TABLE 2.
Baseline pre-biologics characteristics of those who meet remission versus those who do not meet remission at annual review (n=830) (remission definition: Asthma Control Questionnaire (ACQ)-5 <1.5, and no maintenance oral corticosteroids (mOCS) or OCS bursts, and forced expiratory volume in 1 s (FEV1) above lower limit of normal or ≤100 mL less than pre-biologics FEV1)
| n | Category |
Non-remission
(81.7% (n=678)) |
Remission
(18.3% (n=152)) |
p-value | |
| Time to first annual review (years) | 830 | 1.1 (1.0–1.4) | 1.1 (1.0–1.2) | 0.097 | |
| Sex | 830 | Female | 412 (60.8) | 77 (50.7) | 0.022 |
| Age at first assessment (years) | 830 | 51.0 (41.0–59.0) | 55.0 (48.0–65.0) | <0.001 | |
| Age at onset of symptoms (years) | 737 | 20.0 (6.0–39.0) | 32.0 (14.0–52.0) | <0.001 | |
| Duration of symptoms from baseline (years) | 737 | 24.5 (12.0–37.0) | 20.0 (8.0–32.0) | 0.008 | |
| Ethnicity | 828 | White | 583 (86.2) | 141 (92.8) | 0.028 |
| Smoking status | 809 | Never | 430 (64.9) | 109 (74.7) | 0.023 |
| BMI (kg·m−2) | 823 | 30.5 (26.6–35.1) | 27.9 (25.4–31.8) | 0.001 | |
| Atopic disease | 830 | 355 (52.4) | 72 (47.4) | 0.226 | |
| Depression/anxiety | 830 | 85 (12.5) | 3 (2.0) | <0.001 | |
| Gastro-oesophageal reflux | 830 | 119 (17.6) | 25 (16.4) | 0.745 | |
| Nasal polyps | 830 | 123 (18.1) | 48 (31.6) | <0.001 | |
| OCS bursts for exacerbation (last year) | 817 | 5 (3–8) | 4 (3–6) | <0.001 | |
| Any OCS bursts (last year) | 817 | 624 (93.6) | 138 (92.0) | 0.493 | |
| Frequent exacerbator at baseline | 817 | Yes (≥3 in last year) | 554 (83.1) | 114 (76.0) | 0.043 |
| Invasive ventilations (ever) | 798 | 68 (10.5) | 8 (5.4) | 0.058 | |
| Any ED attendance for asthma (last year) | 807 | 259 (39.2) | 34 (23.3) | <0.001 | |
| Hospital admissions for asthma (last year ) | 814 | 270 (40.5) | 45 (30.4) | 0.022 | |
| Highest BEC recorded (×109 L−1) # | 821 | 0.68 (0.40–1.00) | 0.79 (0.58–1.33) | <0.001 | |
| FENO (ppb) | 638 | 41.0 (22.0–72.0) | 51.0 (35.0–81.0) | 0.002 | |
| Composite T2 biomarker group | 627 | BEC low (<0.15)/FENO low (<20) | 38 (7.7) | 2 (1.5) | 0.004 |
| BEC high (≥0.15)/FENO low (<20) | 69 (13.9) | 10 (7.6) | |||
| BEC low (<0.15)/FENO high (≥20) | 86 (17.3) | 21 (16.0) | |||
| BEC high (≥0.15)/FENO high (≥20) | 303 (61.1) | 98 (74.8) | |||
| FEV1 (L) | 818 | 2.0 (1.5–2.6) | 2.1 (1.6–2.7) | 0.073 | |
| FEV1 (% pred) | 811 | 67.0 (52.4–81.2) | 68.6 (55.0–88.2) | 0.027 | |
| FVC (L) | 802 | 3.1 (2.5–3.9) | 3.3 (2.7–4.2) | 0.048 | |
| FVC (% pred) | 772 | 85.2 (73.8–97.0) | 86.7 (75.8–99.4) | 0.065 | |
| FEV1/FVC | 802 | 63.7 (54.3–72.2) | 64.5 (54.4–73.6) | 0.498 | |
| ACQ-5 score | 736 | 3.2 (2.2–4.2) | 2.0 (1.2–3.4) | <0.001 | |
| Uncontrolled asthma | 711 | ACQ-5 ≥1.5 | 531 (88.8) | 91 (65.9) | <0.001 |
| EuroQoL health scale | 350 | 60.0 (40.0–70.0) | 75.0 (50.0–85.0) | <0.001 | |
| EuroQoL utility | 362 | 0.7 (0.5–0.8) | 0.9 (0.8–1.0) | <0.001 | |
| Maintenance OCS | 826 | 398 (59.1) | 77 (50.7) | 0.059 | |
| Maintenance OCS (mg) ¶ | 474 | 10 (8–15) | 10 (7–10) | 0.001 | |
| ICS | 830 | 676 (99.7) | 151 (99.3) | 0.500 | |
| ICS dose (µg BDP-equivalent)+ | 775 | 2000 (1600–2000) | 2000 (1600–2000) | 0.556 | |
| Theophylline | 821 | 184 (27.3) | 32 (21.6) | 0.153 | |
| SABA | 823 | 643 (95.5) | 142 (94.7) | 0.644 | |
| LABA | 818 | 619 (92.8) | 144 (95.4) | 0.258 | |
| LAMA | 821 | 420 (62.7) | 105 (69.5) | 0.113 | |
| LTRA | 799 | 327 (50.1) | 80 (54.8) | 0.303 | |
| Maintenance macrolides | 816 | 60 (9.0) | 9 (6.0) | 0.202 | |
| Nebuliser use | 819 | 164 (24.5) | 16 (10.7) | <0.001 |
Results are presented as median (interquartile range) or n (%). “Last year” refers to measures assessed using clinical records in the 12 months prior to initial presentation at the severe asthma centre; other measures were as observed or recorded at initial presentation unless otherwise indicated. BMI: body mass index; ED: emergency department; BEC: blood eosinophil count; FENO: fractional exhaled nitric oxide; T2: type 2; FVC: forced vital capacity; ICS: inhaled corticosteroids; BDP: beclometasone dipropionate; SABA: short-acting β2-agonists; LABA: long-acting β2-agonists; LAMA: long-acting muscarinic antagonists; LTRA: leukotriene receptor antagonists. #: highest recorded according to prior medical records; ¶: among patients on OCS; +: among patients on ICS.