Assessment of asthma control identifies new super responders to anti-IL5r therapy in severe asthma

<bold>Background:</bold> A recent worldwide consensus on the definition of super responders (SR) established the use of Asthma Control Questionnaire (ACQ) score as one of three major factors (doi:10.1016/j.jaip.2021.06.041.). <bold>Aim:</bold> Assess the impact of using ACQ score in severe asthma biologics outcomes. <bold>Methods:</bold> After one year on benralizumab treatment, patients' response was assessed as follows: <table-wrap><object-id>erj;64/suppl_68/PA4817/T1</object-id><object-id>T1</object-id><object-id>t1</object-id><table><colgroup><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td>Factors</td><td><bold>NHS England</bold></td><td><bold>Consensus No ACQ</bold></td><td><bold>Consensus</bold></td></tr><tr><td>Criteria</td><td>One of:</td><td>Two of:</td><td>Two of: (plus 1 minor)</td></tr><tr><td><bold>Exacerbations</bold></td><td>50 % reduction</td><td>None</td><td>None</td></tr><tr><td><bold>mOCS</bold></td><td>50 % reduction</td><td>None</td><td>None</td></tr><tr><td><bold>ACQ</bold></td><td>X</td><td>X</td><td>2x MCID</td></tr><tr><td>Minor factors</td><td>X</td><td>X</td><td>Exacerbation/FEV1/ACQ</td></tr></tbody></table></table-wrap> <bold>Results:</bold> Of the 114 patients that gave consent, 84% (96) and 80% (92) responded to treatment after 1 yr for NHS England and consensus respectively (Χ² p<0.001). When the ACQ score was used, 32% patients changed consensus classification category: Χ² <italic>p</italic><0.001 (Fig. 1). <fig><object-id>erj;64/suppl_68/PA4817/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <bold>Discussion:</bold> When using a multifactorial approach, severe asthma patients' response status was changed (third) and improved (quarter). The SR consensus uses more stringent clinical criteria than NHS England but incorporates PROM. The overall number of responders is slightly reduced so this could have implications for funding. However this highlights the potential for the voice of the patient and further PROM to be given a more prominent place as is already the case in some countries, in the light of different pathways targeted with alternative biologic therapies.