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The following is a summary of “Is the prevalence of allergic bronchopulmonary aspergillosis greater in severe asthma?,” published in the September 2024 issue of Allergy and Immunology by Sehgal et al.

Allergic bronchopulmonary aspergillosis (ABPA) is frequently suspected to be more common in patients with severe asthma compared to those with mild asthma; however, empirical data supporting this hypothesis is limited. The objective of this study was to determine the prevalence of ABPA among individuals with asthma of varying severity. Researchers conducted a secondary analysis of prospectively collected data from 543 adult asthma patients, categorized according to the 2004 Global Initiative for Asthma guidelines into mild, moderate, and severe asthma groups. 

The prevalence of ABPA was assessed within each asthma severity category, and multivariable logistic regression was performed to identify factors associated with ABPA. Of the 543 subjects, 81 (15%) were classified as having mild asthma, 257 (47%) as having moderate asthma, and 205 (38%) as having severe asthma. ABPA was diagnosed in 106 (19.5%) patients overall. The prevalence of ABPA was 11.1% (9/81) in the mild asthma group, 21% (54/257) in the moderate asthma group, and 20.7% (43/205) in the severe asthma group, with no statistically significant difference among the groups (p=0.12). Multivariable analysis revealed that age and asthma duration were important factors associated with ABPA, while asthma severity did not significantly correlate with the presence of ABPA. 

These findings suggest that ABPA prevalence is consistent across different asthma severities, supporting the International Society of Human and Animal Mycology’s revised recommendations for screening all asthma patients for ABPA, regardless of the severity of their asthma. Further research involving larger cohorts and diverse geographic locations is needed to corroborate these results and refine screening guidelines.

Source: sciencedirect.com/science/article/abs/pii/S2213219824008900