Sophie F. Demarche, MPharm
Correspondence information about the author MPharm Sophie F. Demarche
Email the author MPharm Sophie F. Demarche
, Correspondence information about the author MPharm Sophie F. DemarcheEmail the author MPharm Sophie F. Demarche
Florence N. Schleich, MD, PhD
,
Virginie A. Paulus, MLT
,
Monique A. Henket, MLT
,
Thierry J. Van Hees, MPharm, PhD
,
Renaud E. Louis, MD, PhD
Open Access
Article InfoBackground
Objective
To investigate the relationship between asthma control and sputum eosinophils in clinical practice.
Methods
A retrospective longitudinal study was conducted on 187 patients with asthma with at least 2 successful sputum inductions at our Asthma Clinic. Linear mixed models were used to assess the relationship between asthma control and individual changes in sputum eosinophils. Receiver-operating characteristic curves were constructed to define minimal important differences (MIDs) of sputum eosinophils associated with a change of at least 0.5 in Asthma Control Questionnaire (ACQ) score. Then, a validation cohort of 79 patients with asthma was recruited to reassess this relationship and the accuracy of the MID values.
Results
A multivariate analysis showed that asthma control was independently associated with individual fluctuations in sputum eosinophil count (P < .001). In patients with intermittent/persistently eosinophilic asthma, we calculated a minimal important decrease of 4.3% in the percentage of sputum eosinophils (area under the curve [AUC], 0.69; P < .001) or 3.4-fold (AUC, 0.65; P = .003) for a significant improvement in asthma control and a minimal important increase of 3.5% (AUC, 0.67; P = .004) or 1.8-fold (AUC, 0.63; P = .02) for a significant worsening in asthma control. The association between asthma control and sputum eosinophils and the accuracy of the MIDs of sputum eosinophils were confirmed in the validation cohort.
Conclusions
At the individual level, asthma control was associated with fluctuations in sputum eosinophil count over time.
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