Journal of Asthma最新文献

{"title":"Circulating IL-6 associates with a distinct pediatric asthma subtype and serves as a potential key predictor for risk stratification.","authors":"Yuyang Liu, Lina Cheng, Lu Wang","doi":"10.1080/02770903.2026.2666086","DOIUrl":"10.1080/02770903.2026.2666086","url":null,"abstract":"<p><strong>Backgrounds: </strong>Childhood asthma is a heterogeneous disease wherein systemic inflammation, particularly involving nontype 2 cytokines such as interleukin-6 (IL-6), is not universally present and its clinical significance remains unclear. This cross-sectional observational study aimed to elucidate the association between circulating IL-6 levels and the phenotypic characteristics of pediatric asthma, and to explore the potential value of IL-6 as a predictive biomarker for asthma phenotypic risk stratification.</p><p><strong>Methods: </strong>Plasma IL-6 levels were quantified in 105 newly diagnosed pediatric asthma patients (≤15 years old) and 104 age-matched healthy controls to establish a normal reference range. Asthma patients were stratified into two subgroups based on a predefined threshold: \"IL-6-normal\" (<3.1 pg/mL) and \"IL-6-high\" (≥3.1 pg/mL, the 95th percentile of IL-6 levels in the healthy control group). Clinical, inflammatory, and lung function characteristics were compared between the two subgroups. Spearman's rank correlation analysis was conducted to explore the associations between cytokine levels and lung function/airway inflammation indices. Multivariate logistic regression analysis was performed to identify variables associated with asthma phenotypic characteristics, and subsequent feature selection was carried out using Least Absolute Shrinkage and Selection Operator (LASSO) regression with fivefold cross-validation. <i>A priori</i> sample size estimation and sex-stratified analyses were conducted, and all methods followed STROBE reporting guidelines.</p><p><strong>Results: </strong>Compared with healthy controls, pediatric asthma patients had significantly elevated serum IgE levels, peripheral blood eosinophil counts, and plasma concentrations of IL-4, IL-6, and IL-12 (all <i>p</i> < 0.05). Among the asthma cohort, the \"IL-6-high\" subgroup (<i>n</i> = 20, 19.0%) had significantly higher body mass index (BMI) and plasma IL-12 levels relative to the \"IL-6-normal\" subgroup (<i>n</i> = 85). Sex-stratified analyses demonstrated consistent patterns of elevated IL-6-related airway inflammation and reduced lung function across male and female children, without significant subgroup divergence. Correlation analysis showed that plasma IL-4 levels were significantly negatively correlated with percent predicted forced expiratory volume in 1 s (FEV<sub>1</sub>; <i>r</i> = -0.245, <i>p</i> = 0.025), and plasma IL-6 levels were significantly positively correlated with fractional exhaled nitric oxide (FeNO) levels (<i>r</i> = 0.214, <i>p</i> = 0.021). Multivariate logistic regression analysis identified asthma onset after 4 years of age, oral corticosteroid use, blood eosinophil count, FeNO level, and percent predicted FEV<sub>1</sub> as variables independently associated with asthma phenotypic characteristics. Notably, LASSO regression selected circulating IL-6 as the most prominent predictive biomarker for asthma phenotypic ","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1317-1328"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147929844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting length of hospital stay in children with moderate to severe asthma exacerbations.","authors":"Aymen Hişmioğulları, Ozlem Sancakli, Soner Günder, Figen Celebi Celik, Canan Sule Unsal Karkıner, Demet Can","doi":"10.1080/02770903.2026.2666091","DOIUrl":"10.1080/02770903.2026.2666091","url":null,"abstract":"<p><strong>Objective: </strong>Hospitalizations due to moderate to severe asthma exacerbations in children remain a significant burden for healthcare systems and families. Identifying factors associated with prolonged duration of hospitalization may improve asthma management and reduce morbidity. To investigate demographic and clinical factors associated with prolonged hospitalization in children admitted with moderate to severe asthma exacerbations.</p><p><strong>Methods: </strong>This prospective cohort study included 159 children aged 5-18 years hospitalized for moderate to severe asthma exacerbations at a tertiary pediatric center between January 1 and December 31, 2024. Exacerbation severity was classified according to Global Initiative for Asthma criteria. Length of hospital stay was categorized according to the University of California, San Francisco Consensus Guidelines as short-term hospitalization (≤72 h) or prolonged hospitalization (>72 h). Demographic, clinical, laboratory, environmental, and treatment-related variables were obtained from medical records.