Introduction

Current definition of Super-Responders (SR) to severe asthma biologic treatment mainly relies on clinical features, without considering patient-healthcare provider (HCP) agreement SR features.

Aims and objectives

To identify patients? perception concerning the impact of biological therapy on severe asthma.

Methods

We enrolled 71 patients with severe asthma treated with monoclonal antibodies. All patients performed a 6-domains questionnaire exploring several aspects of severe asthma response:

1)Daytime symptoms

2)daily activities and exercise

3)Night rest

4)Exacerbations

5)Perception of prescribed therapy

6)Time to treatment response

Each question was rated in a 0-4 scale. Patients? perceived SR was defined considering the top 2 scores for each domain?s question. HCP?s definition of SR was based on the achievement of the following criteria after 6 months of biologic treatment:

Major criteria

·No exacerbations;

·No OCS administration;

·ACT improvement ? 6 points

Minor criteria

·Exacerbations decrease ? 75% from baseline;

·ACT ? 20;

·FEV1 improvement ? 500 ml from baseline

SR were defined with ? 3 features with at least 2 major criteria fulfilled.

Results

We found no concordance between HCP and patients reported definition of SR, without significant variations in mean domain scores in SR vs non-SR. SR in night rest domain showed higher ACT (P=0.04) and FVC (P=0.01), while SR on exacerbations domain had higher FEV1 (P=0.02), FVC (P=0.004) and blood eosinophils count (P=0.004).

Conclusions

Patients? reported features of biologic treatment response seem to be still too far from HCP definition of SR, although some clinical features could be associated with domains of perceived asthma response.