1. What bothers severe asthma patients most? : A paired patient–clinician study across seven European countriesBen Ainsworth, Eleanor Chatburn, Aruna T. Bansal, Olivia Fulton, Dominique Hamerlijnck, Courtney Coleman, Michael E. Hyland, Joshua Holmes, Sabina Škrgat, Natalija Edelbaher, 2023, izvirni znanstveni članek Objavljeno v DiRROS: 31.08.2026; Ogledov: 97; Prenosov: 62
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2. Characteristics of severe asthma patients on biologics : a real-life European registry studyStefania Principe, Levi B. Richards, Simone Hashimoto, Johannes A. Kroes, Job J. M. H. van Bragt, Susanne J Vijverberg, Jacob K. Sont, Nicola Scichilone, Sabina Škrgat, 2023, izvirni znanstveni članek Objavljeno v DiRROS: 31.08.2026; Ogledov: 116; Prenosov: 60
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3. Evaluation of real-world mepolizumab use in severe asthma across Europe - the SHARP experience with privacy-preserving federated analysisJohannes A. Kroes, Rafael Alfonso-Cristancho, Aruna T. Bansal, Emmanuelle Berret, Kristina Bieksiene, Arnaud Bourdin, Luisa Brussino, Diogo Canhoto, Cristina Cardini, Gulfem Celik, Peter Kopač, Sabina Škrgat, 2023, izvirni znanstveni članek Povzetek: Background: An objective of the severe heterogeneous asthma registry, patient-centered (SHARP) is to produce real-world evidence on a pan-European scale by linking non-standardized, patient-level registry-data. Mepolizumab has shown clinical efficacy in RCTs and prospective real-world studies and could therefore serve as a proof of principle for this novel approach. The aim of the present study was to harmonise data from 10 national severe asthma registries and characterise patients receiving mepolizumab, assess its effectiveness on annual exacerbations and maintenance oral glucocorticoid (OCS) use, and evaluate treatment patterns.
Methods: In this observational cohort study, registry data (5871 patients) were extracted for harmonisation. Where harmonisation was possible, patients who initiated mepolizumab between 1 January 2016 and 31 December 2021 were examined. Changes of a 12-month (range 11–18 months) period in frequent (two or more) exacerbations, maintenance OCS use and dose were analysed in a privacy-preserving manner using meta-analysis of generalised estimating equation parameters. Periods before and during the coronavirus disease 2019 pandemic were analysed separately.
Results: In 912 patients who fulfilled selection criteria, mepolizumab significantly reduced frequent exacerbations (OR 0.18, 95% CI 0.13–0.25), maintenance OCS use (OR 0.75, 95% CI 0.61–0.92) and dose (mean −3.93 mg·day−1, 95% CI −5.24–2.62 mg·day−1) in the pre-pandemic group, with similar trends in the pandemic group. Marked heterogeneity was observed between registries in patient characteristics and mepolizumab treatment patterns.
Conclusions: By harmonising patient-level registry data and applying federated analysis, SHARP demonstrated the real-world effectiveness of mepolizumab on asthma exacerbations and maintenance OCS use in severe asthma patients across Europe, consistent with previous evidence. This paves the way for future pan-European real-world severe asthma studies using patient-level data in a privacy-proof manner.
Objavljeno v DiRROS: 31.08.2026; Ogledov: 94; Prenosov: 61
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4. Systemic immunologic effects of long-term dupilumab treatment in severe eosinophilic asthma beyond clinical outcomesSabina Škrgat, Luka Kunej, Urška Bidovec, Matevž Harlander, Saša Rink, Peter Korošec, Peter Kopač, 2026, izvirni znanstveni članek Povzetek: Introduction: Dupilumab, an IL-4Rα antagonist that blocks IL-4/IL-13 signalling, is used in severe eosinophilic asthma to improve clinical control and suppress type 2 inflammation.Methods: We evaluated the clinical and systemic immunologic effects of dupilumab, focusing on type 2 biomarkers, total and aeroallergen-specific IgE, and FcεRI (High affinity IgE receptor) - expressing cells. Thirty-three adults with severe eosinophilic asthma were enrolled and followed up for 12 months in two Slovenian centres. Clinical assessments, spirometry, FeNO (Fractional exhaled nitric oxide), ACT (Asthma Control Test) scores, complete blood counts, total IgE, aeroallergen-specific IgE, and FcεRI expression on basophils were measured at baseline and at 1.5, 3, 6, and 12 months.Results: Twenty-seven patients completed follow-up and were included in the final analysis. Dupilumab treatment resulted in significant improvement in ACT (p = 0.0221), FEV1 (p = 0.0139) and reduction in exacerbations requiring OCS (oral corticosteroid) (p < 0.0001). FeNO declined by 78 %, total IgE by 83%, and aeroallergen-specific IgE by 65% with consistent reductions across perennial and seasonal allergens. Circulating eosinophils increased transiently, whereas basophils increased by 39%.Conclusions: Dupilumab demonstrated sustained clinical improvement in patients with severe eosinophilic asthma, accompanied by broad immunologic modulation. Concurrent reductions in FeNO, total IgE, and aeroallergen-specific IgE indicate upstream inhibition of IL-4/IL-13-mediated inflammation, suggesting modulation of the underlying type 2 inflammatory network.
