D1.104 - Severe Bronchial Asthma Phenotypes in a Referral Tertiary Center in Saudi Arabia

Asthma presents a substantial global health challenge. Despite successful management in many cases, some individuals experience uncontrolled asthma, contributing significantly to morbidity and mortality. Advances in identifying asthma phenotypes and endotypes allow for more personalized treatment. This study seeks to determine the prevalence of phenotypes (Allergic, Eosinophilic, Non-allergic, Non-eosinophilic) in severe asthma patients at a tertiary care center and explore their associations with various atopies.

This single-center retrospective chart review study, conducted at King Faisal Specialist Hospital and Research Centre in Riyadh focused on severe and difficult-to-treat bronchial asthma patients until 2018. Retrospective data collection from electronic records aimed to determine the prevalence of eosinophilic, allergic, and non-allergic non-eosinophilic asthma phenotypes. The study explored associations between phenotypes and various atopic conditions and comorbidities through predefined criteria and data analysis.

The study included 445 bronchial asthma patients, primarily female (60.90%), with a mean age of 46.48 ± 17.77 years and 70% having excess weight. 

The predominant asthma phenotype was eosinophilic (64.49%) followed by the non-allergic, non-eosinophilic phenotype and allergic phenotype at (27.42%.) and (8.9%), respectively [figure 1]. 

Common comorbidities included allergic rhinitis (79.78%), drug allergies (34.61%), and food allergies (24.04%). Significant associations were found between phenotypes, allergic rhinitis, and chronic rhinosinusitis. GERD prevalence was observed across phenotypes, while obstructive sleep apnea ranged from 14–5% across groups.

In summary, the study concludes that the eosinophilic asthma phenotype appears to be more severe and challenging to control. The significant associations with allergic rhinitis, chronic rhinosinusitis, and nasal polyposis underscore the importance of addressing type 2 inflammation through biologics. Additionally, managing asthma co-morbidities, such as obesity, is crucial for effectively addressing severe cases.