69% of adult patients with asthma had eosinophilic asthma, according to an analysis of NHANES data*1

Eosinophilic asthma (e-asthma) is a distinct type of asthma characterized by elevated levels of eosinophils. Patients with e-asthma can present with varying degrees of atopy, ranging from nonatopic to atopic.2-5

Eosinophils are a major inflammatory cell involved in the pathophysiology of asthma.5-7

NHANES=National Health and Nutrition Examination Survey.

*Data from the 2005 to 2006 annual survey of a nationally representative sample of a noninstitutionalized United States population in patients with asthma (aged 18-64 years) identified based on the participants’ self-report. Eosinophilic asthma was defined as a blood eosinophil cutoff point of ≥150 cells/μL. Of the 310 adult patients, 69% had a blood eosinophil level ≥150 cells/μL.

Multiple pathways can lead to eosinophil production, proliferation, and survival6,8-11

In e-asthma, immune cells catalyzed by allergic or nonallergic triggers can lead to the production of various signaling molecules called cytokines. The multitude of cytokines produced by these cells can contribute to the recruitment, activation, and survival of eosinophils.5,12-14

Therefore, instead of targeting cytokines, patients may benefit from treatments designed to target eosinophils, a key driver of severe asthma.12,13,15

Eosinophils are a direct cause of chronic inflammation in severe asthma5,16

lungs Logo

Untreated eosinophilic asthma can lead to serious consequences, including16:

  • Airway smooth muscle contraction and airway hyperresponsiveness
  • Airway remodeling

Eosinophils are a direct cause of chronic inflammation in severe asthma5,16

lungs Logo

Untreated eosinophilic asthma can lead to serious consequences, including16:

  • Airway smooth muscle contraction and airway hyperresponsiveness
  • Airway remodeling

Eosinophilic inflammation can lead to progressive airway damage and poor control.5,16

Clinical characteristics can help identify an eosinophilic asthma patient5

Patients may have eosinophilic asthma if they have3,5:

Patients may have e-asthma if they have increased blood eosinophil levels.

Increased blood
eosinophil levels

And / Or

Patients may have e-asthma if they had more than 2 exacerbations per year, a response to systemic corticosteroid treatment.

Exacerbations per year

Response to systemic
corticosteroid treatment

Additional clinical characteristics5,17:

  • Low FEV1 with persistent airflow limitation
  • Poor asthma control
  • Allergic rhinitis
  • Normal or moderately elevated immunoglobulin E (IgE)
  • Late-onset asthma

Understanding e-asthma characteristics can help inform clinical decision-making.5,17-19

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References: 1. Tran TN, Zeiger RS, Peters SP, et al. Overlap of atopic, eosinophilic, and TH2-high asthma phenotypes in a general population with current asthma. Ann Allergy Asthma Immunol. 2016;116(1):37-42. 2. Lötvall J, Akdis CA, Bacharier LB, et al. Asthma endotypes: a new approach to classification of disease entities within the asthma syndrome. J Allergy Clin Immunol. 2011;127(2):355-360. 3. de Groot JC, Storm H, Amelink M, et al. Clinical profile of patients with adult-onset eosinophilic asthma. ERJ Open Res. 2016;2(2):1-8. 4. Miranda C, Busacker A, Balzar S, et al. Distinguishing severe asthma phenotypes: role of age at onset and eosinophilic inflammation. J Allergy Clin Immunol. 2004;113:101-108. 5. de Groot JC, ten Brinke A, Bel EH. Management of the patient with eosinophilic asthma: a new era begins. ERJ Open Res. 2015;1:1-11. 6. Mukherjee M, Sehmi R, Nair P. Anti-IL5 therapy for asthma and beyond. World Allergy Organ J. 2014;7(1):32. 7. Wenzel SE. Asthma phenotypes: the evolution from clinical to molecular approaches. Nat Med. 2012;18(5):716-725. 8. Lambrecht B, Hammad H. The immunology of asthma. Nat Immunol. 2015;16(1):45-56. 9. Kim J, Choi G, Lee BJ, et al. Natural killer cells regulate eosinophilic inflammation in chronic rhinosinusitis. Sci Rep. 2016;6:27615. 10. Awad A, Yassine H, Barrier M, et al. Natural killer cells induce eosinophil activation and apoptosis. PLoS ONE. 2014;9(4):e94492. 11. Shen ZJ, Malter JS. Determinants of eosinophil survival and apoptotic cell death. Apoptosis. 2015;20(2):224-234. 12. McBrien C, Menzies-Gow A. The biology of eosinophils and their role in asthma. Front Med (Lausanne). 2017;4(93):1-14. 13. Fulkerson PC, Rothenberg ME. Targeting eosinophils in allergy, inflammation, and beyond. Nat Rev Drug Discov. 2013:12;117-129. 14. Hogan SP, Rosenberg HF, Moqbel R, et al. Eosinophils: biological properties and role in health and disease. Clin Exp Allergy. 2008:38;709-750. 15. Buhl R, Humbert M, Bjermer L, et al. Severe eosinophilic asthma: a roadmap to consensus. Eur Respir J. 2017;49:1700634. 16. Trivedi SG, Lloyd CM. Eosinophils in the pathogenesis of allergic airways disease. Cell Mol Life Sci. 2007;64(10):1269-1289. 17. Price DB, Rigazio A, Campbell JD, et al. Blood eosinophil count and prospective annual asthma disease burden: a UK cohort study. Lancet Respir Med. 2015;3:849-858. 18. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2018. https://ginasthma.org/2018-gina-report-global-strategy-for-asthma-management-and-prevention/ Accessed September 5, 2018. 19. Chung KF, Wenzel SE, Brozek JL, et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J. 2014;43(2):343-373.