Objavljeno v DiRROS: 23.07.2026; Ogledov: 198; Prenosov: 132
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5. Endotipi astme, povezani z nepovratno okvaro dihalne potiSabina Škrgat, 2025, pregledni znanstveni članek Povzetek: Astma je po svojem kliničnem poteku heterogena bolezen. Vnetje, ki na ravni dihalne poti vztraja, vodi v nepovratno izgubo pljučne funkcije. Astma z izraženo eozinofiijo v krvi in povišano koncentracijo dušikovega oksida v izdihanem zraku je povezana z nekontrolirano klinično sliko, slabšo pljučno funkcijo in pogostimi poslabšanji bolezni, zato je te bolnike potrebno pravočasno prepoznati in zdraviti. Namen prispevka je predstavitev sodobnega pristopanja k bolniku z astmo. Ta vključuje temelje prepoznavanja perzistentnega vnetja na ravni dihalne poti, ki sicer predstavlja tveganje za pogosta poslabšanja bolezni in okvaro dihalne poti pri bolniku z astmo.
Ključne besede: izdihani zrak, okvara dihalne poti
Objavljeno v DiRROS: 30.06.2026; Ogledov: 321; Prenosov: 181
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6. Newly diagnosed eosinophilic granulomatosis with polyangiitis in patients on biologics for severe asthma- a multi-centre case seriesHitasha Rupani, Aruna T. Bansal, Svetlana Sergejeva, Alexandra Nanzer, Marco Caminati, Peter Kopač, Zsuzsanna Csoma, Sabina Škrgat, Branislava Milenković, Kristina Bieksiene, Saša Rink, 2025, drugi znanstveni članki Ključne besede: alergology, severe asthma, biologics, EGPA
Objavljeno v DiRROS: 22.04.2026; Ogledov: 371; Prenosov: 453
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7. Targeting of the IL-5 pathway in severe asthma reduces mast cell progenitorsAbigail P. Alvarado-Vazquez, Erika Mendez-Enriquez, Maya Salomonsson, Peter Kopač, Ana Koren, Urška Bidovec, Sabina Škrgat, Oscar E. Simonson, Valentyina Yasinska, Peter Korošec, 2025, izvirni znanstveni članek Ključne besede: asthma, benralizumab, IL-5, mepolizumab, mast cells, mast cell progenitors
Objavljeno v DiRROS: 15.04.2026; Ogledov: 401; Prenosov: 353
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8. Mapping EQ-5D-5L utility scores from the Severe Asthma Questionnaire in the SHARP CRC RegistryFleur L. Meulmeester, M. Elske Van den Akker-van Marle, Lianne ten Have, Joseph Lanario, Michael E. Hyland, Anne Mcgahey, Dominique Hamerlijnck, Aruna T. Bansal, Anneke Ten Brinke, Kim De Jong, Tania Wainwright, Joanna Tilley, Simon Doe, K. Bayani, Valentyina Yasinska, Oksana Tenselius, Barbro Dahlén, Kristina Bieksiene, Jolita Palacionyte, Clàudia Loureiro, M Gonçalves Cunha, Diogo Canhoto, Sanja Hromiš, Sabina Škrgat, Ana Žaže Bertoncel, Peter Kopač, Mariana Paula Rezelj, Matthew Masoli, Jacob K. Sont, 2026, izvirni znanstveni članek Povzetek: Background Severe asthma imposes a substantial burden on individuals’ health-related quality of life (HRQoL), which might not be fully captured by generic instruments. The Severe Asthma Questionnaire (SAQ) is a validated disease-specific HRQoL instrument capturing the unique lived experience of people with severe asthma. However, the SAQ does not generate preference-based utility values required for health economic evaluations. This study aimed to develop and validate mapping algorithms from the SAQ to the EuroQol (EQ)-5D-5L, enabling estimation of utility values when EQ-5D data are unavailable. Methods We used baseline and 6-month data from the longitudinal, multicentre SHARP Burden of Asthma study, including adults with severe asthma across 7 European countries. Direct mapping (ordinary least squares and beta-mixture regression models) using the UK value set and indirect mapping (ordered probit regression models) were developed with baseline data to predict EQ-5D-5L utility values from SAQ scores. Performance was assessed via mean absolute error (MAE), root mean square error (RMSE), and