Identification of Asthma Phenotypes in the Spanish MEGA Cohort Study Using Cluster Analysis.
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Matabuena Marcos, Salgado Francisco Javier, Nieto-Fontarigo Juan José, Álvarez-Puebla María J, Arismendi Ebymar, Barranco Pilar, Bobolea Irina, Caballero María L, Cañas José Antonio, Cárdaba Blanca, Cruz María Jesus, Curto Elena, Domínguez-Ortega Javier, Luna Juan Alberto, Martínez-Rivera Carlos, Mullol Joaquim, Muñoz Xavier, Rodriguez-Garcia Javier, Olaguibel José María, Picado César, Plaza Vicente, Quirce Santiago, Rial Manuel J, Romero-Mesones Christian, Sastre Beatriz, Soto-Retes Lorena, Valero Antonio, Valverde-Monge Marcela, Del Pozo Victoria, Sastre Joaquín, González-Barcala Francisco Javier
Аннотация
METHODS: We performed a multicentre prospective cohort study, including adult patients with asthma (N=512) from the MEGA study (Mechanisms underlying the Genesis and evolution of Asthma). A standardised clinical history was completed for each patient. Cluster analysis was performed using the kernel k-groups algorithm.
RESULTS: Four clusters were identified. Cluster 1 (31.5% of subjects) includes adult-onset atopic patients with better lung function, lower BMI, good asthma control, low ICS dose, and few exacerbations. Cluster 2 (23.6%) is made of adolescent-onset atopic asthma patients with normal lung function, but low adherence to treatment (59% well-controlled) and smokers (48%). Cluster 3 (17.1%) includes adult-onset patients, mostly severe non-atopic, with overweight, the worse lung function and asthma control, and receiving combination of treatments. Cluster 4 (26.7%) consists of the elderly-onset patients, mostly female, atopic (64%), with high BMI and normal lung function, prevalence of smokers and comorbidities.
CONCLUSION: We defined four phenotypes of asthma using unsupervised cluster analysis. These clusters are clinically relevant and differ from each other as regards FEV1, age of onset, age, BMI, atopy, asthma severity, exacerbations, control, social class, smoking and nasal polyps.