ArticleThe European respiratory journal2025
Patient-centred composite scores as tools for assessment of response to biological therapy for paediatric and adult severe asthma.
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Article in The European respiratory journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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16 citing papers in PubMed.
- Update on Pediatric asthma management: Recent advances.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026Review
- Update on biologic and small molecules treatments in pediatric allergic diseases.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026Review
- Delphi Consensus of the Italian Society of Pediatric Allergy and Immunology (SIAIP) on the management of severe asthma in children and adolescents.Multidisciplinary respiratory medicine · 2026Article
- COMSA-MEWS: a simple quantitative algorithm for determining response to biologics in severe asthma, tested in a real-world mepolizumab study.ERJ open research · 2026Article
- Early and Sustained Asthma Control and Remission in Real-World Patients With Severe Eosinophilic Asthma Treated With Benralizumab: XALOC-2.Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2026Observational
- Biologic therapies for severe pediatric asthma: efficacy, safety, and biomarker-guided selection.Frontiers in allergy · 2026Review
- Exploring associations between nasal fluid inflammatory proteins and patient-reported symptom burden in respiratory disease.Frontiers in allergy · 2026Article
- Sophocarpine Alleviates Airway Epithelial Cell Inflammation in Asthma via Modulating the Cytokine- Cytokine Receptor and JAK2/STAT3 Signaling Pathways.Drug design, development and therapy · 2026Article
- Age-specific efficacy of biologics in severe asthma: a pediatric perspective.Frontiers in allergy · 2026Review
- Redefining asthma treatment success: bridging remission goals with patient-centred outcomes.European respiratory review : an official journal of the European Respiratory Society · 2026Article
- Precision Medicine for Asthma: Tailored to its Severity and Endotype/Phenotype.Allergy, asthma & immunology research · 2026Review
- Beyond survival: improving lung cancer rehabilitation through standardised outcomes.ERJ open research · 2025Article
- Beyond Clinical Remission: Redefining Disease Control in Severe Asthma?Allergy, asthma & immunology research · 2025Article
- Recent evidence for stepping down severe asthma therapies.Current opinion in pulmonary medicine · 2025Review
- Trade-offs from a family perspective: considerations in choosing between omalizumab and complementary alternative medicine for pediatric severe asthma.Frontiers in pharmacology · 2025Review
- [BioSAT: Development and conceptual validation of a satisfaction questionnaire regarding biologic therapies for severe asthma through a structured patient-professional co-creation process].Open respiratory archivesArticle
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78 authors.
Ekaterina KhalevaClinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.ORCID https://orcid.org/0000-0002-2220-7745
Chris BrightlingInstitute for Lung Health, Leicester NIHR BRC, University of Leicester, Leicester, UK.
Thomas EiweggerKarl Landsteiner University of Health Sciences, Krems, Austria.
Alan AltrajaDepartment of Pulmonology, University of Tartu and Lung Clinic, Tartu University Hospital, Tartu, Estonia.ORCID https://orcid.org/0000-0001-7798-9871
Philippe BéginDepartment of Medicine, CHUM, Montréal, QC, Canada.
Katharina BlumchenDepartment of Children and Adolescent Medicine, Division of Pneumology, Allergology and Cystic fibrosis, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany.
Apostolos BossiosKarolinska Severe Asthma Center, Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Huddinge, Sweden.ORCID https://orcid.org/0000-0002-0494-2690
Arnaud BourdinPhyMedExp, University of Montpellier, Montpellier, France.ORCID https://orcid.org/0000-0002-4645-5209
Anneke Ten BrinkeDepartment of Respiratory Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
Guy BrusselleDepartment of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.ORCID https://orcid.org/0000-0001-7021-8505
Roxana Silvia BumbaceaDepartment of Allergology "Carol Davila", University of Medicine and Pharmacy, Bucharest, Romania.
Andrew BushCentre for Paediatrics and Child Health and National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital, London, UK.ORCID https://orcid.org/0000-0001-6756-9822
Thomas B CasaleDivision of Allergy/Immunology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
Graham W ClarkeTranslational Science and Experimental Medicine, Research and Early Development, Respiratory and Immunology, BioPharmaceuticals, R&D, AstraZeneca, Molndal, Sweden.
Rekha ChaudhuriSchool of Infection and Immunity, University of Glasgow, Glasgow, UK.
Kian Fan ChungNational Heart and Lung Institute, Imperial College London, London, UK.ORCID https://orcid.org/0000-0001-7101-1426
Courtney ColemanEuropean Lung Foundation, Sheffield, UK.ORCID https://orcid.org/0000-0001-7687-1273
Jonathan CorrenDavid Geffen School of Medicine, UCLA, Los Angeles, CA, USA.
