Eosinophilic phenotype in adults with severe asthma in a tropical middle-income country: The ISAR Colombia experience

<bold>Introduction:</bold> The eosinophilic phenotype (EOSp) is responsible for more than 60% of cases of severe asthma (SA) in adults. There is limited information about EOSp in tropical middle-income countries where the conditions could influence the blood eosinophils count (BEC). <bold>Methods:</bold> Cross-sectional study in adults with SA included in the International Severe Asthma Registry (ISAR) in Colombia, 2019 to 2023, with a BEC measurement in the last year. Prevalence of EOSp was estimated and baseline characteristics (Visit 0) were compared according to the presence or absence of EOSp, which was defined as a BEC ≥150 cells/µL. For defining EOSp in patients on biologic therapy (BT) at visit 0, we used the BEC measurement taken before BT initiation with a cutoff ≥300 cells/µL. <bold>Results:</bold> We included 401 patients, 294 (73.5%) women, 192 (37%) on BT. Prevalence of EOSp was 76.1%. Using a cutoff of BEC ≥300 cells/µL was 66.3%. Patients with EOSp had more frequently allergic rhinitis (p=0.016), chronic rhinosinusitis (p=0.094), nasal polyps (p=0.035) and required more steroid bursts in the last year (p=0.003), without differences in age, sex, or any other characteristics. Patients on BT had more frequently EOSp (p=0.012). <bold>Conclusion:</bold> The prevalence and characteristics of EOSp in a tropical middle-income country resemble those described in developed regions. Patients with EOSp are more frequently treated with BT. <fig><object-id>erj;64/suppl_68/PA4820/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>