</p><p><strong>Results: </strong>Among the patients, 52.8% were female, and the median age was 8 years (IQR: 6-12). Overall, 34% had short-term hospitalization, whereas 66% experienced prolonged hospitalization. Multivariate logistic regression analysis demonstrated that weekend admission (OR: 4.564, <i>p</i> = 0.004), increased number of exacerbations requiring systemic corticosteroids during the previous year (OR: 1.620, <i>p</i> = 0.012), and longer time spent at home before admission (OR: 1.069, <i>p</i> < 0.001) were independent predictors of prolonged hospitalization. Female sex, tobacco exposure, obesity, polysensitization, allergic rhinitis, rhinovirus infection, and poor treatment adherence were also associated with longer hospital stay.</p><p><strong>Conclusions: </strong>Clinical severity and modifiable environmental factors contribute to prolonged hospitalization in pediatric asthma exacerbations. Early intervention, treatment adherence, and environmental control may reduce hospitalization duration and improve outcomes.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1350-1358"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the association between omalizumab use and adverse fetal outcomes among pregnant women with asthma: a population-based retrospective cohort study.","authors":"Chun-Tse Hung, Ting-An Yen, Hsin-Yi Huang, Chung-Hsuen Wu","doi":"10.1080/02770903.2026.2666093","DOIUrl":"10.1080/02770903.2026.2666093","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the association between omalizumab use during pregnancy and the risk of adverse fetal outcomes among pregnant women with asthma.</p><p><strong>Methods: </strong>This population-based retrospective cohort study was conducted using data from the 2010-2022 National Health Insurance Research Database and the Birth Certification Application in Taiwan. The study population was pregnant women with asthma. An active-comparator design was employed. Pregnant women who received at least one dose of omalizumab during pregnancy were assigned as the exposure group, while those having at least one prescription for inhaled corticosteroid (ICS) during pregnancy were assigned as the control group. The study outcome was adverse fetal outcomes. Propensity score matching was used to adjust for measurable confounders. Conditional logistic regression models were used to estimate the risk of adverse fetal outcomes.</p><p><strong>Results: </strong>A total of 4,416 pregnant women with asthma were included, with 16 (0.1%) receiving omalizumab and 4,410 (99.9%) using ICS during pregnancy. The risk of adverse fetal outcomes, including pre-term birth (OR, 1.74; 95% CI, 0.46-6.63), low birth weight (OR, 1.04; 95% CI, 0.22-4.87), small for gestational age (OR, 1.11; 95% CI, 0.14-8.98), did not differ between omalizumab and ICS users.</p><p><strong>Conclusions: </strong>Omalizumab was not associated with an increased risk of adverse fetal outcomes among pregnant women with asthma. Further investigation with a larger sample of omalizumab users is warranted.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1369-1378"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician perspectives on the discontinuation of brand name Flovent in pediatric asthma care.","authors":"Ashley L Saint-Fleur, Robyn T Cohen, Michelle Trivedi, Gregory S Sawicki","doi":"10.1080/02770903.2026.2660098","DOIUrl":"10.1080/02770903.2026.2660098","url":null,"abstract":"<p><strong>Objective: </strong>In 2024, brand-name Flovent (fluticasone propionate), the most widely prescribed inhaled corticosteroid (ICS) in the United States, was discontinued, eliminating a key treatment option for pediatric asthma. There have yet to be reports describing pediatric clinicians' experiences with this abrupt loss of a mainstay therapy for one of the most common chronic diseases in children. The study aimed to examine the experience of pediatric clinicians with the discontinuation of Flovent for asthma management.</p><p><strong>Methods: </strong>A web-based survey was disseminated via pediatric and pediatric pulmonary networks, both regionally and nationally, to pediatric primary care and subspecialty physicians and advanced practice practitioners. The survey assessed clinician awareness, preparedness, and the clinical impact of Flovent discontinuation.</p><p><strong>Results: </strong>Among 226 respondents, 71% were aware of the Flovent discontinuation in advance; however, 79% felt unprepared or very unprepared once it went into effect. Clinicians reported significant disruptions in prescribing and clinical workflow, with 56% describing the impact on their practice as severe. Factors most frequently cited as causing moderate or severe burden included prescribing alternate ICS therapy, including insurance authorization requirements (90%), pharmacy shortages (85%), and difficulty finding age-appropriate alternatives (82%). In free-text responses, clinicians described perceived worsening asthma control and increased acute healthcare utilization following the discontinuation, particularly among younger patients.