{
  "abstract": "RATIONALE: The efficacy of biologics remains debatable in current or ex- smokers with severe asthma. OBJECTIVES: This study aimed to evaluate responses to biologics by smoking exposure and to assess variations in management practice across Europe. METHODS: 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. MEASUREMENTS AND MAIN RESULTS: Of the 3,876 adult patients, 2,383 were never-smokers, 540 ex-smokers (<10 pack-years), 812 (≥10 pack-years), and 141 current-smokers. In all 4 groups, symptom control (ACT≥20/ACQ≤1.5) improved, frequent exacerbations (≥2/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. CONCLUSION: 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.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 48,
  "authors": [
    {
      "name": "Marco Caminati"
    },
    {
      "name": "Jeremy Charriot"
    },
    {
      "name": "Aruna Bansal"
    },
    {
      "name": "Shane Hanon"
    },
    {
      "name": "Renaud Louis"
    },
    {
      "name": "Florence Schleich"
    },
    {
      "name": "Muriel Delvaux"
    },
    {
      "name": "Guy Brusselle"
    },
    {
      "name": "Stéphanie Ziant"
    },
    {
      "name": "Virginie Paulus"
    },
    {
      "name": "Sanja Grle Popovic"
    },
    {
      "name": "Gordana Pavlisa"
    },
    {
      "name": "Marina Lampalo"
    },
    {
      "name": "Celeste Porsbjerg"
    },
    {
      "name": "Kjell Håkansson"
    },
    {
      "name": "Susanne Hansen"
    },
    {
      "name": "Arnaud Bourdin"
    },
    {
      "name": "Eve Klising"
    },
    {
      "name": "Candice Estellat"
    },
    {
      "name": "Caroline Giboin"
    },
    {
      "name": "Dounya Metdaoui"
    },
    {
      "name": "Zsuzsanna Csoma"
    },
    {
      "name": "Dora Lúðvíksdóttir"
    },
    {
      "name": "Giorgio Walter Canonica"
    },
    {
      "name": "Enrico Heffler"
    },
    {
      "name": "Cristina Cardini"
    },
    {
      "name": "Anna Alloni"
    },
    {
      "name": "Iveta Kroica"
    },
    {
      "name": "Kristina Bieksiene"
    },
    {
      "name": "Romain Tching"
    },
    {
      "name": "Anneke ten Brinke"
    },
    {
      "name": "Jacob Sont"
    },
    {
      "name": "Piotr Kuna"
    },
    {
      "name": "Maria Morawska"
    },
    {
      "name": "Florin Mihaltan"
    },
    {
      "name": "Sanja Hromis"
    },
    {
      "name": "Aleksa Golubovic"
    },
    {
      "name": "Mihailo Stjepanovic"
    },
    {
      "name": "Vojislav Ćupurdija"
    },
    {
      "name": "Peter Kopac"
    },
    {
      "name": "Valentyna Yasinska"
    },
    {
      "name": "Fabienne Jaun"
    },
    {
      "name": "Joerg Leuppi"
    },
    {
      "name": "Ebru Damadoglu"
    },
    {
      "name": "Ozlem Goksel"
    },
    {
      "name": "Sabina Skrgat"
    },
    {
      "name": "Ratko Djukanovic"
    },
    {
      "name": "Bilun Gemicioglu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4e5et001wfagr.bib",
  "cited_by": 1,
  "doi": "10.1093/ajrccm/aamag473",
  "fulltext_url": null,
  "id": "4e5et001wfagr",
  "issns": [
    "1073-449X",
    "1535-4970"
  ],
  "landing_url": "https://hal.science/hal-05762209v1",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "openalex",
      "2737|Asthma and respiratory diseases"
    ]
  ],
  "openalex": "W7214102891",
  "pdf_url": "https://academic.oup.com/ajrccm/advance-article-pdf/doi/10.1093/ajrccm/aamag473/71326173/aamag473.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-22",
  "publisher": "American Thoracic Society",
  "ris": "https://research.draconitic.com/paper/4e5et001wfagr.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:40Z",
      "native_id": "hal-05762209",
      "source": "hal",
      "url": "https://hal.science/hal-05762209v1"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2737|Asthma and respiratory diseases",
      "subfield": "physiology"
    }
  ],
  "title": "Biologic outcomes in severe asthma patients by smoking status: evidence from SHARP",
  "title_text": "Biologic outcomes in severe asthma patients by smoking status: evidence from SHARP",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:40Z",
  "url": "https://research.draconitic.com/paper/4e5et001wfagr",
  "venue": "American Journal of Respiratory and Critical Care Medicine",
  "versions": []
}