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

Alvaro A. Cruz*, John H. Riley, Aruna T. Bansal, Eduardo V. Ponte, Adelmir Souza-Machado, Paula C.A. Almeida, Valmar Biao-Lima, Maggie Davis, Stewart Bates, Ian M. Adcock, Peter J. Sterk, Kian Fan Chung, ProAR Study Group, U-BIOPRED Study Groups, N. Alcantara-Neves, P. C.A. Almeida, L. Amorim, M. I. Araujo, K. C. Barnes, M. L. BarretoE. Belitardo, V. Bião-Lima, L. Cardoso, P. A. Camargos, J. M. Chatkin, R. S. Costa, A. C.C. Coelho, P. J. Cooper, A. A. Cruz, C. S. Cruz, J. Cunha, J. V. de Jesus, J. Fernandes, R. A. Franco, I. Gomes-Filho, A. Lima-Matos, C. A. Figueiredo, M. A. Lessa, L. Lins, L. M. Mello, P. Moura-Santos, I. S. Muniz, I. Paixao-Araujo, G. P. Pinheiro, E. V. Ponte, L. C. Rodrigues, C. V.N. Santana, G. Santos-Lima, T. M.O. Souza, A. Souza-Machado, C. Souza-Machado, Yi-Ke GUO

*Corresponding author for this work

    Research output: Contribution to journalJournal articlepeer-review

    17 Citations (Scopus)

    Abstract

    Background: Asthma prevalence is 339 million globally. ‘Severe asthma’ (SA) comprises subjects with uncontrolled asthma despite proper management. Objectives: To compare asthma from diverse ethnicities and environments. Methods: A 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. Results: Among 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%. Conclusions: ProAR 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.

    Original languageEnglish
    Article number105817
    JournalRespiratory Medicine
    Volume161
    DOIs
    Publication statusPublished - Jan 2020

    Scopus Subject Areas

    • Pulmonary and Respiratory Medicine

    User-Defined Keywords

    • Asthma
    • Biomarkers
    • Cohort studies
    • Cross sectional study
    • Disease management
    • Phenotypes

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