</p><p><strong>Conclusions: </strong>Pediatric clinicians who care for children with asthma reported significant disruptions to patient care following the discontinuation of Flovent. These findings underscore the need for systems-level support of clinicians during major formulary transitions to minimize disruptions, particularly within pediatric asthma.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1267-1274"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging trends and research frontiers in refractory asthma: a comprehensive bibliometric analysis from 2004 to 2025.","authors":"Xun Xu, Shiyuan Gao, Zhengjun Huang, Yong Mao","doi":"10.1080/02770903.2026.2660324","DOIUrl":"10.1080/02770903.2026.2660324","url":null,"abstract":"<p><strong>Objective: </strong>Refractory asthma remains a significant challenge in respiratory medicine, requiring advanced therapeutic strategies and precision medicine approaches. Bibliometric analysis provides insights into research trends, key contributors, and evolving frontiers in this field.</p><p><strong>Methods: </strong>The present study conducted a bibliometric analysis using data from the Web of Science Core Collection (WoSCC) databases. The included articles between 2004 and 2025 were analyzed scientifically and quantitatively using R 4.3.3, CiteSpace (V 6.3.R1) and VOSviewer (V 1.6.20).</p><p><strong>Results: </strong>A total of 711 eligible publications were analyzed, with 4,253 authors from 2,824 institutions across 49 countries/regions contributing to this field. The United States, the United Kingdom, and China were the most productive countries. The University of Newcastle, the University of Leicester, and Université Paris Cité emerged as leading institutions. <i>The Journal of Allergy and Clinical Immunology</i> had the highest publication count and impact. Keyword cluster analysis identified three themes: clinical and epidemiological aspects, immunological mechanisms, and biologic therapies and clinical trials. Emerging research hotspots include \"guidelines,\" representing future trends.</p><p><strong>Conclusions: </strong>This study identifies the main research hotspots in refractory asthma, including clinical and epidemiological aspects, immunological mechanisms, and biologic therapies and clinical trials. Future trends in refractory asthma research emphasize guideline-informed precision medicine, integrating biomarkers, digital tools, and individualized treatment strategies to enhance care standardization and effectiveness.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1295-1307"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world effects of asthma biologics on blood eosinophil levels: data from the CHRONICLE study.","authors":"Warner W Carr, Dennis K Ledford, Bradley E Chipps, Njira L Lugogo, Andrew W Lindsley, Joseph D Spahn, Christopher S Ambrose","doi":"10.1080/02770903.2026.2666092","DOIUrl":"10.1080/02770903.2026.2666092","url":null,"abstract":"<p><strong>Objective: </strong>High blood eosinophil counts (BECs) are associated with increased asthma exacerbation risk. Studies show anti-IL-5/5R biologics meaningfully reduce BEC; however, there are limited data describing the real-world effects of anti-IgE and anti-IL-4R biologics on BECs. This analysis aimed to describe BECs before and after initiation of different biologics in a real-world cohort of patients with severe asthma (SA).</p><p><strong>Methods: </strong>CHRONICLE (NCT03373045) was an observational study of subspecialist-treated adults with SA in the US receiving biologics or maintenance systemic corticosteroids or whose disease was persistently uncontrolled on high-dosage inhaled corticosteroids and additional controllers. This analysis included patients enrolled between February 2018 and November 2023 who initiated omalizumab, mepolizumab, benralizumab, or dupilumab treatment. Patients' highest BECs in the 12 months before, 2 to <12 months after, and ≥12 months after biologic initiation were evaluated.</p><p><strong>Results: </strong>In total, 323 of the 3912 enrolled patients met the inclusion criteria, of whom 61 received omalizumab, 80 received mepolizumab, 118 received benralizumab, and 64 received dupilumab. Patients treated with anti-IL-5/5R biologics (mepolizumab, benralizumab) had higher pretreatment BECs that were reduced at both 2 to <12 months and ≥12 months following initiation. Conversely, patients treated with anti-IL-4R (dupilumab) or anti-IgE (omalizumab) biologics had lower pretreatment BECs that were slightly reduced 2 to <12 months following initiation but increased ≥12 months following initiation.</p><p><strong>Conclusion: </strong>Among US subspecialist-treated patients with SA, those treated with biologics that do not block or reduce IL-5/5R may experience an increase in BEC over time.