Ian D Pavord
Predictive value of blood eosinophils and exhaled nitric oxide in adults with mild asthma: a prespecified subgroup analysis of an open-label, parallel-group, randomised controlled trial
Pavord, Ian D; Holliday, Mark; Reddel, Helen K; Braithwaite, Irene; Ebmeier, Stefan; Hancox, Robert J; Harrison, Tim; Houghton, Claire; Oldfield, Karen; Papi, Alberto; Williams, Mathew; Weatherall, Mark; Beasley, Richard; Corin, Andrew; Helm, Colin; Poudel, Bhuwan; Sheahan, Davitt; Sheahan, Pamela; Bennett, Miriam; Chang, Caterina; Ellis, Hollie; Hancox, Bob; Hopping, Sandra; Tuffery, Christine; Ramsahai, James Michael; Simpson, Jodie; Wark, Peter; Aliani, Maria; Genco, Maddalena; Capozzolo, Alberto; Carone, Mauro; Maini, Elisa; Mancin, Jenny; Meriggi, Antonio; Perfetti, Luca; Cherubino, Francesca; Spanevello, Antonio; Visca, Dina; Zampogna, Elisabetta; Baggott, Christina; Beasley, Richard; Braithwaite, Irene; Eathorne, Allie; Ebmeier, Stefan; Fingleton, James; Hardy, Jo; Holliday, Mark; Houghton, Claire; Oldfield, Karen; Pilcher, Janine; Sabbagh, Donah; Semprini, Alex; Williams, Mathew; Harrison, Tim; Shaw, Karen; Mackisack, Summer; Montgomery, Barney; Autridge, Karen; Joseph, Joanna;...
Authors
Mark Holliday
Helen K Reddel
Irene Braithwaite
Stefan Ebmeier
Robert J Hancox
TIM HARRISON tim.harrison@nottingham.ac.uk
Professor of Asthma and Respiratory Medicine
Claire Houghton
Karen Oldfield
Alberto Papi
Mathew Williams
Mark Weatherall
Richard Beasley
Andrew Corin
Colin Helm
Bhuwan Poudel
Davitt Sheahan
Pamela Sheahan
Miriam Bennett
Caterina Chang
Hollie Ellis
Bob Hancox
Sandra Hopping
Christine Tuffery
James Michael Ramsahai
Jodie Simpson
Peter Wark
Maria Aliani
Maddalena Genco
Alberto Capozzolo
Mauro Carone
Elisa Maini
Jenny Mancin
Antonio Meriggi
Luca Perfetti
Francesca Cherubino
Antonio Spanevello
Dina Visca
Elisabetta Zampogna
Christina Baggott
Richard Beasley
Irene Braithwaite
Allie Eathorne
Stefan Ebmeier
James Fingleton
Jo Hardy
Mark Holliday
Claire Houghton
Karen Oldfield
Janine Pilcher
Donah Sabbagh
Alex Semprini
Mathew Williams
TIM HARRISON tim.harrison@nottingham.ac.uk
Professor of Asthma and Respiratory Medicine
Karen Shaw
Summer Mackisack
Barney Montgomery
Karen Autridge
Joanna Joseph
Stella Moon
Dean Quinn
Dean Millar-Coote
Jim Reid
Federico Bellini
Martina Marchi
Luca Morandi
Marianna Padovani
Alberto Papi
Daniela Scalet
Katie Borg
Clare Connolly
Anna Gittins
Gareth Hynes
Helen Jeffers
Ian Pavord
Rahul Shrimanker
Gloria Foxley
Elyse Guevara-Rattray
Stephen Milne
Helen Reddel
Brett Toelle
Abstract
Background
Whether blood eosinophil counts and exhaled nitric oxide (FeNO) are associated with important outcomes in mild asthma is unclear. In this prespecified subgroup analysis of a previously published open-label clinical trial, we aimed to assess associations between blood eosinophil counts and FeNO with outcomes and response to asthma treatment.
Methods
In the previously reported 52-week, open-label, randomised controlled trial, people with mild asthma receiving only β agonist reliever inhalers were enrolled at one of 16 clinical trials units in New Zealand, the UK, Italy, or Australia. Eligible participants were randomly assigned (1:1:1, stratified by country), to receive inhalers to take as-needed salbutamol (two inhalations of 100 μg in a pressurised metered dose inhaler), maintenance budesonide (200 μg twice per day by inhaler) plus as-needed salbutamol (two inhalations of 100 μg), or as-needed budesonide–formoterol (one inhalation of 200 μg budesonide and 6μg formoterol by inhaler). The primary outcome was the annual rates of asthma exacerbations per patient, and in this prespecified subgroup analysis, we assessed whether annual exacerbation rates in each treatment group were significantly different depending on levels of blood eosinophil count, FeNO, or a composite score of both. Analyses were done for patients with available biomarker measurements The study was registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12615000999538.
Findings
675 participants were enrolled between March 17, 2016, and Aug 29, 2017, of whom 656 had results for blood eosinophil analysis and 668 had results for FeNO. Of the patients who received as-needed salbutamol, the proportion of patients having a severe exacerbation increased progressively with increasing blood eosinophil count (two [4%] of 49 participants with
Citation
Pavord, I. D., Holliday, M., Reddel, H. K., Braithwaite, I., Ebmeier, S., Hancox, R. J., …Toelle, B. (2020). Predictive value of blood eosinophils and exhaled nitric oxide in adults with mild asthma: a prespecified subgroup analysis of an open-label, parallel-group, randomised controlled trial. Lancet Respiratory Medicine, 8(7), 671-680. https://doi.org/10.1016/s2213-2600%2820%2930053-9
Journal Article Type | Article |
---|---|
Acceptance Date | Nov 1, 2019 |
Online Publication Date | Mar 11, 2020 |
Publication Date | Jul 1, 2020 |
Deposit Date | Jan 18, 2021 |
Publicly Available Date | Jan 19, 2021 |
Journal | The Lancet Respiratory Medicine |
Print ISSN | 2213-2600 |
Publisher | Elsevier |
Peer Reviewed | Peer Reviewed |
Volume | 8 |
Issue | 7 |
Pages | 671-680 |
DOI | https://doi.org/10.1016/s2213-2600%2820%2930053-9 |
Keywords | Pulmonary and Respiratory Medicine |
Public URL | https://nottingham-repository.worktribe.com/output/5152453 |
Publisher URL | https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30053-9/fulltext |
Additional Information | Authors on behalf of the Novel START Study Team. |
Files
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