Abstract :
[en] Introduction: Asthma related quality of life has become an important outcome in the assessment of a patient alongside classical objective physiological and inflammatory parameters.
Methods: We conducted a retrospective study in a large population of asthmatics recruited from a University secondary care center between 2010 and 2019 (N= 1337). Patients completed asthma quality of life questionnaire (AQLQ) and underwent sputum induction. A disease severity classification was determined by the combination of the alteration of physiological and cytological variables. Group 1 (n=304) included mild asthmatics with FEV1 > 80 % of predicated values, sputum eosinophils <3% and sputum neutrophils < 76%. Group 2 (n=81) included moderate asthmatics with FEV1 between 60% and 80% and sputum eosinophils between 3% and 20% or sputum neutrophils between 76% and 90%. Group 3 (n=72) included severe asthmatics with FEV1 <60% and sputum eosinophils > 20% or sputum neutrophils > 90%.
Results: For the whole cohort, AQLQ reached on average 4,5 ranging from 1,07 to 7. AQLQ was correlated with FEV1 (rs=0,33 ; p <0,001) and with sputum eosinophils (rs=-0,14 ; p< 0,001) but not with sputum neutrophils (rs=-0,001 ; p = 0,76).
There was a progressive and significant decline in mean AQLQ from group 1 to group 3. Mean (± SEM) AQLQ was 4,8 (±0,07), 4 (± 0,14) and 3,5 (± 0,13) in group 1, 2 and 3 respectively.
Conclusion: In our retrospective study, asthma related quality of life deteriorates as airway obstruction and sputum eosinophils increase. Because of its impact on quality of life, it seems essential to consider the eosinophilic inflammatory component in asthma management.