R2, with 6-month data used for validation. Results Data from 327 patients were included. The beta-mixture model using SAQ subscales marginally outperformed the other models in the development set (MAE=0.090, RMSE=0.129, R2=0.704), whereas in the validation set the ordered probit regression model showed the best predictive performance (MAE=0.106, RMSE=0.151, R2=0.589). Conclusions Direct mapping with beta-mixture regression showed good overall performance, aligning with prior studies. Indirect mapping may be advantageous in settings requiring flexibility across EQ-5D-5L value sets. These findings demonstrate that EQ-5D-5L utility values can be reliably estimated from the SAQ, supporting use of the instrument in health-economic analyses.
Ključne besede: questionnaires, quality of life, health economic evaluation, patient registries
Objavljeno v DiRROS: 23.03.2026; Ogledov: 450; Prenosov: 690
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9. Multimorbidity phenotypes and associated characteristics in severe asthma : an observational study of European severe asthma registriesAnna Freeman, Saša Rink, Aruna T. Bansal, Betty Frankemölle, Mehar Singh, Jacob K. Sont, Apostolos Bossios, Ben Ainsworth, Michael E. Hyland, Rekha Chaudhuri, Dace Matisa, Florin Mihaltan, Antonio Spanevello, Enrico Heffler, Ian Adcock, Peter Kopač, Sabina Škrgat, Ramesh Kurukulaaratchy, 2026, izvirni znanstveni članek Povzetek: Background The phenotypic nature of multimorbidity in severe asthma is poorly understood. Our aims in this study were to define multimorbidity phenotypes and their characteristics in severe asthma across Europe by identifying and characterising co-aggregation of comorbidities. Methods Cross-sectional patient data were analysed from the pan-European Severe Heterogenous Asthma Research Collaboration: Patient Centred (SHARP) Central database of national severe asthma registries. Patients were grouped by four European regions (North, South, East, and West). Hierarchical clustering of comorbidities was applied to characterise the correlation structure of the ten commonest comorbidities within these geographical regions. Subsequent multimorbidity phenotypes (MMP) and their clinical features were then defined. Findings Data were available for 2690 severe asthma patients and 23 comorbidities from 11 countries. Three comorbidity clusters were consistently seen across the four European regions: 1) osteoporosis plus steroid-induced weight gain, 2) eczema plus rhinitis, and 3) chronic sinusitis plus nasal polyps. Four further comorbidities (obesity, bronchiectasis, gastro-oesophageal reflux disease, psychological factors) showed variable clustering. Multimorbidity was ubiquitous. Patients were assigned multimorbidity phenotypes (MMP) according to comorbidity cluster alignment. MMP sn (sinonasal-associated) and MMP u (no specific cluster alignment) were commonest. MMP ster (steroid-associated multimorbidity) had highest maintenance oral steroid (m-OCS) use, and Body Mass Index, plus worst lung function, asthma control, and asthma exacerbation frequency. MMP max (maximal multimorbidity) showed high prevalence of variably assigned comorbidities, higher m-OCS and biologic treatment needs. Interpretation Multimorbidity is common in severe asthma and can be classified into replicable novel phenotypes with characteristic clinical traits and outcomes. Recognising these phenotypes can guide better care of the ‘whole patient’ with severe asthma. Future clinical guidance should promote such understanding in order to support delivery of more effective personalised asthma care.
Ključne besede: severe asthma, multimorbidity, comorbidities, cluster phenotype, European asthma registries
Objavljeno v DiRROS: 13.03.2026; Ogledov: 523; Prenosov: 368
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