Sven-Erik DahlénDepartment of Respiratory Medicine and Allergy, Karolinska University Hospital, Huddinge, Sweden.
Antoine DeschildreUniv Lille, CHU Lille, Unité de Pneumologie et Allergologie Pédiatrique, Hôpital Jeanne de Flandre, Lille, France.ORCID https://orcid.org/0000-0003-2006-7221
Ratko DjukanovicNIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Katrien EgerDepartment of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.ORCID https://orcid.org/0000-0002-9628-2174
Andrew ExleyAdept Biologica Consulting Limited, London, UK.
Louise FlemingNational Heart and Lung Institute, Imperial College London, London, UK.ORCID https://orcid.org/0000-0002-7268-7433
Stephen J FowlerFaculty of Biology, Medicine and Health, School of Biological Sciences, Division of Infection, Immunity and Respiratory Medicine, The University of Manchester, Manchester, UK.ORCID https://orcid.org/0000-0002-4524-1663
Erol A GaillardUniversity of Leicester, Department of Respiratory Sciences, Leicester NIHR Biomedical Research Centre (Respiratory theme), Leicester, UK.
Monika GappaDepartment of Pediatrics, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Germany.
Atul GuptaDepartment of Paediatric Respiratory Medicine, King's College Hospital, London, UK.ORCID https://orcid.org/0000-0002-1610-0335
Hans Michael HaitchiNIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.ORCID https://orcid.org/0000-0001-8603-302X
Simone HashimotoDepartment of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.ORCID https://orcid.org/0000-0001-8995-3817
Liam G HeaneyWellcome-Wolfson Centre for Experimental Medicine School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
Gunilla HedlinDepartment of Women's and Children's Health and Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden.
Markaya HendersonEuropean Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium.
Wen HuaKey Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
David J JacksonKing's Centre for Lung Health, King's College London, London, UK.
Bülent KaradagMarmara University Faculty of Medicine, Division of Pediatric Pulmonology, Istanbul, Turkey.ORCID https://orcid.org/0000-0003-0605-8871
Constance Helen KatelarisImmunology and Allergy Unit Campbelltown Hospital and Western Sydney University Campbelltown, Sydney, Australia.
Mariko S KohDepartment of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore.ORCID https://orcid.org/0000-0002-1230-0129
Matthias Volkmar KoppUniversity Children's Hospital of Bern, Inselspital, University of Bern, Bern, Switzerland.
Gerard H KoppelmanUniversity of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Department of Pediatric Pulmonology and Pediatric Allergology, Groningen, The Netherlands.ORCID https://orcid.org/0000-0001-8567-3252
Inger KullDepartment of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Ramesh J KurukulaaratchyNIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Ji-Hyang LeeDepartment of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Vera MahlerPaul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Division of Allergology, Langen, Germany.
Mika MäkeläHUS Skin and Allergy Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Matthew MasoliUniversity of Exeter, Royal Devon and Exeter Hospital, Exeter, UK.ORCID https://orcid.org/0000-0003-0909-0148
Alexander G MathioudakisDivision of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK.ORCID https://orcid.org/0000-0002-4675-9616
Angel MazonUnit of Pediatric Allergy and Pneumology, Health Research Institute La Fe, University and Polytechnic Hospital La Fe, Valencia, Spain.
Erik MelénDepartment of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-8248-0663
Katrin MilgerDepartment of Medicine V, University Hospital, LMU Munich, Munich, Germany.ORCID https://orcid.org/0000-0003-2914-8773
Alexander MoellerDepartment of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland.ORCID https://orcid.org/0000-0001-7284-4251
Clare S MurrayFaculty of Biology, Medicine and Health, School of Biological Sciences, Division of Infection, Immunity and Respiratory Medicine, The University of Manchester, Manchester, UK.
Prasad NagakumarDepartment of Respiratory Medicine, Birmingham Children's Hospital, Birmingham, UK.
Parameswaran NairDepartment of Medicine, Division of Respirology, St Joseph's Healthcare and McMaster University, Hamilton, ON, Canada.
Jenny Negus3TR respiratory working group, Brussels, Belgium.
Antonio NietoPediatric Pulmonology and Allergy Unit, Health Research Institute, Hospital la Fe, Valencia, Spain.
Nikolaos G PapadopoulosAllergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
James PatonSchool of Medicine, College of Medical, Veterinary, and Life Sciences, University of Glasgow, Glasgow, UK.
