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. 2022 Jul 8;48(3):e20210367.
doi: 10.36416/1806-3756/e20210367. eCollection 2022.

Prevalence of the eosinophilic phenotype among severe asthma patients in Brazil: the BRAEOS study

[Article in English, Portuguese]
Rodrigo Athanazio  1 , Rafael Stelmach  1 , Martti Antila  2 , Adelmir Souza-Machado  3 , L Karla Arruda  4 , Alcindo Cerci Neto  5 , Faradiba Sarquis Serpa  6 , Daniela Cavalet Blanco  7 , Marina Lima  8 , Pedro Bianchi Júnior  9 , Márcio Penha  10 , Marcelo Fouad Rabahi  11
Affiliations

Prevalence of the eosinophilic phenotype among severe asthma patients in Brazil: the BRAEOS study

[Article in English, Portuguese]
Rodrigo Athanazio et al. J Bras Pneumol. .

Abstract
in English, Portuguese

Objective: To assess the prevalence of the eosinophilic and allergic phenotypes of severe asthma in Brazil, as well as to investigate the clinical characteristics of severe asthma patients in the country.

Methods: This was a cross-sectional study of adult patients diagnosed with severe asthma and managed at specialized centers in Brazil. The study was conducted in 2019.

Results: A total of 385 patients were included in the study. Of those, 154 had a blood eosinophil count > 300 cells/mm3 and 231 had a blood eosinophil count of ≤ 300 cells/mm3. The median age was 54.0 years, and most of the patients were female, with a BMI of 29.0 kg/m2 and a history of allergy (81.6%). The prevalence of patients with a blood eosinophil count > 300 cells/mm3 was 40.0% (95% CI: 35.1-44.9), and that of those with a blood eosinophil count > 300 cells/mm3 and a history of allergy was 31.9% (95% CI: 27.3-36.6). Age and BMI showed positive associations with a blood eosinophil count > 300 cells/mm3 (OR = 0.97, p < 0.0001; and OR = 0.96, p = 0.0233, respectively), whereas the time elapsed since the onset of asthma symptoms showed an increased association with a blood eosinophil count > 300 cells/mm3 (OR = 1.02, p = 0.0011).

Conclusions: This study allowed us to characterize the population of severe asthma patients in Brazil, showing the prevalence of the eosinophilic phenotype (in 40% of the sample). Our results reveal the relevance of the eosinophilic phenotype of severe asthma at a national level, contributing to increased effectiveness in managing the disease and implementing public health strategies.

Objetivo:: Avaliar a prevalência dos fenótipos eosinofílico e alérgico da asma grave no Brasil e investigar as características clínicas dos pacientes com asma grave no país.

Métodos:: Estudo transversal com pacientes adultos com diagnóstico de asma grave atendidos em centros especializados no Brasil. O estudo foi realizado em 2019.

Resultados:: Foram incluídos no estudo 385 pacientes. Destes, 154 apresentavam contagem de eosinófilos no sangue > 300 células/mm3 e 231 apresentavam contagem de eosinófilos no sangue ≤ 300 células/mm3. A mediana da idade foi de 54,0 anos, e a maioria dos pacientes era do sexo feminino, com IMC de 29,0 kg/m2 e história de alergia (81,6%). A prevalência de pacientes com contagem de eosinófilos no sangue > 300 células/mm3 foi de 40,0% (IC95%: 35,1-44,9), e a daqueles com contagem de eosinófilos no sangue > 300 células/mm3 e história de alergia foi de 31,9% (IC95%: 27,3-36,6). A idade e o IMC apresentaram associações positivas com contagem de eosinófilos no sangue > 300 células/mm3 (OR = 0,97, p < 0,0001 e OR = 0,96, p = 0,0233, respectivamente), ao passo que o tempo decorrido desde o início dos sintomas de asma apresentou associação aumentada com contagem de eosinófilos no sangue > 300 células/mm3 (OR = 1,02, p = 0,0011).

Conclusões:: Este estudo possibilitou a caracterização da população de pacientes com asma grave no Brasil, mostrando a prevalência do fenótipo eosinofílico (em 40% da amostra). Nossos resultados revelam a relevância do fenótipo eosinofílico da asma grave em nível nacional, contribuindo para aumentar a eficácia no manejo da doença e na implantação de estratégias de saúde pública.

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Conflict of interest statement

CONFLICT OF INTEREST STATEMENT: Rodrigo Athanazio has participated in clinical studies funded by or has received conference/consultancy fees from the following pharmaceutical companies: AstraZeneca, Chiesi, GlaxoSmithKline, Novartis, Sanofi, Pfizer, Roche, and Vertex. Rafael Stelmach has participated in clinical studies funded by or has received conference/consultancy fees from the following pharmaceutical companies: AstraZeneca, Boehringer Ingelheim, Eurofarma, GlaxoSmithKline, Novartis, and Sanofi. Martti Antila has participated in clinical studies funded by AbbVie, AstraZeneca, EMS, Eurofarma, GlaxoSmithKline, Humanigen, Janssen, Novartis, Sanofi, Angion Biomedica, BeiGene, and Rigel Pharmaceuticals, Inc., as well as having received consultancy fees from Abbott Laboratories, Aché, AstraZeneca, Chiesi, Eurofarma, IPI ASAC Brasil, and Sanofi. Adelmir Souza-Machado has no conflicts of interest to declare. L. Karla Arruda has received research support or lecture fees from AstraZeneca, Novartis, Sanofi, GlaxoSmithKline, and Takeda. Alcindo Cerci Neto has no conflicts of interest to declare. Faradiba Sarquis Serpa has been a member in advisory boards and a speaker for Novartis, Sanofi, and Takeda-Shire, as well as having participated in clinical trials funded by Novartis and AstraZeneca. Daniela Cavalet Blanco has no conflicts of interest to declare. Marina Lima has received conference and lecture fees from AstraZeneca. Marcelo Rabahi has participated in clinical research funded by AstraZeneca and Boehringer Ingelheim. Pedro Bianchi Júnior has received sponsorship from AstraZeneca, Bayer, Novartis, Sanofi, and Takeda-Shire. Márcio Penha was an employee of AstraZeneca Brasil at the time the study was conducted; he is currently employed by Chiese Brasil.

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