Real-World Patient Characteristics and Treatment Patterns in Severe Asthma: A Retrospective Cohort Study from Poland (POLSAR)

OBJECTIVE: Severe asthma 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 severe asthma in Polish specialist care. METHODS: 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. RESULTS: 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 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 OCS use occurred in 42.7% (n = 259). Biologic therapy was initiated in 96.4%, most commonly anti-IgE. CONCLUSIONS: Adults entering biologic pathways in this setting represent a highly selected, clinically advanced severe asthma population with poor control, impaired lung function, frequent exacerbations, corticosteroid burden, type 2 inflammation, and multimorbidity consistent with unified airway disease.