Mariëlle W PijnenburgErasmus MC - Sophia Children's Hospital, University Medical Centre Rotterdam, Department of Paediatrics/Paediatric Respiratory Medicine and Allergology, Rotterdam, The Netherlands.
Katharine C PikeDepartment of Paediatric Respiratory Medicine, Bristol Royal Hospital for Children, Bristol, UK.
Celeste PorsbjergDepartment of Respiratory Medicine, Respiratory Research Unit, Bispebjerg Hospital, Copenhagen, Denmark.
Anna RattuClinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.ORCID https://orcid.org/0000-0002-7497-9552
Hitasha RupaniRespiratory Medicine Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK.ORCID https://orcid.org/0000-0002-0150-138X
Franca RusconiDepartment of Mother and Child Health, Azienda USL Toscana Nord Ovest, Pisa, Italy.ORCID https://orcid.org/0000-0002-9544-6472
Niels W RutjesDepartment of Pediatric Respiratory Medicine and Allergy, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
Sejal SaglaniNational Heart and Lung Institute, Imperial College London, London, UK.
Paul SeddonRespiratory Care, Royal Alexandra Children's Hospital, Brighton, UK.ORCID https://orcid.org/0000-0003-2136-958X
Salman SiddiquiImperial NIHR Biomedical Research Centre, National Lung and Heart Institute, Imperial College London, London, UK.
Florian SingerDepartment of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland.ORCID https://orcid.org/0000-0003-3471-5664
Tomoko TajiriDepartment of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Nagoya, Japan.
Steve TurnerWomen and Children Division, NHS Grampian, Aberdeen, UK.ORCID https://orcid.org/0000-0001-8393-5060
John W UphamFrazer Institute, The University of Queensland, Brisbane, Australia.ORCID https://orcid.org/0000-0002-0017-3433
Susanne J H VijverbergDepartment of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.ORCID https://orcid.org/0000-0002-4579-4081
Peter A B WarkSchool of Translational Medicine, Monash University, Clayton, Australia.ORCID https://orcid.org/0000-0001-5676-6126
Michael E WechslerNJH Cohen Family Asthma Institute, Department of Medicine, National Jewish Health, Denver, CO, USA.
Valentyna YasinskaDepartment of Respiratory Medicine and Allergy, Karolinska University Hospital, Huddinge, Sweden.ORCID https://orcid.org/0000-0002-1379-1265
Graham RobertsClinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK g.c.roberts@soton.ac.uk.ORCID https://orcid.org/0000-0003-2252-1248
3TR Asthma Definition of Response Working Group
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe have previously developed Core Outcome Measures sets for Severe Asthma (COMSA) by multi-stakeholder consensus. There are no patient-centred tools to quantify response to biological therapies for severe asthma. We aimed to develop paediatric and adult CompOsite iNdexes For Response in asthMa (CONFiRM) incorporating clinical parameters and patient-reported quality of life.
methodsInternational expert healthcare professionals and patients with severe asthma were invited to 1) develop consensus levels of clinically relevant changes for each outcome measure within COMSA, 2) use multicriteria decision analysis to develop the CONFiRM scores and 3) assess their internal validity. A separate group of healthcare professionals evaluated CONFiRM's external validity.
resultsFive levels of change for each COMSA outcome were agreed. Severe exacerbations and maintenance oral corticosteroid use were rated as the most important in determining both paediatric and adult CONFiRM scores. There was strong agreement between healthcare professionals and patients, although patients assigned greater importance to quality of life. The CONFiRM score quantified response to a biologic from -31 (deterioration) to 69 (best possible response). Paediatric and adult CONFiRMs had good discriminative ability for a sufficient (area under the curve ≥0.92) and a substantial (area under the curve ≥0.95) response to biologics. Both CONFiRMs demonstrated excellent external validity (Spearman correlation coefficients 0.9 and 0.8 for paediatric and adult, respectively; p<0.0001).
conclusionsWe have developed novel patient-centred paediatric and adult CONFiRMs that include quality of life measures. CONFiRMs should allow a more holistic understanding of response for the patient and a standardised assessment of the effectiveness of biologics between studies. Further research is needed to prospectively validate CONFiRM scores.
Indexed as
Anti-Asthmatic AgentsAsthmaBiological ProductsBiological TherapyAdolescentAdrenal Cortex HormonesAdultChildConsensusFemaleHumansMalePatient-Centered CarePatient Reported Outcome MeasuresQuality of LifeSeverity of Illness IndexAdrenal Cortex HormonesAnti-Asthmatic AgentsBiological Products
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