Analysis of comorbidities and multimorbidity in adult patients in the International Severe Asthma Registry

Ghislaine Scelo, Carlos A. Torres-Duque, Jorge F Maspero, Trung N Tran, Ruth B Murray, Andrew Menzies-Gow, Mark Hew, Matthew J Peters, Peter G. Gibson, George C. Christoff, Todor A Popov, Andréanne Côté, Celine Bergeron, Delbert Dorscheid, J. Mark FitzGerald, Kenneth R. Chapman, Louis Philippe Boulet, Mohit Bhutani, Mohsen Sadatsafavi, Libardo Jiménez-MaldonadoMauricio Duran-Silva, Bellanid Rodriguez, Carlos Andres Celis-Preciado, Diana Jimena Cano-Rosales, Ivan Solarte, Maria Jose Fernandez-Sanchez, Patricia Parada-Tovar, Anna von Bülow, Anne Sofie Bjerrum, Charlotte Suppli Ulrik, Karin Dahl Assing, Susanne Hansen, Alan Altraja, Arnaud Bourdin, Camille Taillé, Jeremy Charriot, Nicolas Roche, Andriana I. Papaioannou, Konstantinos Kostikas, Nikolaos G Papadopoulos, Sundeep Salvi, Deirdre Long, Patrick Mitchell, Richard W Costello, Concetta Sirena, Cristina Cardini, Enrico Heffler, Francesca Puggioni, Giorgio Walter Canonica, Giuseppe Guida, Takashi Iwanaga, Mona Al-Ahmad, Désirée Larenas-Linnemann, Ulises García, Piotr Kuna, João A. Fonseca, Riyad Al-Lehebi, Mariko Siyue Koh, Chin Kook Rhee, Borja G. Cosio, Luis Perez de Llano, Diahn-Warng Perng Steve, Erick Wan-Chun Huang, MingJu Tsai, Bassam Mahboub, Laila Ibraheem Jaber Salameh, John Busby, Liam G Heaney, Paul E Pfeffer, Amanda Grippen Goddard, Eileen Wang, Flavia Hoyte, Michael E Wechsler, Nicholas Chapman, Rohit Katial, Victoria Carter, Lakmini Bulathsinhala, Nevaashni Eleangovan, Cono Ariti, Juntao Lyu, David Price, Celeste Porsbjerg

Research output: Contribution to journalArticlepeer-review


Background: Investigation for the presence of asthma comorbidities is recommended by GINA as their presence can complicate asthma management.

Objective: To understand the prevalence and pattern of comorbidities and multimorbidity in adults with severe asthma and their association with asthma-related outcomes.

Methods: This was a cross-sectional study using data from the International Severe Asthma Registry from 22 countries. Thirty comorbidities were identified and categorized a priori as either (1) potentially T2-related, (2) potentially oral corticosteroid (OCS)-related or (3) mimicking/aggravating asthma. The association between comorbidities and asthma-related outcomes was investigated using multivariable models adjusted for country, age at enrollment, and sex.Results: Of 11,821 patients, 69%, 67%, and 55% had ≥1 potentially T2-related, potentially OCSrelated, or mimicking/aggravating comorbidities, respectively; 57% had ≥3 comorbidities, and 33% had comorbidities in all three categories. Patients with allergic rhinitis (AR), nasal polyposis (NP), and chronic rhinosinusitis (CRS) experienced 1.12- (p=0.003), 1.16- (p(ORs: 1.37-1.57). Greater number of comorbidities was associated with worse outcome.

Conclusion: In a global study, comorbidity or multimorbidity is reported in most adults with severe asthma and is associated with poorer asthma-related outcomes.

Original languageEnglish
JournalAnnals of Allergy, Asthma and Immunology
Publication statusAccepted - 12 Aug 2023


  • Allergic rhinitis
  • anxiety/depression
  • chronic obstructive pulmonary disease
  • chronic rhinosinusitis
  • diabetes, dyslipidemia
  • gastroesophageal reflux disease
  • hypertension
  • nasal polys
  • Obesity
  • osteoporosis
  • sleep apnea


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