P205 Real world outcomes of Tezepelumab in obese and non-obese severe asthmatics

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Introduction Obese patients with severe asthma have a distinct clinical phenotype. These patients are more likely to have low T2 biomarkers (T2low) so are less likely to meet criteria to be treated with most biologics. Use of Tezepelumab does not require raised eosinophils or FeNO so it may be able to reach this population. Here we present real world outcomes for patients treated with Tezepelumab comparing obese and non obese groups. Methods Data from our service registry were used to study asthma outcomes from Tezepelumab comparing the obese (BMI≥30 kg/m2 ) and the non obese population. Results A total of 142 patients were analysed (60% were obese). The cohort median BMI was 31.0 (27.2–37.2). At baseline, obese patients had non-significant trend of higher exacerbation frequency (5 vs 4.5 p=0.371), median ACQ (3.83 vs 3.5 p= 0.16) and mOCS use (8.4% vs 19.7% n=40 p =0.124) compared to non obese. 31.2% of patients had been treated with another biologic previously. Overall, 34.5% of patients were T2low. Outcomes for patients who completed 12 month trials are described in table 1. Trials were discontinued for adverse effects in 9.2% (n= 13/142 including rash and joint pains. 2.8% (n=4/142) of patients felt no improvement in their symptoms and so trials were discontinued early at their request. A further 2.1% (n=3) of patients did not attend (DNA) multiple appointments and so were unable to complete trials. There were no significant differences in the responses of obese and non obese in this regard. Conclusion Tezepelumab improves asthma outcomes for both obese and non obese patients. However, obese patients still have significantly higher exacerbation frequency. Symptoms remain uncontrolled in the obese group though this did not reach statistical significance. However, this may be affected by the number of patients who did not complete a 12-month trial because of adverse effects or non improvement in symptoms. There is a need for other management options in obesity related severe asthma.

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