20.500.12556/DiRROS-28315 Multimorbidity phenotypes and associated characteristics in severe asthma an observational study of European severe asthma registries Multimorbidity phenotypes and associated characteristics in severe asthma: an observational study of European severe asthma registries 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. severe asthma multimorbidity comorbidities cluster phenotype European asthma registries huda astma multimorbidnost soobolevnost fenotipi bolezni evropski registri astme true false true Angleški jezik Slovenski jezik Neznano 2026-03-13 13:45:32 2026-03-13 13:45:32 2026-03-14 04:26:02 0000-00-00 00:00:00 2026 0 0 Nasl. z nasl. zaslona; Opis vira z dne 6. 2. 2026; str. 1-16 article no. 101600 Vol. 63 2026 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.248-06-08:519.23 2666-7762 10.1016/j.lanepe.2026.101600 267628547 RAZ_Freeman_Anna_2026.pdf RAZ_Freeman_Anna_2026.pdf 1 AC0167AFB365E876E26451A1A3C4D8EF 6146e7030262e7f459beb8c4dc7bc1c34f50e0521e08a5695d1bb85844fe3df4 c65ff0ce-1eda-11f1-acf8-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=41813 https://www.sciencedirect.com/science/article/pii/S2666776226000128 1 892ea64f-1eda-11f1-acf8-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=41812 Univerzitetni klinični center Ljubljana 0 0 0