Wechsler, Michael EMichael EWechslerScelo, GhislaineGhislaineSceloLarenas-Linnemann, Désirée E SDésirée E SLarenas-LinnemannTorres-Duque, Carlos ACarlos ATorres-DuqueMaspero, JorgeJorgeMasperoTran, Trung NTrung NTranMurray, Ruth BRuth BMurrayMartin, NeilNeilMartinMenzies-Gow, Andrew NAndrew NMenzies-GowHew, MarkMarkHewPeters, Matthew JMatthew JPetersGibson, Peter GPeter GGibsonChristoff, George CGeorge CChristoffPopov, Todor ATodor APopovCôté, AndréanneAndréanneCôtéBergeron, CelineCelineBergeronDorscheid, DelbertDelbertDorscheidFitzGerald, J MarkJ MarkFitzGeraldChapman, Kenneth RKenneth RChapmanBoulet, Louis PhilippeLouis PhilippeBouletBhutani, MohitMohitBhutaniSadatsafavi, MohsenMohsenSadatsafaviJiménez-Maldonado, LibardoLibardoJiménez-MaldonadoDuran-Silva, MauricioMauricioDuran-SilvaRodriguez, BellanidBellanidRodriguezCelis-Preciado, Carlos AndresCarlos AndresCelis-PreciadoCano-Rosales, Diana JimenaDiana JimenaCano-RosalesSolarte, IvanIvanSolarteFernandez-Sanchez, Maria JoseMaria JoseFernandez-SanchezParada-Tovar, PatriciaPatriciaParada-Tovarvon Bülow, AnnaAnnavon BülowBjerrum, Anne SofieAnne SofieBjerrumUlrik, Charlotte SCharlotte SUlrikAssing, Karin DahlKarin DahlAssingRasmussen, Linda MakowskaLinda MakowskaRasmussenHansen, SusanneSusanneHansenAltraja, AlanAlanAltrajaBourdin, ArnaudArnaudBourdinTaille, CamilleCamilleTailleCharriot, JeremyJeremyCharriotRoche, NicolasNicolasRochePapaioannou, Andriana IAndriana IPapaioannouKostikas, KonstantinosKonstantinosKostikasPapadopoulos, Nikolaos GNikolaos GPapadopoulosSalvi, SundeepSundeepSalviLong, DeirdreDeirdreLongMitchell, Patrick DPatrick DMitchellCostello, RichardRichardCostelloSirena, ConcettaConcettaSirenaCardini, CristinaCristinaCardiniHeffler, EnricoEnricoHefflerPuggioni, FrancescaFrancescaPuggioniCanonica, Giorgio WalterGiorgio WalterCanonicaGuida, GiuseppeGiuseppeGuidaIwanaga, TakashiTakashiIwanagaAl-Ahmad, MonaMonaAl-AhmadGarcía, UlisesUlisesGarcíaKuna, PiotrPiotrKunaFonseca, João AJoão AFonsecaAl-Lehebi, RiyadRiyadAl-LehebiKoh, Mariko SMariko SKohRhee, Chin KookChin KookRheeCosio, Borja GBorja GCosioPerez de Llano, LuisLuisPerez de LlanoPerng, Diahn-Warng SteveDiahn-Warng StevePerngHuang, Erick Wan-ChunErick Wan-ChunHuangHAO-CHIEN WANGTsai, Ming-JuMing-JuTsaiMahboub, BassamBassamMahboubSalameh, Laila Ibraheem JaberLaila Ibraheem JaberSalamehJackson, David JDavid JJacksonBusby, JohnJohnBusbyHeaney, Liam GLiam GHeaneyPfeffer, Paul EPaul EPfefferGoddard, Amanda GrippenAmanda GrippenGoddardWang, EileenEileenWangHoyte, Flavia C LFlavia C LHoyteChapman, Nicholas MNicholas MChapmanKatial, RohitRohitKatialCarter, VictoriaVictoriaCarterBulathsinhala, LakminiLakminiBulathsinhalaEleangovan, NevaNevaEleangovanAriti, ConConAritiLyu, JuntaoJuntaoLyuPorsbjerg, CelesteCelestePorsbjergPrice, David BDavid BPrice2024-02-292024-02-292024-02-011073-449X1535-4970https://scholars.lib.ntu.edu.tw/handle/123456789/640028Rationale: Previous studies investigating the impact of comorbidities on the effectiveness of biologic agents have been relatively small and of short duration and have not compared classes of biologic agents. Objectives: To determine the association between type 2-related comorbidities and biologic agent effectiveness in adults with severe asthma (SA). Methods: This cohort study used International Severe Asthma Registry data from 21 countries (2017-2022) to quantify changes in four outcomes before and after biologic therapy-annual asthma exacerbation rate, FEV1% predicted, asthma control, and long-term oral corticosteroid daily dose-in patients with or without allergic rhinitis, chronic rhinosinusitis (CRS) with or without nasal polyps (NPs), NPs, or eczema/atopic dermatitis. Measurements and Main Results: Of 1,765 patients, 1,257, 421, and 87 initiated anti-IL-5/5 receptor, anti-IgE, and anti-IL-4/13 therapies, respectively. In general, pre- versus post-biologic therapy improvements were noted in all four asthma outcomes assessed, irrespective of comorbidity status. However, patients with comorbid CRS with or without NPs experienced 23% fewer exacerbations per year (95% CI, 10-35%; P < 0.001) and had 59% higher odds of better post-biologic therapy asthma control (95% CI, 26-102%; P < 0.001) than those without CRS with or without NPs. Similar estimates were noted for those with comorbid NPs: 22% fewer exacerbations and 56% higher odds of better post-biologic therapy control. Patients with SA and CRS with or without NPs had an additional FEV1% predicted improvement of 3.2% (95% CI, 1.0-5.3; P = 0.004), a trend that was also noted in those with comorbid NPs. The presence of allergic rhinitis or atopic dermatitis was not associated with post-biologic therapy effect for any outcome assessed. Conclusions: These findings highlight the importance of systematic comorbidity evaluation. The presence of CRS with or without NPs or NPs alone may be considered a predictor of the effectiveness of biologic agents in patients with SA.enallergic rhinitis; chronic rhinosinusitis; nasal polyposisjournal article10.1164/rccm.202305-0808OC380160032-s2.0-85184138353https://api.elsevier.com/content/abstract/scopus_id/85184138353