Real-world patient characteristics and treatment patterns in severe asthma: a retrospective cohort study from Poland...

Severe asthma (SA) is a heterogeneous, high-burden disease requiring intensified treatment and substantial healthcare resource use. However, real-world characterization of patients managed under restricted biologic access remains limited in Poland. This study described clinical and demographic characteristics of adults with SA in Polish specialist care.

This non-interventional, retrospective cohort study used anonymized data from the Polish Severe Asthma Registry (POLSAR), within the International Severe Asthma Registry (ISAR). Adults enrolled at a tertiary specialist center between August 2013 and December 2024 were included. Baseline characteristics were assessed during the 12 months preceding ISAR enrollment.

Overall, 503 adults were analyzed; 63.2% were female, mean age was 54 years, and mean asthma duration was 19.4 years. Disease control was poor: 97.2% were uncontrolled by GINA (n = 72), and 82.7% had ACQ ≥1.5 (n = 139). Mean FEV₁ was 65.8% predicted, with 39.9% <60% (n = 193). Exacerbation burden was substantial (mean 3.1/year; 31.5% ≥4, n = 238). Type 2 inflammatory features predominated, with BEC ≥350 cells/µL in 64.0% (n = 283), total immunoglobulin E (IgE) ≥75 kU/L in 74.3% (n = 191), and combined biomarker elevation in 61.0% (n = 136). Multimorbidity was frequent (≥3 comorbidities in 46.1%), particularly chronic rhinosinusitis, allergic rhinitis, and nasal polyposis. Long-term oral corticosteroids use occurred in 42.7% (n = 259). Biologic therapy was initiated in 96.4%, most commonly anti-IgE.

Adults entering biologic pathways in this setting represent a highly selected, clinically advanced SA population with poor control, impaired lung function, frequent exacerbations, corticosteroid burden, type 2 inflammation, and multimorbidity consistent with unified airway disease.