D3.152 - Phenotype and treatment response of allergic patients with severe asthma: a real-world experience from Argentina

allergic diseases and asthma may share common pathological pathways that are targeted by biological agents. This therapeutic strategy reduces exacerbations, hospitalizations and corticosteroid use in patients with severe asthma. Nevertheless, real-world data from Latin America describing the specific subpopulation of allergic patients with severe asthma and their response to biological treatment is lacking.

data from adolescents and adult subjects with severe asthma treated with biologics for 12 months from 9 specialized centers in Argentina was retrieved. Allergic patients (positive prick test and/or radioallergosorbent test) were identified and compared with non-allergic subjects. Data were described and compared with non-parametric tests

115 allergic subjects and 59 non-allergic subjects were identified. Allergic patients were significantly younger (median age: 55 years; interquartile range [IQR]: 43.5-64 vs. 61 years [IQR: 47-67]; p=0.049) and had higher total immunoglobulin E (median: 452.25 U/ml [IQR: 149.5–938.5] vs. 125 U/ml [IQR: 46.3-512]; p<0.001). Allergic rhinitis was more frequently present among allergic patients (68.7% vs. 32.2%; p<0.001), who had ≥2 T2 comorbidities in 51.3% of cases (vs. 25.42% among non-allergic; p=0.001). No basal significant differences were found in terms of body mass index, duration of asthma and prevalence of atopic dermatitis, chronic rhinosinusitis with or without polyposis, aspirin-exacerbated respiratory disease, total blood eosinophils count and chest computed tomography patterns. Basal use of maintenance with oral corticosteroids (OCS) was significantly higher among allergic patients (66.67% vs. 46.15%, p=0.015). In both groups, treatment with biologic agents was associated with a significant and similar improvement of proportion of patients with Asthma Control Test (ACT) score ≥20, free of exacerbations, free of use of OCs and normalization of lung function. Clinical remission rates were 21.74% for allergic patients and 18.64% for non-allergic patients (p=0.633)

 in our real-world cohort from Argentina, allergic patients with severe asthma have a distinct clinical phenotype (younger age, different comorbidities distribution, and a higher basal need of maintenance treatment with OCS). However, response to biologic agents and clinical remission rates were similar to non-allergic patients.