Severe asthma with fungal sensitisation (SAFS)


SAFS is a relatively new disease classification; therefore, there is limited information on its clinical features. Studies are ongoing, and diagnosis is primarily made by excluding other conditions. 


The criteria for diagnosis include the following: 

  • The presence of severe asthma that is poorly controlled with conventional treatment 
  • Fungal sensitisation – identified by a blood or skin prick test 
  • The absence of allergic bronchopulmonary aspergillosis 


Similar to allergic bronchopulmonary aspergillosis (ABPA), SAFS is caused by inadequate airway clearance of inhaled fungus.   


  • Long-term steroids 
  • Antifungals 
  • Biologics such as omalizumab (an anti-IgE monoclonal antibody)