Common comorbidities in severe asthma

Patients with severe asthma often harbour comorbidities. Atopic dermatitis and chronic rhinosinusitis with nasal polyps (CRSwNP) are common comorbidities of severe type2 asthma which respond well to treatment with biologicals targeting the underlying inflammation.

Dr Asger Sverrild (Bispebjerg Hospital, Denmark) summed up the most common comorbidities in patients with severe asthma. “CRSwNP occurs in 30 to 50% of patients with severe asthma, for which the standard of care consists of intranasal steroids, systemic corticosteroids, and/or sinus surgery. Around 10–30% of patients with severe asthma have concomitant atopic dermatitis. One both FDA- and EMA-approved biological targeting the underlying type2-inflammation is currently available for the treatment of atopic dermatitis (dupilumab), and this may also be used for the treatment of asthma and/or CRSwNP. Importantly, dupilumab allows tapering off systemic corticosteroids in severe asthma (approx. 25–45 % of whom receive systemic corticosteroids maintenance therapy) [1]. A less common pulmonary comorbidity in severe asthma is allergic bronchopulmonary aspergillosis (ABPA), with an estimated prevalence <5% of patients [2].”

1. Domingo C, et al. J Allergy Clin Immunol Pract. 2022;10:1835-43.
2. Sverrild A. Define the right T2 endotype as the right target for biologics - The role of comorbidities and chronic OCS use. Nordic Lung Congress 2022, 01–03 June, Copenhagen, Denmark.

 

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Posted on 17 August 202216 August 2022