D1.369 - Characteristics of patients with severe asthma undergoing biological treatment at a reference center

Biologicals in asthma have positively influenced the morbidity of the disease, resulting, in some studies, in remission during treatment. Objective: To describe the characteristics of adult patients with severe asthma undergoing treatment with biologicals.

Retrospective study with patients > 18 years old age, descriptive analysis of frequencies. 

: 53 patients were included, mean age 54.45 ± 14.16 years, 87% women, 20 patients started symptoms in childhood, mean onset of symptoms at 40.46 ± 11.74 years of age. 66% with chronic rhinosinusitis (RNSC), of these 91% had nasal polyposis. 34% patients had respiratory sensitization to NSAIDs. gastroesophageal reflux, obesity, arterial hypertension and sleep apnea syndrome were the most associated comorbidities. Chest CT scans showed varied changes such as bronchiectasis. All had LABA associated with corticosteroids in moderate/high doses, anticholinergic, montelukast. The mean IgE was 294.38 ± 309.46 IU/ml and eosinophils 481.19 ± 383.45 cells/mm3 in peripheral blood, 68% of which were eosinophilic (> 300 eosinophils/mm3). The mean pre-bronchodilator FEV1 and FVC were respectively 62.42 ± 20.75% and 73.70 ± 17.79%, with the majority having negative PBD. Mepolizumab was the most used biological agent (47.5%) , followed by Dupilumab (27.5%), omalizumab (20%) and Benralizumab. There was a need to change the biological in 16 patients, one patient changed for the third time and another is waiting for the fourth biological. Some changes were necessary due to adverse effects.

The majority of patients are female, with RNSCwNP, had fixed obstruction of the airways airways, were eosinophilic and atopic. The need to change the biological agent was most often due to lack of response, some due to adverse effects, which resolved after discontinuing the medication. Studies are needed to help identify the markers associated with better biological response in severe asthma.