Severe asthma patients frequently experience multiple comorbidities that complicate treatment and worsen outcomes, yet these conditions remain inconsistently documented and managed across healthcare systems, requiring standardized assessment approaches and expanded access to multidisciplinary teams for improved care.
- 91% of severe asthma patients have at least one comorbidity, with more than half having three or more additional conditions
- Most common comorbidities include chronic sinusitis (40%), nasal polyps (35%), obesity (30%), allergic rhinitis (30%) and GERD (29%)
- 41% of severe asthma specialists lack access to multidisciplinary teams, citing lack of time (36%) and funding (26%) as barriers
- Steroid-related complications and mental health disorders are significantly underreported across registries, limiting comprehensive care
Patients with severe asthma routinely face an array of complex health conditions, yet many of these comorbidities remain inconsistently documented and managed across healthcare systems, creating challenges for both patients and physicians.
Investigators have outlined significant gaps in asthma care in the paper, “Comorbidity Burden and Clinical Management Challenges in Severe Asthma: Insights From a Pan-European SHARP Study,” and have called for a more coordinated, multidisciplinary approach. Their paper was published in the Journal of Asthma and Allergy.
Researchers analyzed data from 13,245 severe asthma patients across 22 European registries and surveyed 239 severe asthma specialists from 25 countries to better understand how comorbidities are recognized and managed in clinical practice.
The study found that severe asthma rarely occurs in isolation. Previous registry data cited by the researchers showed that 91% of severe asthma patients have at least one comorbidity and more than half have three or more additional conditions, increasing treatment complexity and worsening outcomes.
The most common comorbidities, according to the study, were chronic sinusitis (40%), nasal polyps (35%), obesity (30%), allergic rhinitis (30%) and gastroesophageal reflux disease (29%). The authors said these conditions have been linked to poorer asthma control, more frequent exacerbations, a greater reliance on medication and reduced quality of life.
Researchers also uncovered substantial differences in how countries record and monitor these conditions. While type 2 inflammatory diseases and pulmonary conditions were generally well documented, they said steroid-related complications, mental health disorders and other extrapulmonary conditions were often underreported. Osteoporosis was the only steroid-related condition consistently captured across all registries, they noted.
The physician survey revealed additional challenges. Forty-one percent of severe asthma specialists reported not having access to multidisciplinary teams (MDTs), which are considered critical for managing patients with multiple chronic conditions. They credited the deficiency in providing comprehensive care to lack of time (36%) and funding (26%).
Despite these limitations, awareness of the problem remains high, researchers said. In fact, the study reported that more than 85% of physicians said multimorbidity significantly affects asthma outcomes, and 92% reported considering multiple comorbidities when treating severe asthma patients. Yet many respondents also indicated a need for additional training and better educational resources for patients.
The researchers emphasized that treating comorbidities alongside asthma may improve disease control and quality of life. They noted that conditions such as obesity, depression, allergic rhinitis and chronic sinus disease can directly influence treatment effectiveness and long-term outcomes.
Upon reviewing the study results, its authors concluded that improving severe asthma care requires standardized approaches to comorbidity assessment, expanded access to multidisciplinary teams and greater investment in physician and patient education.
