Introduction
Intramuscular triamcinolone can provide a long-acting alternative to the use of oral corticosteroids for severe asthma. The utility of triamcinolone as a marker of response in asthma phenotypes with high symptom scores who are not accessing oral corticosteroid therapy is explored in this abstract.
Here we aim to demonstrate with a retrospective cohort analysis that patients trialled with triamcinolone prior to commencing biological treatments for severe asthma exhibit similar outcomes to those who access these biological agents via conventional routes.  

Methods 
Data was collected retrospectively from two severe asthma tertiary outpatient clinic cohorts for patients receiving benralizumab, mepolizumab or omalizumab. These cohorts were defined as those referred for biologic treatments via conventional routes or those that had a successful 3-month trial of triamcinolone.  Assessment data was collected as recommended by national guidelines and included the use of standardised questionnaires, spirometry, FENO, oral corticosteroid usage and exacerbation frequency.  

Results

The data analysed demonstrated a clear benefit from biologics in patients that accessed any of these 3 agents after a triamcinolone trial with statistically significant improvements in asthma control questionaire-6 scores and number of exacerbations per annum. There was no significant difference between the two patient cohorts in other measure.

Conclusions

This retrospective cohort analysis shows the viability of using a trial of triamcinolone to identify those patients who would benefit from biologics. This is the first reported evidence of positive clinical outcomes in this patient cohort.