{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T21:34:13Z","timestamp":1783373653954,"version":"3.54.6"},"reference-count":35,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,2]],"date-time":"2025-02-02T00:00:00Z","timestamp":1738454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"AstraZeneca"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) are chronic respiratory conditions that frequently coexist. However, an integrated assessment tool for both conditions is currently lacking. This study aimed to develop and preliminarily evaluate a composite score capable of simultaneously assessing asthma and CRSwNP in comorbid patients. Methods: An expert panel comprising three pulmonologists, one allergist\/clinical immunologist, and four ear, nose and throat (ENT) specialists developed a tool to capture asthma and CRSwNP severity. The tool (D\u2019Amato-De Corso score, or DAMADECO score) incorporates eight parameters, four specific to asthma and four specific to CRSwNP, to assign individual scores for each condition. A composite score is then calculated to reflect the overall disease burden (ranging from \u22128: poor control and +8: optimal control). A retrospective pilot study was conducted to evaluate the tool. Results: The DAMADECO composite score was applied to 21 comorbid patients. The mean partial scores for asthma and CRSwNP were \u22121.57 and \u22121.67, respectively, with a mean total composite score of \u22123.24. A total of 13 out of 21 patients had uncontrolled domains in both diseases, while fewer patients had only uncontrolled domains in asthma (1\/21) or CRSwNP (6\/21). The DAMADECO score also allows researchers to track disease progression and monitor treatment effectiveness. Conclusions: The preliminary results suggest that the DAMADECO score is a promising tool for simultaneously assessing asthma and CRSwNP, addressing the unmet need for an integrated approach to comorbid respiratory diseases. Further validation studies are needed to validate the tool in larger patient populations.<\/jats:p>","DOI":"10.3390\/jcm14030957","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T05:55:22Z","timestamp":1738648522000},"page":"957","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Proposal of a New Composite Score (DAMADECO) to Simultaneously Evaluate Asthma and CRSwNP Severity in Comorbid Patients"],"prefix":"10.3390","volume":"14","author":[{"given":"Maria","family":"D\u2019Amato","sequence":"first","affiliation":[{"name":"Respiratory Department, Monaldi Hospital AO Dei Colli, Federico II University, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5560-1979","authenticated-orcid":false,"given":"Patrizio","family":"Pasqualetti","sequence":"additional","affiliation":[{"name":"Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7389-2033","authenticated-orcid":false,"given":"Elena","family":"Cantone","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive and Dentistry Science, Federico II University of Naples, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7383-1487","authenticated-orcid":false,"given":"Marco","family":"Caminati","sequence":"additional","affiliation":[{"name":"Allergy Unit and Asthma Center, Department of Medicine, University of Verona, 37129 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3042-0765","authenticated-orcid":false,"given":"Matteo","family":"Bonini","sequence":"additional","affiliation":[{"name":"Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy"},{"name":"National Heart and Lung Institute, Imperial College London, London SW7 2AZ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1743-0504","authenticated-orcid":false,"given":"Fabiano","family":"Di Marco","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Universit\u00e0 degli Studi di Milano, Pulmonology ward, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlotta","family":"Pipolo","sequence":"additional","affiliation":[{"name":"Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6297-8034","authenticated-orcid":false,"given":"Veronica","family":"Seccia","sequence":"additional","affiliation":[{"name":"U.O. Otorhinolaryngology Unit, Pisa University Hospital, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1600-4474","authenticated-orcid":false,"given":"Giovanni","family":"Sotgiu","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5761-7018","authenticated-orcid":false,"given":"Eugenio","family":"De Corso","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1186\/s12931-023-02475-6","article-title":"Global, regional, and national burden of asthma and its attributable risk factors from 1990 to 2019: A systematic analysis for the Global Burden of Disease Study 2019","volume":"24","author":"Wang","year":"2023","journal-title":"Respir. Res."},{"key":"ref_2","first-page":"Doc11","article-title":"Epidemiology of chronic rhinosinusitis, selected risk factors, comorbidities, and economic burden","volume":"14","author":"Beule","year":"2015","journal-title":"GMS Curr. Top. Otorhinolaryngol.