, more doctor visits, more breathlessness, and worse overall health compared with people with controlled severe asthma. A large proportion of people with uncontrolled severe asthma had low levels of eosinophils or no biomarkers; since biomarkers are used as eligibility criteria for certain treatments, these people have the fewest treatment options available. Therefore, the needs of both of these groups of people should be evaluated and addressed.