Characteristics of Patients with Severe Uncontrolled Asthma in Saudi Arabia: A Cross-Sectional Study

Riyad O Al-Lehebi,1,2 Rana A Saleh,3 Abdalla M Alasiri,4 Bader J Alghamdi,5,6 Hajer Y Almudaiheem,7,8 Ahmed H Al-jedai,8,9 Eid A Almutairi,3 Haifa Aldakhil,10 Khaulah A Alokili,7 Fahad Zuriqan,7 Adeeb A Bulkhi11 1Pulmonary Department, King Fahad Medical City, Riyadh, Saudi Arabia; 2Internal Medicine Department, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; 3Lung Health Centre Department, Organ Transplant Centre of Excellence, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; 4Pulmonary Department, Aseer Central Hospital, Abha, Saudi Arabia; 5College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; 6Pulmonary Department, King Abdulaziz Medical City, National Guard Ministry, Jeddah, Saudi Arabia; 7Drug Policy and Regulations Unit, Ministry of Health, Riyadh, Saudi Arabia; 8The Saudi Society of Clinical Pharmacy, Riyadh, Saudi Arabia; 9Colleges of Medicine and Pharmacy, Alfaisal University, Riyadh, Saudi Arabia; 10Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; 11Internal Medicine Department, College of Medicine, Umm Al-Qura University, Makkah, Saudi ArabiaCorrespondence: Adeeb A Bulkhi, Internal Medicine Department, College of Medicine, Umm Al-Qura University, 3135 Abdulaziz Kurdi St, Makkah, 24372, Saudi Arabia, Tel +966554533650, Email [email protected]: Severe asthma poses significant morbidity and healthcare burden, with the eosinophilic phenotype being particularly prevalent. This study aims to characterize the demographic and clinical profiles of severe eosinophilic asthma patients in a Saudi Arabian cohort involving multiple centers in the country.Methods: A cross-sectional analysis of a prospective cohort of 268 patients with severe eosinophilic asthma, eligible for benralizumab treatment, was analyzed from the Saudi Arabian Ministry of Health database. Demographic data, biomarker profiles, and historic disease and medication burden were examined and stratified by various parameters including city/region, eosinophil count, and type 2 inflammatory comorbidities.Results: Patients were predominantly female (66.4%), with an average age of 45.3 years, and had a median BMI of 27.7 kg/m2. The majority were never smokers, and about one-third had type 2 inflammatory comorbidities. High exacerbation rates (median of 5 exacerbations per year) and frequent healthcare utilization were noted despite high-dose inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) treatment. Nearly 20% of patients were on maintenance oral corticosteroids. The median blood eosinophil count was 656 cells/μL, indicating a high prevalence of severe eosinophilic asthma (defined as a blood eosinophil count ≥ 150 cells/μL.Conclusion: This study confirms the substantial burden of severe eosinophilic asthma in the Saudi population, with significant exacerbation rates and healthcare resource use despite conventional therapy. The data suggest a potential role for benralizumab in improving disease outcomes for severe eosinophilic asthma. Further research is needed to evaluate the efficacy and cost-effectiveness of benralizumab in these patients.Keywords: severe asthma, eosinophilic asthma, benralizumab, Saudi Arabia, asthma exacerbations, biological therapy, healthcare utilization