Introduction Proper evaluation of the allergic sensitizations is inevitable in treating severe asthma. Besides seasonal allergens, perennial aeroallergens have to be considered. However, within the German reimbursement system testing of only 8 allergens per quarter is reimbursed by health insurances, and thus, analyses of relevant allergens beyond the 8 common ones is often not done.

Purpose The aim of this ongoing project is to gain data on sensitizations towards 35 perennial aeroallergens in severe asthmatic patients, in which no allergen could be detected in previous testing and who are thus considered non-atopic.

Methods 35 locally common perennial aeroallergens (mites, fungi, animal epithelia, insects) are tested via Immulite® (specific IgE in blood) in 600 severe asthmatic patients in Germany who had negative results in previous allergen testing by either Skin Prick Test or analyses of specific IgE. Furthermore, total IgE levels are determined and a general anamnesis is documented including historical allergen testing, comorbidities, symptoms, exposure to allergens etc.

Results In an interims analysis, 56.1% of 214 patients demonstrated at least one sensitisation towards a perennial aeroallergen despite they were considered non-atopic before. The most common sensitizations were found towards Rhizopus nigricans (16.8%), Aspergillus fumigatus (15.9%), Cat dander (11.1%), Dermatophagoides farina (10.7%) and Dog dander (9.9%). 84.2% of patients were (partly) uncontrolled according to GINA classification of asthma control and 51.7% had ≥2 exacerbations in the past 12 months. These results indicate a lack in diagnostics of perennial aeroallergens in severe asthmatic patients in Germany. The correct ascertainment of the allergic status is crucial to make optimal treatment decisions for the asthmatic patient.