Heterogeneity of Aspergillus fumigatus sensitization testing captured by national severe asthma registries in SHARP

Backround: Aspergillus fumigatus sensitization (AFS) is associated with various clinical outcomes in asthma. It remains unclear how AFS is recognized and captured in severe asthma (SA) clinical practice. <bold>Aims:</bold> To assess differences in AFS testing practices among SHARP countries and evaluate clinical profile differences between AFS and non-AFS tested patients. <bold>Methods:</bold> We performed a cross-sectional analysis using data from 3443 patients across 11 countries in SHARP. <bold>Results:</bold> 1954 (57%) were AFS-tested; 441 (23%) were AFS-positive, and 1513 (77%) AFS-negative. Testing was most frequent in southern Europe (82%), with a positivity rate of 17%, followed by western (60%/31%), eastern (41%/7%), and northern Europe (27%/16%). <table-wrap><object-id>erj;66/suppl_69/PA3660/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><caption> Table 1: Clinical characteristics tested vs non-tested </caption><table><colgroup><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td>Characteristic</td><td>Tested</td><td>Non-tested</td><td> p</td></tr><tr><td>Asthma duration, years*</td><td>20.7(16.3)</td><td>19.2(15.5)</td><td> 0.010</td></tr><tr><td>FEV1, %predicted*</td><td>69.9(22.3)</td><td>72.9(22.6)</td><td> 0.002</td></tr><tr><td>Chronic sinusitis with nasal polyps**</td><td>612(31)</td><td>328(22)</td><td><0.001</td></tr><tr><td>Bronchiectasis**</td><td>383(20)</td><td>195(13)</td><td><0.001</td></tr><tr><td>Adrenal insufficiency**</td><td>127(6)</td><td>47(3)</td><td><0.001</td></tr><tr><td>Daily oral corticosteroids (OCS)**</td><td>353(36)</td><td>158(26)</td><td><0.001</td></tr></tbody></table><table-wrap-foot><fn> *mean(SD), **N(%) </fn></table-wrap-foot></table-wrap> <bold>Conclusion:</bold> Aspergillus fumigatus sensitization (AFS) testing and the positive test rate in severe asthma patients varies widely across Europe. AFS testing is more common in those with longer asthma duration, poorer lung function, multiple comorbidities, and higher OCS use. Further research should clarify the clinical relevance of AFS, particularly its impact on biological treatment responses and systematic testing value in severe asthma management.

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Published
2025-09-27
DOI
https://doi.org/10.1183/13993003.congress-2025.pa3660
Primary Topic
Antifungal resistance and susceptibility
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article
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article

Heterogeneity of Aspergillus fumigatus sensitization testing captured by national severe asthma registries in SHARP

Piotr Kuna, Ramesh Kurukulaaratchy, Anneke Ten Brinke, Bilun Gemicioğlu et al.
Antifungal resistance and susceptibility
article

Heterogeneity of Aspergillus fumigatus sensitization testing captured by national severe asthma registries in SHARP

Piotr Kuna, Ramesh Kurukulaaratchy, Anneke Ten Brinke, Bilun Gemicioğlu, Jeanne‐Marie Perotin, Marcus O. Butler, Sabina Škrgat, Dóra Lúðvíksdóttir, Aruna T. Bansal, Cláudia Loureiro, Giorgio Walter Canonica, Zsuzsanna Csoma, Vratislav Sedlák, ARNAUD AB BOURDIN, Kristina Biekšienė, Florin Dumitru Mihaltan, Sanja Popović‐Grle, Jörg D. Leuppi, Shane Hanon, Valentyna Yasinska, Kostas Samitas, Celeste Porsbjerg, Peter Kopač, Gordana Pavliša, Ineta Grisle, Ana Žaže Bertoncel, Florence Scleich
article en