\u2014Head Neck Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"48","DOI":"10.2500\/aap.2019.40.4182","article-title":"A cross-sectional, population-based survey of U.S. adults with symptoms of chronic rhinosinusitis","volume":"40","author":"Palmer","year":"2019","journal-title":"Allergy Asthma Proc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1897","DOI":"10.1080\/03007995.2020.1815682","article-title":"Systematic literature review of the epidemiology and clinical burden of chronic rhinosinusitis with nasal polyposis","volume":"36","author":"Chen","year":"2020","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/s00408-023-00603-z","article-title":"Prevalence and Severity Distribution of Type 2 Inflammation-Related Comorbidities Among Patients with Asthma, Chronic Rhinosinusitis with Nasal Polyps, and Atopic Dermatitis","volume":"201","author":"Khan","year":"2023","journal-title":"Lung"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"383","DOI":"10.2500\/ajra.2014.28.4076","article-title":"A Comparative and Descriptive Study of Asthma in Chronic Rhinosinusitis with Nasal Polyps","volume":"28","author":"Thomsen","year":"2014","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1016\/j.jaip.2018.10.016","article-title":"The Severe Asthma Network in Italy: Findings and Perspectives","volume":"7","author":"Heffler","year":"2019","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1183\/09031936.00202013","article-title":"International ERS\/ATS guidelines on definition, evaluation and treatment of severe asthma","volume":"43","author":"Chung","year":"2014","journal-title":"Eur. Respir. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1016\/j.jaci.2014.08.042","article-title":"The prevalence of severe refractory asthma","volume":"135","author":"Hekking","year":"2015","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Bakakos, A., Loukides, S., and Bakakos, P. (2019). Severe Eosinophilic Asthma. J. Clin. Med., 8.","DOI":"10.3390\/jcm8091375"},{"key":"ref_11","first-page":"00024","article-title":"Management of the patient with eosinophilic asthma: A new era begins","volume":"1","author":"Bel","year":"2015","journal-title":"ERJ Open Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1016\/j.chest.2021.04.013","article-title":"Eosinophilic and Noneosinophilic Asthma: An Expert Consensus Framework to Characterize Phenotypes in a Global Real-Life Severe Asthma Cohort","volume":"160","author":"Heaney","year":"2021","journal-title":"Chest"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.jaip.2016.04.012","article-title":"Chronic Rhinosinusitis with Nasal Polyps","volume":"4","author":"Stevens","year":"2016","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"105947","DOI":"10.1016\/j.rmed.2020.105947","article-title":"Chronic rhinosinusitis with nasal polyps impact in severe asthma patients: Evidences from the Severe Asthma Network Italy (SANI) registry","volume":"166","author":"Canonica","year":"2020","journal-title":"Respir. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1016\/j.jaip.2020.09.063","article-title":"Chronic Rhinosinusitis with Nasal Polyps and Asthma","volume":"9","author":"Laidlaw","year":"2021","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1016\/j.anai.2021.01.012","article-title":"Dupilumab improves upper and lower airway disease control in chronic rhinosinusitis with nasal polyps and asthma","volume":"126","author":"Laidlaw","year":"2021","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ryu, G., Min, C., Park, B., Choi, H.G., and Mo, J.-H. (2020). Bidirectional association between asthma and chronic rhinosinusitis: Two longitudinal follow-up studies using a national sample cohort. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-66479-8"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Kanda, A., Kobayashi, Y., Asako, M., Tomoda, K., Kawauchi, H., and Iwai, H. (2019). Regulation of Interaction between the Upper and Lower Airways in United Airway Disease. Med. Sci., 7.","DOI":"10.3390\/medsci7020027"},{"key":"ref_19","unstructured":"Klain, A., Indolfi, C., Dinardo, G., Licari, A., Cardinale, F., Caffarelli, C., Manti, S., Ricci, G., Pingitore, G., and Tosca, M. (2021). United airway disease. Acta Biomed. Atenei Parm., 92."