Porpodis Konstantinos, Zias Nikolaos, Kostikas Konstantinos, Tzouvelekis Argyris, Makris Michael, Konstantinou George N, Zervas Eleftherios, Loukides Stelios, Steiropoulos Paschalis, Katsoulis Konstantinos, Palamidas Anastasios, Syrigou Aikaterini, Gangadi Maria, Christopoulos Antonios, Papapetrou Dimosthenis, Psarros Fotios, Gourgoulianis Konstantinos, Tzortzaki Eleni, Vittorakis Stylianos K, Paraskevopoulos Ioannis, Papanikolaou Ilias, Krommidas Georgios, Latsios Dimitrios, Tzanakis Nikolaos, Markatos Miltiadis, Damianaki Angeliki, Manikas Argyrios, Chatzipetrou Alexia, Vourdas Dimitrios, Tsiouprou Ioanna, Papista Christina, Bartsakoulia Marina, Mathioudakis Nikolas, Galanakis Petros, Bakakos Petros
Pulmonary Department, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, Thessaloniki, Greece.
Respiratory Department, Navy Hospital of Athens, Athens, Greece.
Clin Transl Allergy. 2025 Feb;15(2):e70035. doi: 10.1002/clt2.70035.
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.
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 (ACT), 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.
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.
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.
关于2型（T2）低重度哮喘（SA）的发生频率的数据稀缺，导致这一患者群体中未满足的治疗需求尚不明确。我们的目的是评估希腊T2低SA的发生频率，并描述其特征和负担。
PHOLLOW是一项针对成年SA患者的横断面研究。基于一种新提出的分类系统，如果血液嗜酸性粒细胞计数（BEC；细胞/μL）<150、呼出一氧化氮分数（FeNO）<25 ppb且有任何过敏状态，或者BEC<150/FeNO<50 ppb/无过敏，或者BEC<300/FeNO<25 ppb/无过敏，则患者被分类为T2低。对于接受生物制剂和/或口服糖皮质激素治疗的患者，只有那些BEC<150/FeNO<25 ppb/无过敏/对治疗无反应的患者被分类为T2低。次要结局指标包括：哮喘控制测试（ACT）、小型哮喘生活质量问卷（Mini-AQLQ）、医院焦虑抑郁量表（HADS）以及工作效率和活动障碍：呼吸道症状（WPAI:RS）问卷。
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低哮喘的发生率为20.1%。其中，71.1%的患者在过去一年中经历了≥1次具有临床意义的加重，62.8%的患者ACT评分<20（未控制的哮喘），22.3%的患者接受了生物制剂治疗。79.5%的患者Mini-AQLQ评分<6（受损），43.8%的患者HADS总分≥15（具有临床意义的情绪困扰），而两个领域的活动受损百分比和工作效率损失中位数均为30.0。在ACT定义的未控制哮喘患者中，临床和患者报告的结局更差。
五分之一的SA患者表现为T2低表型。这些患者的疾病常常未得到控制，并且在生活质量、情绪和工作能力方面存在损害。
