title: Value of peripheral blood eosinophil markers to predict severity of asthma.
abstract: Asthma represents a significant clinical and economic burden to the US healthcare system. Along with other clinical manifestations of the disease, elevated sputum and blood eosinophil levels are observed in patients experiencing asthma exacerbations. The aim of this study was to evaluate the association between blood eosinophil levels and asthma severity defined using Expert Panel Report 3 guidelines.
  
  
  
  Patients with asthma diagnosis between 2004 and 2011 were extracted from the EMRClaims+ database (eMAX Health, White Plains, NY) containing electronic medical records linked to insurance claims for over 675,000 patients. The date of first asthma diagnosis was defined as the 'index date'. Patients were required to have at least 1 peripheral eosinophil test (elevated defined as ≥ 400 cells/μL) in the 12 month 'assessment' period following the index date. We classified patients as those with mild asthma and moderate-to-severe asthma based on the pattern of medication use, as recommended by the 2007 National Institutes of Health Expert Panel Report. Logistic regression models were used to determine if patients with moderate-to-severe asthma had increased likelihood of an elevated peripheral eosinophil count, after accounting for demographics and comorbidities.
  
  
  
  Among 1,144 patients with an asthma diagnosis, 60 % were classified as having moderate-to-severe asthma. Twenty four percent of patients with moderate-to-severe asthma and 19 % of patients with mild asthma had an elevated peripheral eosinophil count (p = 0.053). Logistic regression showed that moderate-to-severe asthma was associated with 38 % increased odds of elevated eosinophil level (OR 1.38, 95 % CI: 1.02 to 1.86, p = 0.04).
  
  
  
  Patients with moderate-severe asthma are significantly more likely to have an elevated peripheral eosinophil count than patients with mild asthma.
authors.affiliation: eMAX Health Systems, LLC, 445 Hamilton Avenue, 11th floor, White Plains, NY, USA.
authors.forename: Julian
authors.initials: J
authors.lastname: Casciano
authors.affiliation: Medicine and Public Health, Division of Pulmonary, Critical Care, Sleep, and Allergy, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Krishnan
authors.affiliation: Teva, Frazer, PA, USA.
authors.forename: Mary Buatti
authors.initials: MB
authors.lastname: Small
authors.affiliation: Teva, Frazer, PA, USA.
authors.forename: Philip O
authors.initials: PO
authors.lastname: Buck
authors.affiliation: Teva, Frazer, PA, USA.
authors.forename: Gokul
authors.initials: G
authors.lastname: Gopalan
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Chenghui
authors.initials: C
authors.lastname: Li
authors.affiliation: eMAX Health Systems, LLC, 445 Hamilton Avenue, 11th floor, White Plains, NY, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Kemp
authors.affiliation: eMAX Health Systems, LLC, 445 Hamilton Avenue, 11th floor, White Plains, NY, USA. zenobiadotiwala@emaxhealth.net.
authors.forename: Zenobia
authors.initials: Z
authors.lastname: Dotiwala
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000097:blood* / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood*; D002648:Child; D016208:Databases, Factual; D018450:Disease Progression; D004804:Eosinophils / Q000166:cytology*; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013183:Sputum / Q000166:cytology; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: Asthma; Asthma severity; Blood eosinophil; EPR guidelines; Elevated eosinophil