D3.150 - Clinical characterization of patients affected by asthma and psoriasis or psoriasic arthritis: an observational retrospective study

Previous studies highlighted common immunophenotypic alterations between a subgroup of asthma with Th17 features and that of psoriasis (PsO), linked to a Th17 and Th22 skewed response. Epidemiological data also pointed to an association between asthma and PsO in both children and adults. However, data about the clinical features of patients affected by both conditions are scant.

The aim of this study was to provide a characterization of asthmatic patients with concurrent PsO or psoriatic arthritis (PsA), compared to patients with asthma only. 

We conducted an observational retrospective study including patients with moderate or severe asthma. We enrolled asthmatic patients (ERS/ATS criteria 2021) with PsO/PsA enrolled at two clinical Centers (allergy-immunology and pneumology). A group of randomly selected patients matched for sex, age, GINA step and without PsO or PsA, was enrolled for comparison

Among 58 patients, 29 were affected by PsO (69% female), the median age was 56.5, IQR 23.8 years. Asthma was severe in 54.4% of patients (GINA 5). Baseline BMI did not differ between the two groups (26.2, IQR 6.06 vs 25.5, IQR 5.11, p=0.586), while patients with PsO had a higher prevalence of smokers. Compared to patients with asthma only, there were not significant differences in lung function (FEV1 94%, IQR 23.0 vs 98%, IQR 23.25, p=0.435; FVC 102%, IQR 25.5 vs 109%, IQR 23.75, p=0.569; FEV1/FVC 0.725, IQR 0.161 vs 0.754, IQR 0.17, p=0.328) and in asthma features (age at onset 35, IQR 36.5 vs 36.5, IQR 28.25 p=1; disease duration 28, IQR 20.5 vs 24, IQR 27, p=0.86). Similarly, the prevalence of asthma-related comorbidities, including nasal polyposis (36% vs 46.4% p=0.442) and food allergies (32.1% vs 11.1%, p=0.059), did not differ significantly. The prevalence of allergic rhinitis (50% vs 76.9%, p= 0.044) was significantly lower in asthmatic patients with PsO/PsA.Among patients with PsO, 10/29 were receiving biologic therapy for asthma, with no observed exacerbations of PsO/PsA; notably, two of them were also on biologic therapy for PsO without any reported complications.

Our study highlighted that the clinical asthma features in patients with PsO closely resemble that of asthmatic patients only, even though this subgroup may be characterized by a Th1 and Th17 underlying inflammatory disease.

Given the limited sample size and single-center design, larger multicenter studies are needed to accurately determine the prevalence of severe asthma in those patients.