Clinical characteristics of Aspergillus fumigatus sensitised severe asthma patients in severe asthma registry (SHARP)

<bold>Background:</bold> Aspergillus fumigatus sensitisation (AFS) is more common in severe asthma (SA) than in mild asthma. While AFS is linked to poor outcomes in asthma, its clinical relevance within SA remains unclear due to limited large-scale real-world data. <bold>Aims:</bold> To compare clinical, functional, inflammatory, and radiographic characteristics between AFS and non-AFS patients in a large SA cohort. <bold>Methods:</bold> We performed a cross-sectional analysis on data from 1954 SA patients across 11 European countries in SHARP. Data were compared between AFS (skin prick test/specific IgE >0.35 kU/L) and non-AFS patients. <bold>Results:</bold> AFS was found in 441 (22.6%) patients. Clinical characteristics differed between AFS and non-AFS patients (Table 1). There were no differences between groups in number of exacerbations per year (0.72±1.9 vs 0.94±1.9, p=0.55), FEV1 (69.7±21.9% vs 69.9±22.4%, p=0.88) and daily oral corticosteroid (OCS) dose (11.3±9.9 vs 11.1± 9.8 mg, p=0.91). <table-wrap><object-id>erj;66/suppl_69/PA3659/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><caption> Table 1 </caption><table><colgroup><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td>Characteristic</td><td>AFS</td><td>Non-AFS</td><td>p</td></tr><tr><td>Age, years</td><td>58.4±13.7*</td><td>55.4±13.8*</td><td><0.0001</td></tr><tr><td>Asthma duration, years</td><td>26.3±18.2*</td><td>19.2±15.4*</td><td><0.0001</td></tr><tr><td>Total IgE, kU/L</td><td>147.0±2.7*</td><td>96.0±3.1*</td><td><0.0001</td></tr><tr><td>Bronchiectasis, %</td><td>30</td><td>16</td><td><0.0001</td></tr><tr><td>Atopic dermatitis, %</td><td>19</td><td>10</td><td><0.0001</td></tr><tr><td>Nasal polyps, %</td><td>26</td><td>33</td><td>0.0035</td></tr><tr><td>Obesity, %</td><td>23</td><td>33</td><td>0.0001</td></tr><tr><td>Osteoporosis, %</td><td>29</td><td>22</td><td>0.0058</td></tr></tbody></table><table-wrap-foot><fn> * Mean±SD </fn></table-wrap-foot></table-wrap> <bold>Conclusion:</bold> Real-world data show that Aspergillus fumigatus sensitisation (AFS) in severe asthma is associated with prolonged asthma duration and suggests increased airway damage (e.g., bronchiectasis). However, AFS does not appear to correlate with higher exacerbation rates and OCS use within severe asthma population. Whether AFS is relevant for biologic treatment response remains to be determined.

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Published
2025-09-27
DOI
https://doi.org/10.1183/13993003.congress-2025.pa3659
Primary Topic
Antifungal resistance and susceptibility
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article
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article

Clinical characteristics of Aspergillus fumigatus sensitised severe asthma patients in severe asthma registry (SHARP)

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

Clinical characteristics of Aspergillus fumigatus sensitised severe asthma patients in severe asthma registry (SHARP)

Piotr Kuna, Ramesh Kurukulaaratchy, Anneke Ten Brinke, Bilun Gemicioğlu, Jeanne‐Marie Perotin, Marcus O. Butler, Sabina Škrgat, Dóra Lúðvíksdóttir, Aruna T. Bansal, Florence Schleich, 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
article en

Abstract

<bold>Background:</bold> Aspergillus fumigatus sensitisation (AFS) is more common in severe asthma (SA) than in mild asthma. While AFS is linked to poor outcomes in asthma, its clinical relevance within SA remains unclear due to limited large-scale real-world data. <bold>Aims:</bold> To compare clinical, functional, inflammatory, and radiographic characteristics between AFS and non-AFS patients in a large SA cohort. <bold>Methods:</bold> We performed a cross-sectional analysis on data from 1954 SA patients across 11 European countries in SHARP. Data were compared between AFS (skin prick test/specific IgE >0.35 kU/L) and non-AFS patients. <bold>Results:</bold> AFS was found in 441 (22.6%) patients. Clinical characteristics differed between AFS and non-AFS patients (Table 1). There were no differences between groups in number of exacerbations per year (0.72±1.9 vs 0.94±1.9, p=0.55), FEV1 (69.7±21.9% vs 69.9±22.4%, p=0.88) and daily oral corticosteroid (OCS) dose (11.3±9.9 vs 11.1± 9.8 mg, p=0.91). <table-wrap><object-id>erj;66/suppl_69/PA3659/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><caption> Table 1 </caption><table><colgroup><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td>Characteristic</td><td>AFS</td><td>Non-AFS</td><td>p</td></tr><tr><td>Age, years</td><td>58.4±13.7*</td><td>55.4±13.8*</td><td><0.0001</td></tr><tr><td>Asthma duration, years</td><td>26.3±18.2*</td><td>19.2±15.4*</td><td><0.0001</td></tr><tr><td>Total IgE, kU/L</td><td>147.0±2.7*</td><td>96.0±3.1*</td><td><0.0001</td></tr><tr><td>Bronchiectasis, %</td><td>30</td><td>16</td><td><0.0001</td></tr><tr><td>Atopic dermatitis, %</td><td>19</td><td>10</td><td><0.0001</td></tr><tr><td>Nasal polyps, %</td><td>26</td><td>33</td><td>0.0035</td></tr><tr><td>Obesity, %</td><td>23</td><td>33</td><td>0.0001</td></tr><tr><td>Osteoporosis, %</td><td>29</td><td>22</td><td>0.0058</td></tr></tbody></table><table-wrap-foot><fn> * Mean±SD </fn></table-wrap-foot></table-wrap> <bold>Conclusion:</bold> Real-world data show that Aspergillus fumigatus sensitisation (AFS) in severe asthma is associated with prolonged asthma duration and suggests increased airway damage (e.g., bronchiectasis). However, AFS does not appear to correlate with higher exacerbation rates and OCS use within severe asthma population. Whether AFS is relevant for biologic treatment response remains to be determined.

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), Chest Diseases Hospital (KW), 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), 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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