{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:01:57Z","timestamp":1791378117727,"version":"4.3.2"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"am","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>The efficacy of biologics remains debatable in current or ex- smokers with severe asthma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to evaluate responses to biologics by smoking exposure and to assess variations in management practice across Europe.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective real-world study of adults with severe asthma from 16 European countries assessed at baseline and after 1-year of biologic treatment. Data were collected within the ERS SHARP (Severe Heterogeneous Asthma Research-Patient Centred) registry, applying the OMOP Common Data Model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Of the 3,876 adult patients, 2,383 were never-smokers, 540 ex-smokers (&amp;lt;10 pack-years), 812 (\u226510 pack-years), and 141 current-smokers. In all 4 groups, symptom control (ACT\u226520\/ACQ\u22641.5) improved, frequent exacerbations (\u22652\/year) decreased, asthma quality of life (AQLQ) improved, and oral corticosteroid use decreased. While the starting point sometimes differed, the order of magnitude of change was not statistically different between groups. A country-averaged analysis of the SHARP survey revealed that 29% of participating nations reported opposition to prescribing biologics to current smokers, while 59% expressed dissatisfaction with current treatment guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study reveals a lower prevalence of biologic therapy among adults with severe asthma who smoke and provides evidence suggesting this practice is unwarranted. Former\/current smokers who underwent biologic therapy for one year responded as effectively as never-smokers. Recognising the complexity of nicotine dependence, smoking cessation should remain a central goal in asthma management. This study underscores the need for randomized controlled trials in smokers to enable more robust and inclusive scientific conclusions and guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajrccm\/aamag473","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:37:09Z","timestamp":1790077029000},"source":"Crossref","is-referenced-by-count":1,"title":["Biologic outcomes in severe asthma patients by smoking status: evidence from SHARP"],"prefix":"10.1093","author":[{"given":"Marco","family":"Caminati","sequence":"first","affiliation":[{"name":"University of Verona Allergy and Clinical Immunology, Department of Medicine, , Verona,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1420-5774","authenticated-orcid":false,"given":"Jeremy","family":"Charriot","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Montpellier CHU Arnaud de Villeneuve - D\u00e9partement de Pneumologie et Addictologie, PhyMedExp, , France - https:\/\/orcid.org\/0000-0002-1420-5774"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aruna T","family":"Bansal","sequence":"additional","affiliation":[{"name":"Acclarogen Ltd, St John\u2019s Innovation Centre Cowley Road , Cambridge,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane","family":"Hanon","sequence":"additional","affiliation":[{"name":"UZ Brussel\/ Vrije Universiteit Brussel (VUB) ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renaud","family":"Louis","sequence":"additional","affiliation":[{"name":"Liege University , Liege,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Schleich","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, CHU of Liege , Belgium, GIGA I3, , Department of Physical Activity and Rehabilitation Sciences, , 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, Liege,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginie","family":"Paulus","sequence":"additional","affiliation":[{"name":"Liege University , Liege,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanja Grle","family":"Popovic","sequence":"additional","affiliation":[{"name":"University Hospital Centre Zagreb KBCZ, Clinic for Pulmonary Diseases Jordanovac ,","place":["Croatia"]},{"name":"University of Zagreb School of Medicine, , Zagreb,","place":["Croatia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordana","family":"Pavlisa","sequence":"additional","affiliation":[{"name":"University Hospital Centre Zagreb KBCZ, Clinic for Pulmonary Diseases Jordanovac ,","place":["Croatia"]},{"name":"University of Zagreb School of Medicine, , 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