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"De Corso, E., Bil\u00f2, M.B., Matucci, A., Seccia, V., Braido, F., Gelardi, M., Heffler, E., Latorre, M., Malvezzi, L., and Pelaia, G. (2022). Personalized Management of Patients with Chronic Rhinosinusitis with Nasal Polyps in Clinical Practice: A Multidisciplinary Consensus Statement. JPM, 12.","DOI":"10.3390\/jpm12050846"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Seccia, V., D\u2019Amato, M., Scioscia, G., Bagnasco, D., Di Marco, F., Fadda, G., Menzella, F., Pasquini, E., Pelaia, G., and Tremante, E. (2022). Management of Patients with Severe Asthma and Chronic Rhinosinusitis with Nasal Polyps: A Multidisciplinary Shared Approach. J. Pers. Med., 12.","DOI":"10.3390\/jpm12071096"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.2147\/JAA.S496193","article-title":"Evaluation Checklist for the Multidisciplinary Approach to Patients with Asthma or Suspected Asthma in United Airway Disease","volume":"17","author":"Almonacid","year":"2024","journal-title":"J. Asthma Allergy"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Backer, V., Cardell, L.O., Lehtim\u00e4ki, L., Toppila-Salmi, S., Bjermer, L., Reitsma, S., Hellings, P.W., Weinfeld, D., Aan\u00e6s, K., and Ulrik, C.S. (2023). Multidisciplinary approaches to identifying and managing global airways disease: Expert recommendations based on qualitative discussions. Front. Allergy, 4.","DOI":"10.3389\/falgy.2023.1052386"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2312","DOI":"10.1111\/all.13875","article-title":"EUFOREA consensus on biologics for CRSwNP with or without asthma","volume":"74","author":"Fokkens","year":"2019","journal-title":"Allergy"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s11882-023-01118-6","article-title":"Remission in Type 2 Inflammatory Diseases: Current Evidence, Unmet Needs, and Suggestions for Defining Remission in Chronic Rhinosinusitis with Nasal Polyps","volume":"24","author":"Caminati","year":"2024","journal-title":"Curr. Allergy Asthma Rep."},{"key":"ref_26","unstructured":"(2025, January 20). GINA Report 2024. Available online: https:\/\/ginasthma.org\/wp-content\/uploads\/2024\/05\/GINA-2024-Main-Report-WMS-1.pdf."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3629","DOI":"10.1016\/j.jaip.2023.07.041","article-title":"Severe Asthma Network Italy Definition of Clinical Remission in Severe Asthma: A Delphi Consensus","volume":"11","author":"Canonica","year":"2023","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_28","first-page":"287","article-title":"EPOS2020\/EUFOREA expert opinion on defining disease states and therapeutic goals in CRSwNP","volume":"62","author":"Fokkens","year":"2024","journal-title":"Rhin"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2147\/JAA.S321017","article-title":"Expert Opinion on Biological Treatment of Chronic Rhinosinusitis with Nasal Polyps in the Gulf Region","volume":"15","author":"Alsaleh","year":"2022","journal-title":"J. Asthma Allergy"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1111\/all.15650","article-title":"European Academy of Allergy and Clinical Immunology position paper on endoscopic scoring of nasal polyposis","volume":"78","author":"Gevaert","year":"2023","journal-title":"Allergy"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Italian Study Group on Nasal Polyps, Gelardi, M., Bocciolini, C., Notargiacomo, M., Schiavetti, I., Lingua, C., Pecoraro, P., Iannuzzi, L., Quaranta, V.A., and Giancaspro, R. (2022). Chronic rhinosinusitis with nasal polyps: How to identify eligible patients for biologics in clinical practice. Acta Otorhinolaryngol. Ital., 42, 75\u201381.","DOI":"10.14639\/0392-100X-N1699"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"129","DOI":"10.4193\/Rhino15.072","article-title":"Stratification of SNOT-22 scores into mild, moderate or severe and relationship with other subjective instruments","volume":"54","author":"Toma","year":"2016","journal-title":"Rhin"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Pelaia, C., Pelaia, G., Maglio, A., Tinello, C., Gallelli, L., Lombardo, N., Terracciano, R., and Vatrella, A. (2023). Pathobiology of Type 2 Inflammation in Asthma and Nasal Polyposis. J. Clin. Med., 12.","DOI":"10.3390\/jcm12103371"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1080\/1744666X.2023.2218617","article-title":"Evaluation of switching or simultaneous use of biologic treatment in patients with severe chronic rhinosinusitis with nasal polyps and severe asthma. Considerations in clinical decision making","volume":"19","author":"Otten","year":"2023","journal-title":"Expert Rev. Clin. Immunol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2438","DOI":"10.1016\/j.jaip.2022.04.039","article-title":"Management of United Airway Disease Focused on Patients With Asthma and Chronic Rhinosinusitis With Nasal Polyps: A Systematic Review","volume":"10","author":"Mullol","year":"2022","journal-title":"J. Allergy Clin. Immunol. Pract."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/957\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:25:58Z","timestamp":1760027158000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/957"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,2]]},"references-count":35,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["jcm14030957"],"URL":"https:\/\/doi.org\/10.3390\/jcm14030957","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,2]]}}}