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Is there more to asthma than allergic and eosinophilic phenotypes?

Get a clearer picture of patients with asthma driven by Type 2 inflammation

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Patients with uncontrolled persistent asthma lack comprehensive care

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Type 2 inflammation
in asthma

encompasses eosinophilic and
allergic phenotypes and occurs
in ~50%a to 70%b of adult
patients with asthma1-4
  • IL-4, IL-13, and IL-5 are key drivers of Type 2 inflammation in asthma1
  • IL-4 and IL-13 are central Type 2 cytokines with distinct and overlapping roles1
Heterogenous and
complex:

Type 2 inflammation in asthma
may be difficult to diagnose1,2,5
  • Use of serum IgE levels and blood eosinophils alone as asthma biomarkers may fail to accurately characterize the broad spectrum of Type 2 inflammation in asthma6,7
  • Reliance on only a narrow range of biomarkers may leave patients with Type 2 asthma suboptimally controlled6,7
Optimal asthma control
goes beyond exacerbation reduction
  • Early and sustained improvements in lung function and following therapy initiation reduced the rate and severity of future exacerbations8
  • Improving lung function is a goal of optimal asthma management9

aN=205.
bN=37.

References:
  1. Robinson D, Humbert M, Buhl R, et al. Revisiting type 2-high and type 2-low airway inflammation in asthma: current knowledge and therapeutic implications. Clin Exp Allergy. 2017;47(2):161-175.
  2. Wenzel SE. Emergence of biomolecular pathways to define novel asthma phenotypes: type-2 immunity and beyond. Am J Respir Cell Mol Biol. 2016;55(1):1-4.
  3. Seys SF, Scheers H, Van den Brande P, et al. Cluster analysis of sputum cytokine-high profiles reveals diversity in T(h)2-high asthma patients. Respir Res. 2017;18(1):39. doi:10.1186/s12931-017-0524-y
  4. Peters MC, Mekonnen ZK, Yuan S, Bhakta NR, Woodruff PG, Fahy JV. Measures of gene expression in sputum cells can identify TH2-high and TH2-low subtypes of asthma. J Allergy Clin Immunol. 2014;133(2):388-394.
  5. Ray A, Raundhal M, Oriss TB, Ray P, Wenzel SE. Current concepts of severe asthma. J Clin Invest. 2016;126(7):2394-2403.
  6. Albers FC, Müllerová H, Gunsoy NB, et al. Biologic treatment eligibility for real-world patients with severe asthma: the IDEAL study. J Asthma. 2018;55(2):152-160.
  7. Korevaar DA, Westerhof GA, Wang J, et al. Diagnostic accuracy of minimally invasive markers for detection of airway eosinophilia in asthma: a systematic review and meta-analysis. Lancet Respir Med. 2015;3(4):290-300.
  8. O’Byrne PM, Pedersen S, Lamm CJ, Tan WC, Busse WW; START Investigators Group. Severe exacerbations and decline in lung function in asthma. Am J Crit Care Med. 2009;179(1):19-24.
  9. Nguyen VQ, Ulrik CS. Measures to reduce maintenance therapy with oral corticosteroid in adults with severe asthma. Allergy Asthma Proc. 2016;37(6):125-139.