Real-world characterisation of severe asthma in Greece: results from the Greek Severe Asthma Registry.

Background: Severe asthma (SA) imposes a disproportionate burden on patients and healthcare systems worldwide, yet region-specific data from Southern Europe remain scarce. The Greek Severe Asthma Registry (GSAR), an initiative of the Hellenic Thoracic Society, provides the first nationwide characterisation of severe asthma in Greece. Methods: We analysed data cross-sectionally from 619 adult patients (median age: 56 years; 61.1% female) with severe asthma, recruited across 13 specialised hospital centres and 11 private respiratory practices between March 2018 and November 2021. Patients were stratified by age of asthma onset, biologic therapy use and maintenance oral corticosteroid (mOCS) dependence. Clinical, inflammatory and treatment characteristics were assessed, alongside exacerbation predictors. Results: The study population exhibited substantial disease burden, with 434 patients (70.1%) experiencing ≥1 exacerbation and 149 (24.1%) requiring hospitalisation in the prior year. Late-onset asthma (60.7%) was associated with a faster progression to severe disease, higher exacerbation risk (79.8% Conclusions: This study highlights the phenotypic heterogeneity of severe asthma in Greece and reveals region-specific treatment patterns and unmet clinical needs despite access to advanced therapies. These real-world findings may guide national asthma care strategies and contribute to European initiatives aimed at optimising asthma management.