FASE-CPHG Study: identification of asthma phenotypes in the French Severe Asthma Study using cluster analysis

Abstract

Background In France, data regarding epidemiology and management of severe asthma are scarce. The objective of this study was to describe asthma phenotypes using a cluster analysis in severe asthmatics recruited in a real world setting. Methods The study design was prospective, observational and multicentric. The patients included were adults with severe asthma (GINA 4–5) followed-up in French Non Academic Hospital between May 2016 and June 2017. One hundred and seven physicians included 1502 patients. Both sociodemographic and clinical variables were collected. Hierarchical cluster analysis was performed by the Ward method followed by k-means cluster analysis on a population of 1424 patients. Results Five clusters were identified: cluster 1 (n = 690, 47%) called early onset allergic asthma (47.5% with asthma before 12 years), cluster 2 (n = 153, 10.5%): obese asthma (63.5% with BMI > 30 kg/m2), cluster 3 (n = 299, 20.4%): late-onset asthma with severe obstructive syndrome (89% without atopy), cluster 4 (n = 143, 9.8%): eosinophilic asthma (51.7% had more than 500 eosinophils/mm3), and cluster 5 (n = 139, 9.5%): aspirin sensitivity asthma (63% had severe asthma attacks). Conclusions In our population of adults with severe asthma followed by pulmonologists, five distinct phenotypes were identified and are quite different from those mentioned in previous studies.

Characteristics of Severe Non-Eosinophilic Asthma: Analysis of Data from 1075 Patients Included in the FASE-CPHG Study

“…Its secondary objectives were to compare data from patients with severe eosinophilic and non-eosinophilic asthma and describe the profile of patients with severe non-eosinophilic asthma according to their allergic profile. [13][14][15] Data from 1502 adult (>18 years) patients with severe asthma were collected from May 2016 to June 2017 in France by 104 respiratory physicians in non-academic hospitals. All patients received information about the study and gave their informed consent before being included in the FASE-CPHG study.…”

“…Further details may be found in previous published articles. [13][14][15] Current analyses were performed using data that were deidentified.…”

Research on Footwear Information System based on Matching Foot Type Characteristics and Common Data of Shoe Lasts

“…In this paper, a combination of hierarchical clustering analysis and K-M mean clustering analysis was used in the Hallux valgus foot type classification process. [41,42].The specific process is as follows: Hierarchical clustering according to the foot width index, three clustering centers with the foot width index as the clustering benchmark are obtained, and then K-M clustering of the foot width index is performed again with the obtained clustering centers, and all samples are divided Using K-M cluster analysis to classify the foot thickness index with the foot width index classification, the results can be obtained as shown in the table 3-13. Using the same method to classify the right foot foot width and foot thickness index, the results can be obtained as shown in the table 3-14.…”

Delineating asthma according to inflammation phenotypes with a focus on paucigranulocytic asthma

“…The Global Initiative for Asthma recognizes five common clinical phenotypes: allergic, non-allergic, adult-onset, asthma with persistent airflow limitation, and asthma with obesity. By contrast, cluster analysis of 1502 French adults with asthma identified a different set of five clinical phenotypes: early onset allergic asthma, obese asthma, late-onset asthma with severe obstructive syndrome, eosinophilic asthma, and aspirin-sensitive asthma [5] . Still another phenotypic classification is based on pathogenesis of inflammation and the resulting immune response [6] .…”

“…By contrast, cluster analysis of 1502 French adults with asthma identified a different set of five clinical phenotypes: early onset allergic asthma, obese asthma, late-onset asthma with severe obstructive syndrome, eosinophilic asthma, and aspirin-sensitive asthma. [ 5 ] Still another phenotypic classification is based on pathogenesis of inflammation and the resulting immune response. [ 6 ] Type 1, type 2, or type 3 cell-mediated immune responses drive the release of cytokines that regulate granulocytic infiltration into the airway.…”