T2-low severe asthma clinical spectrum and impact: The Greek PHOLLOW cross-sectional study

IF 4.6 2区 医学 Q2 ALLERGY
Konstantinos Porpodis, Nikolaos Zias, Konstantinos Kostikas, Argyris Tzouvelekis, Michael Makris, George N. Konstantinou, Eleftherios Zervas, Stelios Loukides, Paschalis Steiropoulos, Konstantinos Katsoulis, Anastasios Palamidas, Aikaterini Syrigou, Maria Gangadi, Antonios Christopoulos, Dimosthenis Papapetrou, Fotios Psarros, Konstantinos Gourgoulianis, Eleni Tzortzaki, Stylianos K. Vittorakis, Ioannis Paraskevopoulos, Ilias Papanikolaou, Georgios Krommidas, Dimitrios Latsios, Nikolaos Tzanakis, Miltiadis Markatos, Angeliki Damianaki, Argyrios Manikas, Alexia Chatzipetrou, Dimitrios Vourdas, Ioanna Tsiouprou, Christina Papista, Marina Bartsakoulia, Nikolas Mathioudakis, Petros Galanakis, Petros Bakakos
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引用次数: 0

Abstract

Background

Data on type 2 (T2)-low severe asthma (SA) frequency is scarce, resulting in an undefined unmet therapeutic need in this patient population. Our objective was to assess the frequency and characterize the profile and burden of T2-low SA in Greece.

Methods

PHOLLOW was a cross-sectional study of adult SA patients. Based on a novel proposed classification system, patients were classified as T2-low if blood eosinophil count (BEC; cells/μL) was <150, fractional exhaled nitric oxide (FeNO) < 25 ppb and any allergy status or BEC < 150/FeNO < 50 ppb/no allergy or BEC < 300/FeNO < 25 ppb/no allergy. For patients receiving biologics and/or oral corticosteroids, only those with BEC < 150/FeNO < 25 ppb/no allergy/no response to therapy were classified as T2-low. Secondary outcome measures were: Asthma Control Test (ACTTM), Mini-Asthma Quality of Life Questionnaire (Mini-AQLQ), hospital anxiety and depression scale (HADS), and Work Productivity and Activity Impairment:Respiratory Symptoms (WPAI:RS) questionnaire.

Results

From 22-Mar-2022 to 15-Mar-2023, 602 eligible SA patients were enrolled. The frequency of T2-low asthma was 20.1%. Of those, 71.1% had experienced ≥1 clinically significant exacerbations in the past year, 62.8% had ACT score <20 (uncontrolled asthma), and 22.3% were biologic-treated. Mini-AQLQ score was <6 (impairment) in 79.5% of patients, HADS-total score was ≥15 (clinically significant emotional distress) in 43.8%, while median percent activity impairment and work productivity loss were 30.0 for both domains. Clinical and patient-reported outcomes were worse among patients with ACT-defined uncontrolled asthma.

Conclusions

One-fifth of SA patients present with a T2-low endotype. These patients frequently have uncontrolled disease and experience impairments in their quality of life, emotions and work ability.

Abstract Image

t2 -低严重哮喘临床谱和影响:希腊phlow横断面研究。
背景:关于2型(T2)-低严重哮喘(SA)频率的数据很少,导致该患者群体的治疗需求未得到满足。我们的目的是评估希腊t2 -低SA的频率、特征和负担。方法:对成年SA患者进行横断面研究。基于一种新提出的分类系统,如果患者的血嗜酸性粒细胞计数(BEC;细胞/μL为TM)、迷你哮喘生活质量问卷(Mini-AQLQ)、医院焦虑抑郁量表(HADS)和工作效率和活动障碍:呼吸道症状(WPAI:RS)问卷。结果:从2022年3月22日至2023年3月15日,共纳入602例符合条件的SA患者。t2 -低哮喘发生率为20.1%。其中,71.1%在过去一年中经历了≥1次具有临床意义的恶化,62.8%有ACT评分。结论:五分之一的SA患者表现为t2 -低内型。这些患者经常有不受控制的疾病,并在生活质量、情绪和工作能力方面受到损害。
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来源期刊
Clinical and Translational Allergy
Clinical and Translational Allergy Immunology and Microbiology-Immunology
CiteScore
7.50
自引率
4.50%
发文量
117
审稿时长
12 weeks
期刊介绍: Clinical and Translational Allergy, one of several journals in the portfolio of the European Academy of Allergy and Clinical Immunology, provides a platform for the dissemination of allergy research and reviews, as well as EAACI position papers, task force reports and guidelines, amongst an international scientific audience. Clinical and Translational Allergy accepts clinical and translational research in the following areas and other related topics: asthma, rhinitis, rhinosinusitis, drug hypersensitivity, allergic conjunctivitis, allergic skin diseases, atopic eczema, urticaria, angioedema, venom hypersensitivity, anaphylaxis, food allergy, immunotherapy, immune modulators and biologics, animal models of allergic disease, immune mechanisms, or any other topic related to allergic disease.
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