{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T02:02:05Z","timestamp":1773885725081,"version":"3.50.1"},"reference-count":30,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"unspecified","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"JSA WAO 2020 Memorial Research Grant Program"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2026,2,25]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Biologics have improved clinical remission (CR) rates in severe asthma; however, practical tools for predicting CR are lacking. Our goal was to create a straightforward, interview-based scoring system applicable across various care settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective multicentre study formed exploratory and validation cohorts of adults with severe asthma starting biologic treatment. The primary outcome was achievement of 3-domain CR (no maintenance OCS, no exacerbation, asthma control test (ACT) \u226523). Each baseline characteristic was tested using univariable logistic regression; those with p&lt;0.05 were included in a multivariable model to identify independent predictors. These predictors were combined into a point-based score. Discrimination was evaluated using the area under the receiver operating characteristic curve (AUC) and externally validated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The analysis included 281 patients in the exploratory cohort and 53 in the validation cohort. Three-domain CR occurred in 37.7% (106\/281) of the exploratory cohort and 35.9% (19\/53) of the validation cohort. In the exploratory cohort, male sex (OR, 2.34; 95%\u2009CI 1.22 to 4.57), ACT score \u226520 (OR, 3.75; 95%\u2009CI 1.96 to 7.36) and comorbid chronic rhinosinusitis (CRS) (OR, 3.27; 95%\u2009CI 1.61 to 6.93) were associated with 3-domain CR. We developed a scoring system by assigning 1 point each for male sex (M), ACT \u226520 (A) and comorbid CRS (C), termed MAC score, which showed good discrimination (AUC 0.73; 95%\u2009CI 0.68 to 0.79)\u2009and was externally validated (AUC 0.76; 95%\u2009CI 0.60 to 0.91).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The MAC score, a three-item metric derived from routinely accessible information, effectively predicts 3-domain CR and can be implemented across a range of healthcare settings, from primary care clinics to tertiary hospitals.<\/jats:p>\n                  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