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

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‐secti...

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Main Authors: 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
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:Clinical and Translational Allergy
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Online Access:https://doi.org/10.1002/clt2.70035
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author 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
author_facet 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
author_sort Konstantinos Porpodis
collection DOAJ
description 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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spelling doaj-art-04529771485a46eb9c45da2a8fb541982025-08-20T03:12:24ZengWileyClinical and Translational Allergy2045-70222025-02-01152n/an/a10.1002/clt2.70035T2‐low severe asthma clinical spectrum and impact: The Greek PHOLLOW cross‐sectional studyKonstantinos Porpodis0Nikolaos Zias1Konstantinos Kostikas2Argyris Tzouvelekis3Michael Makris4George N. Konstantinou5Eleftherios Zervas6Stelios Loukides7Paschalis Steiropoulos8Konstantinos Katsoulis9Anastasios Palamidas10Aikaterini Syrigou11Maria Gangadi12Antonios Christopoulos13Dimosthenis Papapetrou14Fotios Psarros15Konstantinos Gourgoulianis16Eleni Tzortzaki17Stylianos K. Vittorakis18Ioannis Paraskevopoulos19Ilias Papanikolaou20Georgios Krommidas21Dimitrios Latsios22Nikolaos Tzanakis23Miltiadis Markatos24Angeliki Damianaki25Argyrios Manikas26Alexia Chatzipetrou27Dimitrios Vourdas28Ioanna Tsiouprou29Christina Papista30Marina Bartsakoulia31Nikolas Mathioudakis32Petros Galanakis33Petros Bakakos34Pulmonary Department Aristotle University of Thessaloniki G. Papanikolaou Hospital Thessaloniki GreeceRespiratory Department Navy Hospital of Athens Athens GreeceRespiratory Medicine Department School of Medicine University of Ioannina Ioannina GreeceDepartment of Respiratory Medicine Medical School University of Patras Patras Greece2nd Department of Dermatology and Venereology Allergy Unit Medical School Attikon University General Hospital National and Kapodistrian University of Athens Athens GreeceDepartment of Allergy and Clinical Immunology 424 General Military Training Hospital Thessaloniki Greece7th Respiratory Department Athens Chest Hospital Sotiria Athens Greece2nd Respiratory Department Medical School Attikon University Hospital National and Kapodistrian University of Athens Athens GreeceDepartment of Respiratory Medicine Medical School University General Hospital Democritus University of Thrace Alexandroupolis GreecePulmonary Department 424 Army General Hospital Thessaloniki GreeceAthens Medical Center‐Marousi Clinic Athens GreeceAllergy Department Sotiria General Hospital Athens Greece10th Department of Pulmonary Medicine Athens Chest Hospital Sotiria Athens GreeceDepartment of Respiratory Medicine University Hospital Patras Patra GreeceAthens Medical Group Paleo Faliro Clinic Athens GreeceAllergy Department Athens Naval Hospital Athens GreeceFaculty of Medicine Department of Respiratory Medicine University Hospital of Larissa University of Thessaly Larissa GreeceOutpatient Respiratory Clinic Heraklion GreecePrivate Practice Chania Greece401 General Military Hospital Athens Athens GreecePulmonary Department Corfu General Hospital Corfu GreecePrivate Practice Athens GreecePrivate Practice Drama GreeceDepartment of Respiratory Medicine Medical School University General Hospital of Heraklion Laboratory of Molecular and Cellular Pneumonology University of Crete Heraklion GreeceOutpatient Clinic for Pulmonary Diseases Chania GreecePulmonary and Sleep Medical Department Chania General Hospital Agios Georgios Chania GreeceEuropean Interbalkan Medical Center Thessaloniki Greece2nd Department of Dermatology and Venereology Allergy Unit University General Hospital Attikon National and Kapodistrian University of Athens Athens GreeceDepartment of Allergy and Clinical Immunology 251 General Airforce Hospital Athens GreecePulmonary Department Aristotle University of Thessaloniki G. Papanikolaou Hospital Thessaloniki GreeceMedical Affairs Department, Respiratory and Immunology AstraZeneca Athens GreeceMedical Affairs Department, Respiratory and Immunology AstraZeneca Athens GreeceMedical Affairs Department, Respiratory and Immunology AstraZeneca Athens GreeceMedical Affairs Department, Respiratory and Immunology AstraZeneca Athens Greece1st University Department of Respiratory Medicine National and Kapodistrian University of Athens Athens GreeceAbstract 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.https://doi.org/10.1002/clt2.70035clinically significant exacerbationsquality of lifereal‐worldsymptom controltreatment patterns
spellingShingle 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
T2‐low severe asthma clinical spectrum and impact: The Greek PHOLLOW cross‐sectional study
Clinical and Translational Allergy
clinically significant exacerbations
quality of life
real‐world
symptom control
treatment patterns
title T2‐low severe asthma clinical spectrum and impact: The Greek PHOLLOW cross‐sectional study
title_full T2‐low severe asthma clinical spectrum and impact: The Greek PHOLLOW cross‐sectional study
title_fullStr T2‐low severe asthma clinical spectrum and impact: The Greek PHOLLOW cross‐sectional study
title_full_unstemmed T2‐low severe asthma clinical spectrum and impact: The Greek PHOLLOW cross‐sectional study
title_short T2‐low severe asthma clinical spectrum and impact: The Greek PHOLLOW cross‐sectional study
title_sort t2 low severe asthma clinical spectrum and impact the greek phollow cross sectional study
topic clinically significant exacerbations
quality of life
real‐world
symptom control
treatment patterns
url https://doi.org/10.1002/clt2.70035
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