Age-related differences in severe asthma patients addressed to biologics: insights from the SHARP Collaboration

<bold>Introduction:</bold> Severe asthma is an heterogeneous disease. The impact of aging on severe asthma features is poorly understood. The real-world data from SHARP collaboration, provides a unique opportunity to study how asthma evolves with age. <bold>Aims:</bold> 1)To analyze age distribution and related characteristics in severe asthmatics addressed to biologics. 2)To explore biologic prescription rates across different ages. <bold>Methods:</bold> We conducted a cross-sectional analysis of severe asthma patients in SHARP Central database. Patients were grouped by age and baseline demographics, pulmonary function, comorbidities, drugs use, and inflammatory markers were analyzed. A summary of selected results is hereby presented. <bold>Results:</bold> Overall, 4116 patients were included. 887(21.5%) were in group 18-44, 929(23%) in 45-54, 2215(54%) in 55-79 and 85(2%) in group 80+. No age-related differences were observed in T2 markers. The 80+ had less patients addressed to biologics compared to the others. <bold>Conclusion:</bold> Older severe asthmatics are less represented and receive fewer biologics than younger ones despite similar inflammation, suggesting age may be a barrier to biologics’ prescription. These findings emphasize the need for optimizing their care. <table-wrap><object-id>erj;66/suppl_69/PA4649/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><table><colgroup><col></col><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td></td><td><bold>18-44</bold></td><td><bold>45-54</bold></td><td><bold>55-79</bold></td><td><bold>80+</bold></td></tr><tr><td><bold>Biologics n(%)</bold></td><td></td><td></td><td></td><td></td></tr><tr><td>Omalizumab</td><td>234(33)</td><td>165(22)</td><td>243(14)</td><td>2(4)</td></tr><tr><td>Mepolizumab</td><td>207(29)</td><td>281(38)</td><td>704(39)</td><td>23(41)</td></tr><tr><td>Reslizumab</td><td>22(3)</td><td>35(5)</td><td>92(5.1)</td><td>2(4)</td></tr><tr><td>Benralizumab</td><td>157(22)</td><td>176(24)</td><td>536(30)</td><td>25(45)</td></tr><tr><td>Dupilumab</td><td>94(13)</td><td>88(12)</td><td>221(12)</td><td>4(7)</td></tr><tr><td>Total</td><td>714(81)</td><td>745(80)</td><td>1796(81)</td><td>56(66)</td></tr><tr><td><bold>T2 markers mean(SD)</bold></td><td></td><td></td><td></td><td></td></tr><tr><td>Blood eos</td><td>0.45(1.3)</td><td>0.47(1.3)</td><td>0.44(1.2)</td><td>0.42(1.3)</td></tr><tr><td>Sputum eos(%)</td><td>15(3)</td><td>15(3)</td><td>16(3)</td><td>13(1)</td></tr><tr><td>FeNO(ppb)</td><td>32(2)</td><td>35(2)</td><td>36(2)</td><td>39(2)</td></tr><tr><td>Total IgE(kU/L)</td><td>100(3)</td><td>93(3)</td><td>93(3)</td><td>80(4)</td></tr></tbody></table></table-wrap>