Severe Asthma Multimorbidity Clusters Across Europe; Findings From SHARP

<bold>Background:</bold> The nature and impact of multimorbidity (MM) in severe asthma (SA) is poorly defined. <bold>Aim:</bold> To better understand this issue we applied cluster analysis to create MM clusters in SA from comorbidities across the SHARP CRC. <bold>Methods:</bold> We analysed data from 2690 patients in 11 SHARP CRC countries spanning North, East, South and Western Europe. <bold>Results:</bold> Ten comorbidities had prevalence ≥5% in all regions. Three MM clusters (MMC) based on 6 conditions were consistently seen across Europe: MMC1) osteoporosis and steroid induced weight gain, MMC2) eczema and rhinitis, and MMC3) chronic sinusitis and nasal polyps. Obesity, bronchiectasis, gastro-oesophageal reflux and psychological comorbidities clustered variably by region (Fig. 1). <fig><object-id>erj;64/suppl_68/PA482/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> Patients were categorised according to whether their comorbidity profile fell into none, 1, 2 or all 3 of these MMC groups (giving 8 possibilities; MMC0 through to MMC123). MMC3 (25%) was the commonest single group and had highest T2 traits. MMC0 (19%) had oldest asthma onset and was more likely to currently smoke. MMC1 (8%) had highest regular oral steroid use, worst lung function and highest BMI. Prevalence of the 8 MMC groups varied by country. <bold>Conclusion:</bold> We found 3 consistent MM clusters in SA across Europe, plus 4 comorbidities that varied in cluster assignment by region. MMC prevalence varied by country, but patients profiled in this way had consistent and distinct clinical traits.