Abstract

Backround: Aspergillus fumigatus sensitization (AFS) is associated with various clinical outcomes in asthma. It remains unclear how AFS is recognized and captured in severe asthma (SA) clinical practice. <bold>Aims:</bold> To assess differences in AFS testing practices among SHARP countries and evaluate clinical profile differences between AFS and non-AFS tested patients. <bold>Methods:</bold> We performed a cross-sectional analysis using data from 3443 patients across 11 countries in SHARP. <bold>Results:</bold> 1954 (57%) were AFS-tested; 441 (23%) were AFS-positive, and 1513 (77%) AFS-negative. Testing was most frequent in southern Europe (82%), with a positivity rate of 17%, followed by western (60%/31%), eastern (41%/7%), and northern Europe (27%/16%). <table-wrap><object-id>erj;66/suppl_69/PA3660/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><caption> Table 1: Clinical characteristics tested vs non-tested </caption><table><colgroup><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td>Characteristic</td><td>Tested</td><td>Non-tested</td><td> p</td></tr><tr><td>Asthma duration, years*</td><td>20.7(16.3)</td><td>19.2(15.5)</td><td> 0.010</td></tr><tr><td>FEV1, %predicted*</td><td>69.9(22.3)</td><td>72.9(22.6)</td><td> 0.002</td></tr><tr><td>Chronic sinusitis with nasal polyps**</td><td>612(31)</td><td>328(22)</td><td><0.001</td></tr><tr><td>Bronchiectasis**</td><td>383(20)</td><td>195(13)</td><td><0.001</td></tr><tr><td>Adrenal insufficiency**</td><td>127(6)</td><td>47(3)</td><td><0.001</td></tr><tr><td>Daily oral corticosteroids (OCS)**</td><td>353(36)</td><td>158(26)</td><td><0.001</td></tr></tbody></table><table-wrap-foot><fn> *mean(SD), **N(%) </fn></table-wrap-foot></table-wrap> <bold>Conclusion:</bold> Aspergillus fumigatus sensitization (AFS) testing and the positive test rate in severe asthma patients varies widely across Europe. AFS testing is more common in those with longer asthma duration, poorer lung function, multiple comorbidities, and higher OCS use. Further research should clarify the clinical relevance of AFS, particularly its impact on biological treatment responses and systematic testing value in severe asthma management.

Reykjavík University (IS), Lithuanian University of Health Sciences (LT), Humanitas University (IT), Vrije Universiteit Brussel (BE), University Hospital Centre Zagreb (HR), Royal College of Surgeons in Ireland (IE), Inserm (FR), University of Liège (BE), University of Iceland (IS), University of Basel (CH), Université de Montpellier (FR), Ljubljana University Medical Centre (SI), TeraView (United Kingdom) (GB), Beaumont Hospital (IE), Bispebjerg Hospital (DK), Hospitais da Universidade de Coimbra (PT), University Hospital of Basel (CH), Medisch Centrum Leeuwarden (NL), University of Łódź (PL), Physiologie et Médecine Expérimentale du Coeur et des Muscles (FR), Riga East University Hospital (LV), Centre Hospitalier Universitaire de Reims (FR), National University Hospital of Iceland (IS), Istanbul University-Cerrahpaşa (TR), University Clinic of Pulmonary and Allergic Diseases Golnik (SI), Clinica de Pneumologie Iaşi (RO), Medical University of Lodz (PL), Department of Biomedicine Basel (CH), Swedish Asthma and Allergy Association (SE), Southampton City Council (GB), Czech Society for Ornithology (CZ), Athena Research and Innovation Center In Information Communication & Knowledge Technologies (GR), IRCCS Humanitas Research Hospital (IT), Országos Korányi Tbc és Pulmonológiai Intézet (HU), Universitäre Psychiatrische Kliniken Basel (CH), University of Southampton (GB), University of Coimbra (PT), Université de Reims Champagne-Ardenne (FR)
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Antifungal resistance and susceptibility
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