@article{Freeman:2026:10.1016/j.lanepe.2026.101600,
author = {Freeman, A and Rink, S and Bansal, AT and Frankemölle, B and Singh, M and Sont, JK and Bossios, A and Ainsworth, B and Hyland, M and Chaudhuri, R and Matisa, D and Mihaltan, F and Spanevello, A and Heffler, E and Adcock, I and Zappa, M and Canonica, GW and Brusselle, G and Bourdin, A and Maria, Luigia Costanzo GA and Horvath, I and Lúðvíksdóttir, D and Principe, S and Kopa, P and Loureiro, CC and Siddiqui, S and Egesten, A and Kalinauskaite-Zukauske, V and Dimic-Janjic, S and Roberts, G and Hromis, S and Milenkovic, B and Varkonyi-Sepp, J and Goksel, O and Pereira, AM and Djukanovic, R and Rizzi, A and Caminati, M and Hou, R and tajduhar, A and Paróczai, D and Brussino, L and Heaney, L and Haitchi, HM and Bonini, M and Bieksiene, K and Damadoglu, E and Yasinska, V and Gemicioglu, B and Grle, SP and Brinke, AT and Csoma, Z and Kroica, I and Kuna, P and Dahlen, B and Porsbjerg, C and Hodge, H and krgat, S and Schleich, F and Kurukulaaratchy, RJ},
doi = {10.1016/j.lanepe.2026.101600},
journal = {Lancet Reg Health Eur},
title = {Multimorbidity phenotypes and associated characteristics in severe asthma: an observational study of European severe asthma registries.},
url = {http://dx.doi.org/10.1016/j.lanepe.2026.101600},
volume = {63},
year = {2026}
}

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TY  - JOUR
AB  - 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 c
AU  - Freeman,A
AU  - Rink,S
AU  - Bansal,AT
AU  - Frankemölle,B
AU  - Singh,M
AU  - Sont,JK
AU  - Bossios,A
AU  - Ainsworth,B
AU  - Hyland,M
AU  - Chaudhuri,R
AU  - Matisa,D
AU  - Mihaltan,F
AU  - Spanevello,A
AU  - Heffler,E
AU  - Adcock,I
AU  - Zappa,M
AU  - Canonica,GW
AU  - Brusselle,G
AU  - Bourdin,A
AU  - Maria,Luigia Costanzo GA
AU  - Horvath,I
AU  - Lúðvíksdóttir,D
AU  - Principe,S
AU  - Kopa,P
AU  - Loureiro,CC
AU  - Siddiqui,S
AU  - Egesten,A
AU  - Kalinauskaite-Zukauske,V
AU  - Dimic-Janjic,S
AU  - Roberts,G
AU  - Hromis,S
AU  - Milenkovic,B
AU  - Varkonyi-Sepp,J
AU  - Goksel,O
AU  - Pereira,AM
AU  - Djukanovic,R
AU  - Rizzi,A
AU  - Caminati,M
AU  - Hou,R
AU  - tajduhar,A
AU  - Paróczai,D
AU  - Brussino,L
AU  - Heaney,L
AU  - Haitchi,HM
AU  - Bonini,M
AU  - Bieksiene,K
AU  - Damadoglu,E
AU  - Yasinska,V
AU  - Gemicioglu,B
AU  - Grle,SP
AU  - Brinke,AT
AU  - Csoma,Z
AU  - Kroica,I
AU  - Kuna,P
AU  - Dahlen,B
AU  - Porsbjerg,C
AU  - Hodge,H
AU  - krgat,S
AU  - Schleich,F
AU  - Kurukulaaratchy,RJ
DO  - 10.1016/j.lanepe.2026.101600
PY  - 2026///
TI  - Multimorbidity phenotypes and associated characteristics in severe asthma: an observational study of European severe asthma registries.
T2  - Lancet Reg Health Eur
UR  - http://dx.doi.org/10.1016/j.lanepe.2026.101600
UR  - https://www.ncbi.nlm.nih.gov/pubmed/41694692
VL  - 63
ER  - 

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