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1359-1368"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ability of impulse oscillometry to predict loss of asthma control during pollution period in previously stable patients.","authors":"Athitarn Tangtermpong, Warawut Chaiwong, Pilaiporn Duangjit, Athavudh Deesomchok","doi":"10.1080/02770903.2026.2654597","DOIUrl":"10.1080/02770903.2026.2654597","url":null,"abstract":"<p><strong>Background: </strong>Impulse oscillometry (IOS) is recognized as a sensitive technique for detecting small airway dysfunction (SAD), and previous studies have demonstrated its association with poor asthma control. However, its utility in predicting future asthma control remains uncertain. This study aimed to assess the predictive value of IOS for future asthma control during high pollution periods.</p><p><strong>Methods: </strong>Patients with well-controlled asthma were enrolled. Baseline data collection including spirometry, IOS measurements, and asthma control test (ACT) scores was performed between January and February 2024. ACT scores were reassessed during a subsequent high air pollution period (March-April 2024). The diagnostic accuracy of IOS in forecasting future loss of asthma control was evaluated.</p><p><strong>Results: </strong>Seventy-nine subjects with a mean age of 60.4 ± 14.0 years, 53 females (67.1%) were included. The mean particulate matter with an aerodynamic diameter less than or equal to 2.5 micrometers (PM_2.5) differed significantly between the nonpollution and pollution periods (21.1 ± 7.8 μg/m³ vs 78.2 ± 31.8 μg/m³, respectively; <i>p</i> < 0.001). Twenty-three participants experienced a loss of asthma control during the pollution period. The area under the receiver operating characteristic curve (AUC) for the %predicted difference between R5 and R20 (R5-R20) in predicting loss of asthma control was 0.39 (95%CI: 0.25, 0.53). Further analysis focusing on %predicted R5-R20 indicated no predictive value for asthma control during periods of high pollution (adjusted RR: 1.00; 95%CI: 0.99, 1.01; <i>p</i> = 0.553).</p><p><strong>Conclusions: </strong>IOS do not predict loss of asthma control during air pollution period in patients with previously stable asthma.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1199-1206"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between nocturnal asthma, symptom severity, and clinical outcomes: a systematic review.","authors":"Patricia Tachinardi, Gustavo Yano Callado, Julia M G Ferreira, Maria Celidonio Gutfreund, Isabele Pardo, Edson C D Lopes, Lucas Bulgarelli, Colin M Rogerson, Rodrigo Octavio Deliberato, Alexandre R Marra, Eneida A Mendonça","doi":"10.1080/02770903.2026.2660319","DOIUrl":"10.1080/02770903.2026.2660319","url":null,"abstract":"<p><strong>Objective: </strong>Nocturnal asthma is characterized by the worsening of asthma symptoms during the night and indicates more severe disease. This review aims to analyze evidence regarding the association between nocturnal asthma, symptom severity, pulmonary function, and clinical outcomes in both adult and pediatric populations.</p><p><strong>Methods: </strong>Databases Embase, PubMed, CINAHL, Cochrane (Wiley), Scopus, and LILACS were searched from their dates of inception to April 8, 2024. We included studies comparing severity of asthma symptoms, pulmonary function, and clinical outcomes in patients with nocturnal asthma to patients with nocturnal asthma.</p><p><strong>Results: </strong>Thirteen studies met the inclusion criteria for this review. These studies varied in setting, population, definitions of nocturnal, and outcome assessment. Despite methodological heterogeneity, a consistent pattern emerged: none of the evaluated outcomes had better results in the nocturnal asthma group, and nocturnal asthma was associated with worse symptom severity and poorer pulmonary function in most studies. However, evidence regarding hospital outcomes was mixed, with only one study reporting increased ward or intensive care unit (ICU) admission rates for nocturnal asthma patients, and no differences observed in length of stay.</p><p><strong>Conclusions: </strong>Evidence presented in this systematic review reinforced the association between nocturnal asthma and more severe disease manifestations, including worse symptom scores and poorer pulmonary function compared to non-nocturnal asthma. While evidence regarding hospitalization outcomes remains inconclusive, the findings underscore the clinical significance of recognizing nocturnal symptoms to improve disease management and diagnosis.