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Clinical Characteristics of Exacerbation-Prone Adult Asthmatics Identified by Cluster Analysis

Kim, MA; Shin, SW; Park, JS; Uh, ST; Chang, HS; Bae, DJ; Cho, YS; Park, HS; Yoon, HJ; Choi, BW; Kim, YH; Park, CS
Allergy, asthma & immunology research, 9(6):483-490, 2017
Journal Title
Allergy, asthma & immunology research
PURPOSE: Asthma is a heterogeneous disease characterized by various types of airway inflammation and obstruction. Therefore, it is classified into several subphenotypes, such as early-onset atopic, obese non-eosinophilic, benign, and eosinophilic asthma, using cluster analysis. A number of asthmatics frequently experience exacerbation over a long-term follow-up period, but the exacerbation-prone subphenotype has rarely been evaluated by cluster analysis. This prompted us to identify clusters reflecting asthma exacerbation.
METHODS: A uniform cluster analysis method was applied to 259 adult asthmatics who were regularly followed-up for over 1 year using 12 variables, selected on the basis of their contribution to asthma phenotypes. After clustering, clinical profiles and exacerbation rates during follow-up were compared among the clusters.
RESULTS: Four subphenotypes were identified: cluster 1 was comprised of patients with early-onset atopic asthma with preserved lung function, cluster 2 late-onset non-atopic asthma with impaired lung function, cluster 3 early-onset atopic asthma with severely impaired lung function, and cluster 4 late-onset non-atopic asthma with well-preserved lung function. The patients in clusters 2 and 3 were identified as exacerbation-prone asthmatics, showing a higher risk of asthma exacerbation.
CONCLUSIONS: Two different phenotypes of exacerbation-prone asthma were identified among Korean asthmatics using cluster analysis: both were characterized by impaired lung function, but the age at asthma onset and atopic status were different between the two.
AsthmaCluster analysisExacerbation
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박, 해심
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