Late Breaking Abstract - Prevalence, characterization and costs of severe asthma in Spain (BRAVO 1)

Abstract

Objectives: To determine the prevalence, comorbidities, biomarkers characterization and costs of severe asthma in patients ≥12-year-old in real life. Methods: Retrospective, cross-sectional, nationwide study that used a top-down approach. Data from BIG-PAC® database (Real Life Data) were used, which is an electronic medical record of 1.9 million Spanish patients (pts) aged ≥12 who had demanded medical care during 2017. Severe asthma (SA) was defined as asthma that required GINA step 5 treatment. Uncontrolled pts were defined by GINA 2019 criteria and oral corticosteroid (OCS) dependent pts were defined by prescription of OCS for at least 6 months. Biomarkers such as blood eosinophils, Fractional Exhaled Nitric Oxide (FeNO) and Immunoglobulin E (IgE) were used to phenotype type 2 pts. Results: The prevalence of asthma was 5.5%. Of these, SA was 7.7%, of whom: 64.1% had uncontrolled SA; 81.2% presented type 2 asthma; 31.2% were OCS-dependent (37% in the uncontrolled SA group); The most common type 2 comorbidities were allergic rhinitis (66.1%), atopic dermatitis (29.1%) and CRSwNP (14.6%). Biologics were administered in 3.8% of total SA patients and 4.3% of patients of the uncontrolled group. The mortality rate was 4.2% and 5.5% in the total SA and the uncontrolled SA group respectively. The total annual costs per patient for uncontrolled SA were 6.010€ and 2.791€ in the controlled SA pts. Conclusions: A vast majority of SA pts present with type-2 asthma. SA continues to have high rates of uncontrolled and OCS dependent asthma despite new available treatments. Uncontrolled SA costs twice as much as controlled pts.