D2.86 - Characteristics of Severe type 2 Asthma Patients in China: A Retrospective Observational Study

Type 2 (T2) inflammation is a cornerstone in the pathophysiology of asthma, yet data on the status of T2 biomarker testing and associated comorbidities among severe asthma patients in China remains sparse.

Patients with severe asthma, as defined by ICD-10 code and with at least two prescriptions for medium-to-high dose inhaled corticosteroids (ICS) in the prior six months, were identified from the Shanghai Medical Database between January 1, 2016, and December 31, 2020. The index date was the day following the most recent ICS prescription meeting the severe asthma criteria. Rates of T2 biomarker testing, most recent results, and prevalence of T2-related comorbidities within one year pre-index were analyzed.

Among 35,900 severe asthma patients (mean age of 57±16.2 years; 50.9% female), the testing rates of T2 biomarkers were 21.0% for fractional exhaled nitric oxide (FeNO), 16.7% for blood eosinophil count (BEC), and 6.4% for specific immunoglobulin E or skin prick test (sIgE/SPT). Among tested patients, FeNO levels were <20 ppb in 26.0%, 20–50 ppb in 48.7%, and ≥50 ppb in 25.3%. For BEC, 33.9% had <150/μL, 23.3% had 150–300/μL, 40.1% had 300–1500/μL, and 2.6% had ≥1500/μL. sIgE/SPT positivity was observed in 79.9% of tested patients. The proportions of patients with 1, 2, and ≥3 T2-related comorbidities were 27.7%, 9.0%, and 1.1%, respectively. Specifically, the prevalence for allergic rhinitis (AR), chronic rhinosinusitis (CRS, with or without nasal polyps), atopic dermatitis (AD), atopic conjunctivitis, and chronic rhinosinusitis with nasal polyps (CRSwNP) were 31.8%, 8.5%, 4.7%, 4.0%, and 3.2%, respectively.

Patients with severe asthma in China shown elevated T2 biomarkers, and/or T2 related comorbidities. However, the biomarker testing rate is low, underscoring the need for comprehensive T2 assessments to optimize management strategies, including T2 targeted therapy.