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1181-1188"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for uncontrolled asthma in a pediatric population with severe asthma: FRAMAG study.","authors":"Elida Duenas-Meza, Sarah Pulido-Fentanes, Monica Mendez-Moreno, Nadia Juliana Proaños-Jurado","doi":"10.1080/02770903.2025.2562583","DOIUrl":"10.1080/02770903.2025.2562583","url":null,"abstract":"<p><strong>Objective: </strong>Severe asthma (SA) in children is associated with significant morbidity, increased healthcare utilization, and reduced quality of life. Despite appropriate treatment, achieving optimal asthma control remains challenging, particularly in pediatric populations.This study aimed to identify factors associated with poor asthma control in children with SA, focusing on clinical, functional, and caregiver-related variables.</p><p><strong>Methods: </strong>This retrospective cohort study included children aged 6-17 years with SA followed for up to three years in the Asmaire-Rexpira Program in Bogota, Colombia. Asthma control was defined using a comprehensive composite score integrating symptom questionnaires, exacerbation history, corticosteroid use, hospitalizations, and spirometry. Multivariable logistic regression was used to identify independent risk factors for uncontrolled asthma.</p><p><strong>Results: </strong>Of the 228 children included, 35.5% had uncontrolled asthma. Obstructive sleep apnea (OR: 2.16; 95% CI: 1.13-4.11; <i>p</i> = .019) and moderate to severe impairment in caregiver quality of life (OR: 12.35; 95% CI: 4.15-36.80; <i>p</i> < .001) were independently associated with uncontrolled asthma. Systemic corticosteroid use and hospitalization in the prior year were significantly more common in this group. Lung function was preserved in most children.</p><p><strong>Conclusions: </strong>Uncontrolled asthma in children with SA is associated with comorbid sleep apnea and caregiver burden. These findings underscore the need for multidimensional evaluation, caregiver support, and longitudinal monitoring to optimize asthma control in high-risk pediatric populations.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1189-1198"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographical variability in severe asthma: comparison of patients' characteristics between national, regional, and international cohorts in ISAR.","authors":"Maria Kallieri, Nikolaos G Papadopoulos, Eleftherios Zervas, Konstantinos Exarchos, Mina Gaga, Konstantinos Kostikas, Athena Gogali, Aggelos A Ladias, Konstantinos Tatsis, Fotios E Psarros, Michael Makris, Maria Ntakoula, Petros Bakakos, Lampros Kalogiros, Giannis Paraskevopoulos, Giorgio Walter Canonica, Enrico Heffler, João A Fonseca, Nuria Marina Malanda, Borja G Cosio, David B Price, Victoria Carter, Ghislaine Scelo, Dominic A Friston, Aaron Beastall, Stelios Loukides, Andriana I Papaioannou","doi":"10.1080/02770903.2026.2654601","DOIUrl":"10.1080/02770903.2026.2654601","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to describe and compare the clinical characteristics, treatment approaches, and associated comorbidities of patients with severe asthma across Greece, Southern Europe, and the global population. This comparative approach aims to enhance the understanding of region-specific differences and similarities among patients living with severe asthma.</p><p><strong>Methods: </strong>Data from the International Severe Asthma Registry (ISAR) were analyzed across three cohorts: Greek, Southern European, and Global. Variables included demographics, baseline characteristics, age at asthma onset, medication use, lung function, exacerbation history, biomarkers, and comorbidities.</p><p><strong>Results: </strong>A total of 16,063 patients from the global ISAR dataset, 3406 from Southern Europe, and 206 from Greece were included. Greek patients had a lower mean annual exacerbation rate (1.24 ± 1.67) compared with the global cohort (1.84 ± 2.58, <i>p</i> = 0.001) and Southern Europe (1.73 ± 2.56, <i>p</i> = 0.052). Uncontrolled asthma was most prevalent in Greece (60.32%) versus Southern Europe (35.58%, <i>p</i> < 0.001) and the global cohort (57.07%, <i>p</i> = 0.034). Long-term oral corticosteroid use was less frequent in Greece (24.73%) and in global cohort (21.50%, <i>p</i> = 0.287) than in Southern Europe (52.04%, <i>p</i> < 0.001). The prevalence of eosinophilic phenotype was high in all cohorts. However, in Greece, it was lower compared to Southern Europe (73.55% vs. 89.89% <i>p</i> < 0.001) and globally (73.55% vs. 83.34%, <i>p</i> = 0.011). Greek patients also demonstrated lower fractional exhaled nitric oxide (FeNO) levels and lower eosinophil counts than Southern Europe, along with reduced biologic therapy initiation (56.31%) compared to Southern Europe (74.02%, <i>p</i> < 0.001) but higher than global rates (48.40%, <i>p</i> = 0.024).</p><p><strong>Conclusions: </strong>Regional differences in severe asthma underline the importance of tailored treatment approaches, and multidisciplinary management of comorbid conditions.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1207-1217"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}