Biomarker-based asthma phenotypes of corticosteroid response

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Biomarker-based asthma phenotypes of corticosteroid response Douglas C. Cowan, BMedSci, MBChB, MRCP, PhD, D. Robin Taylor, MD, DSc, FRCP (Ed), Laura E. Peterson, BA, Jan O. Cowan, Rochelle Palmay, Avis Williamson, Jef Hammel, MS, Serpil C. Erzurum, MD, Stanley L. Hazen, MD, PhD, Suzy A.A. Comhair, PhD Journal of Allergy and Clinical Immunology Volume 135, Issue 4, Pages 877-883.e1 (April 2015) DOI: 10.1016/j.jaci.2014.10.026 Copyright © 2014 The Authors Terms and Conditions

Fig 1 Changes in biomarker values in asthmatic patients treated with ICSs. The percentage of asthmatic patients with decreases in biomarker values with ICS treatment for 28 days is shown proportionately by the size of the colored circles (blue, Feno values; green, sputum eosinophil counts [EOS]; and red, urinary BrTyr levels), and the percentage of asthmatic patients who do not have decreases in values of either of the 2 biomarkers in each panel is shown by black circles. Journal of Allergy and Clinical Immunology 2015 135, 877-883.e1DOI: (10.1016/j.jaci.2014.10.026) Copyright © 2014 The Authors Terms and Conditions

Fig 2 Receiver operating characteristic analysis describes the ability of each biomarker (ie, Feno values, sputum eosinophil counts, and urinary BrTyr levels) to classify asthmatic patients who respond to ICS therapy, as measured by 2 of 3 clinical outcomes (≥12% increase in FEV1 and/or ≥0.5-point decrease in ACQ score and/or ≥2 doubling dose increase in PC20AMP value). Journal of Allergy and Clinical Immunology 2015 135, 877-883.e1DOI: (10.1016/j.jaci.2014.10.026) Copyright © 2014 The Authors Terms and Conditions

Fig 3 ORs and 95% CIs for the association between a high biomarker value (Feno value, ≥35 ppm; sputum eosinophil count, ≥3%; and urinary BrTyr level, ≥0.45 ng/mg of creatinine) or biomarker combination (Feno and urinary BrTyr) and 2 positive clinical outcomes in response to ICS therapy. Results shown represent the ORs (solid circles) and 95% CIs (lines) of having a steroid response versus having no steroid response. Asterisks indicate a P value of less than .05, as determined by using the likelihood ratio χ2 test. Journal of Allergy and Clinical Immunology 2015 135, 877-883.e1DOI: (10.1016/j.jaci.2014.10.026) Copyright © 2014 The Authors Terms and Conditions