A60-28 Baseline Patient Characteristics in a Large Multi-center Severe Asthma Cohort: The U.S. Severe Pediatric Asthma Consortium
S H Averill, W C Anderson, E Ararat, S Baxi, M Cernelc-Kohan, H H De Keyser, M Federico, J M Gaffin, B Geng, T W Guilbert, A A Jefferson, K M Kloepfer, S Leibel, M A Lu, P Patel, R D Pesek, D Rastogi, S Saxena, T Simoneau, J B Tam-Williams, K G Tantisira, N Krupp, E FornoAbstract
Background
The Severe Pediatric Asthma Consortium (SPAC) includes 24 academic pediatric centers across the U.S. with multidisciplinary programs for severe, high-risk, or difficult-to-treat asthma. Here we present patient characteristics from nine SPAC centers upon patient entry into their clinics.
Methods
Participating centers entered patient characteristics into a standardized REDCap registry. We focused on new clinic patients between 1/01/2022 and 12/31/2024. Data included demographics, asthma history and severity, lung function, asthma medications, and atopy biomarkers at the time that patients entered the severe asthma program. We calculated the mean and 95% confidence interval (pooled analysis of centers using random effects); the center range (lowest–highest mean or proportion reported by participating centers); the prediction interval (range predicted for a new center); and the between-center heterogeneity (I2).
Results
The nine SPAC centers provided summary data for 791 new patients, representing approximately 75% (95%CI: 51-98%) of new patients seen at each center between 2022 and 2024. The Table shows the main characteristics of these patients. There was a wide range in the number of new patients for the period (n = 27-255) among centers. Average age at entry was 9.6 years (range 7-10.8, predicted interval ∼7.2-12.0 years) also with wide heterogeneity (I2=85.9%). Overall, SPAC centers represent a diverse population (on average 41% White, 38% Black, and 22% Hispanic) with high asthma severity (5-14% with previous intubation for asthma) and poor symptom control (average ACT or cACT score ∼17 [95%CI: 15.8-18.7]). Average BMI z-score was high at 1.03 (0.80-1.26). Lung function was within normal on average but there was wide variability and some centers reported average values below lower limit of normal. High proportions of patients were on ICS (98%) and LABA (86%), with 22% on LAMA and a small proportion on systemic steroids (2.3% although one center reported 37%). Biologic use varied widely (∼4-91% on any biologics). There was significant center heterogeneity (I2>75%) for most characteristics.
Conclusions
This representative sample of new patients seen in U.S. Severe Pediatric Asthma Consortium centers shows substantial disease severity and burden. The heterogeneity among centers highlights the importance of studying severe asthma both at the patient and the center level, as well as identifying best practices for this severe group. The diverse patient population is a significant strength of our Consortium.
This abstract is funded by: none