Different faces of severe asthma From comorbid bronchiectasis to patient perspectives

In this thesis we described issues from daily clinical practice related to the characterization and treatment of patients with severe asthma. In particular, there was a focus on a sub-group of patients who have comorbid bronchiectasis in addition to severe asthma. This thesis also looked at treatment with biologics and how this is perceived by patients, both in hospital and via intravenous administration at home. Finally, it reflected on 'core outcome measures' and patient-reported outcome measures in severe asthma trials with biologics.
With this thesis we illustrated the multifaceted nature of severe asthma management and the need for individualized and personalized care. We have highlighted the importance of recognizing bronchiectasis as a relevant and common comorbidity in severe asthma, and illustrated its specific characteristics. We also argue against excluding certain groups of patients, particularly those with severe asthma and comorbid bronchiectasis, from anti-IL-5/5Ra biological therapy.
Including patients' perspectives on biologic treatment adds depth, and shows that the burden of disease experienced by patients with severe asthma extends beyond the experience of symptoms. This is demonstrated by our narrative study with in-depth interviews with patients.
Our exploration highlighting the differences in experience between home and hospital-based intravenous biologic treatment and showing that not all patients prefer home treatment, further underscores the importance of personalized care.
Finally, the emphasis on seeking improved and more patient-centred, outcome measures in severe asthma biological studies is consistent with the broader goal of improving patient care and tailoring treatments to individual needs.