Comparison of Asthma Phenotypes in Severe Asthma Cohorts (SARP, U-BIOPRED, ProAR and COREA) From 4 Continents

PURPOSE: Asthma is a clinical syndrome with various underlying pathomechanisms and clinical phenotypes.

Genetic, ethnic, and geographic factors may influence the differences in clinical presentation, severity, and prognosis.

We compared the characteristics of asthma based on the geographical background by analyzing representative cohorts from the United States, Europe, South America, and Asia using the Severe Asthma Research Program (SARP), Unbiased Biomarkers for the Prediction of Respiratory Disease Outcomes (U-BIOPRED), Program for Control of Asthma in Bahia (ProAR), and Cohort for Reality and Evolution of Adult Asthma in Korea (COREA), respectively.

METHODS: The clinical characteristics and medications for the SARP (n = 669), U-BIOPRED (n = 509), ProAR (n = 996), and COREA (n = 3,748) were analyzed.

Subgroup analysis was performed for severe asthma.

RESULTS: The mean age was highest and lowest in the COREA and SARP, respectively.

The asthma onset age was lowest in the ProAR.

The mean body mass index was highest and lowest in the SARP and COREA, respectively.

Baseline pulmonary function was lowest and highest in the U-BIOPRED and COREA, respectively.

The number of patients with acute exacerbation in the previous year was highest in U-BIOPRED.

The mean blood eosinophil count was highest in COREA.

The total immunoglobulin E was highest in the ProAR.

The frequency of atopy was highest in the SARP.

The principal component analysis plot revealed differences among all cohorts.

CONCLUSIONS: The cohorts from 4 different continents exhibited different clinical and physiological characteristics, probably resulting from the interplay between genetic susceptibility and geographical factors.