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.

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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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