Need for Medication Increased With Overlapping Asthma Phenotypes


Experts are beginning to see that some phenotypes respond better to certain treatment approaches for asthma.

Experts in asthma have been increasing their focus on phenotypes (e.g. transient infant wheezing that does not persist, persistent asthma in an atopic child, aspirin/NSAID-sensitive asthma, neutrophilic and eosinophilic asthma). Phenotype is identified by the patient's clinical presentation. And, experts are beginning to see that some phenotypes respond better to certain treatment approaches. Certain phenotypes can be associated with specific laboratory-defined characteristics (e.g. elevated exhaled nitric oxide, blood eosinophils, fraction of exhaled nitric oxide, etc).

Identifying asthma phenotypes based on noninvasive markers could help clinicians better tailor therapy for people with asthma. In addition, asthma phenotypes may overlap. A new study looks at the overlap of 5 common asthma phenotypes in adults in the United States. Published in Clinical and Translational Allergy, the study found that certain phenotypes tend to overlap more frequently than others.

These researchers analyzed data from the National Health and Nutrition Examination Surveys (NHANES) 2007—2012, which included 30,442 adults, with 1,059 having current asthma. They looked at 5 specific phenotypes:

  • B-Eos-high [if blood eosinophils (B-Eos) ≥ 300/mm3]
  • FeNO-high (FeNO ≥ 35 ppb)
  • B-Eos&FeNO-low (B-Eos < 150/mm3 and FeNO < 20 ppb)
  • Asthma with obesity (AwObesity) (BMI ≥ 30 kg/m2)
  • Asthma with concurrent COPD.

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