{
  "abstract": "Background Biologics have improved clinical remission (CR) rates in severe asthma; however, practical tools for predicting CR are lacking. Our goal was to create a straightforward, interview-based scoring system applicable across various care settings.Methods This retrospective multicentre study formed exploratory and validation cohorts of adults with severe asthma starting biologic treatment. The primary outcome was achievement of 3-domain CR (no maintenance OCS, no exacerbation, asthma control test (ACT) ≥23). Each baseline characteristic was tested using univariable logistic regression; those with p<0.05 were included in a multivariable model to identify independent predictors. These predictors were combined into a point-based score. Discrimination was evaluated using the area under the receiver operating characteristic curve (AUC) and externally validated.Results The analysis included 281 patients in the exploratory cohort and 53 in the validation cohort. Three-domain CR occurred in 37.7% (106/281) of the exploratory cohort and 35.9% (19/53) of the validation cohort. In the exploratory cohort, male sex (OR, 2.34; 95% CI 1.22 to 4.57), ACT score ≥20 (OR, 3.75; 95% CI 1.96 to 7.36) and comorbid chronic rhinosinusitis (CRS) (OR, 3.27; 95% CI 1.61 to 6.93) were associated with 3-domain CR. We developed a scoring system by assigning 1 point each for male sex (M), ACT ≥20 (A) and comorbid CRS (C), termed MAC score, which showed good discrimination (AUC 0.73; 95% CI 0.68 to 0.79) and was externally validated (AUC 0.76; 95% CI 0.60 to 0.91).Conclusion The MAC score, a three-item metric derived from routinely accessible information, effectively predicts 3-domain CR and can be implemented across a range of healthcare settings, from primary care clinics to tertiary hospitals.",
  "authors": [
    {
      "affiliations": [
        "Kitano Hospital Medical Research Institute, Osaka, Osaka Prefecture, Japan"
      ],
      "name": "Tsuyoshi Sasada"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan"
      ],
      "name": "Naoya Tanabe"
    },
    {
      "affiliations": [
        "Kitano Hospital Medical Research Institute, Osaka, Osaka Prefecture, Japan"
      ],
      "name": "Satoshi Marumo"
    },
    {
      "affiliations": [
        "Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan"
      ],
      "name": "Yu Hara"
    },
    {
      "affiliations": [
        "Osaka Red Cross Hospital, Osaka, Osaka Prefecture, Japan"
      ],
      "name": "Kyohei Morita"
    },
    {
      "affiliations": [
        "Osaka Metropolitan University, Osaka, Osaka Prefecture, Japan"
      ],
      "name": "Tetsuya Watanabe"
    },
    {
      "affiliations": [
        "First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan"
      ],
      "name": "Kaoruko Shimizu"
    },
    {
      "affiliations": [
        "Kitano Hospital Medical Research Institute, Osaka, Osaka Prefecture, Japan"
      ],
      "name": "Masataka Hirai"
    },
    {
      "affiliations": [
        "Kitano Hospital Medical Research Institute, Osaka, Osaka Prefecture, Japan"
      ],
      "name": "Hiro Ikeda"
    },
    {
      "affiliations": [
        "Kitano Hospital Medical Research Institute, Osaka, Osaka Prefecture, Japan"
      ],
      "name": "Shohei Yano"
    },
    {
      "affiliations": [
        "Osaka Metropolitan University, Osaka, Osaka Prefecture, Japan"
      ],
      "name": "Kaho Hirai"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan"
      ],
      "name": "Shinya Tsukamoto"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan"
      ],
      "name": "Yusuke Hayashi"
    },
    {
      "affiliations": [
        "Osaka Red Cross Hospital, Osaka, Osaka Prefecture, Japan"
      ],
      "name": "Shota Takahashi"
    },
    {
      "affiliations": [
        "Osaka Red Cross Hospital, Osaka, Osaka Prefecture, Japan"
      ],
      "name": "Chie Yoshimura"
    },
    {
      "affiliations": [
        "Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan"
      ],
      "name": "Kota Murohashi"
    },
    {
      "affiliations": [
        "Osaka Red Cross Hospital, Osaka, Osaka Prefecture, Japan"
      ],
      "name": "Moon Hee Hwang"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan"
      ],
      "name": "Atsuyasu Sato"
    },
    {
      "affiliations": [
        "Kitano Hospital Medical Research Institute, Osaka, Osaka Prefecture, Japan"
      ],
      "name": "Motonari Fukui"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan",
        "Department of Respiratory Medicine, Allergology Kindai University Faculty of Medicine, Osaka, Japan"
      ],
      "name": "Hisako Matsumoto"
    },
    {
      "affiliations": [
        "First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan"
      ],
      "name": "Satoshi Konno"
    },
    {
      "affiliations": [
        "Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan"
      ],
      "name": "Takeshi Kaneko"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan"
      ],
      "name": "Toyohiro Hirai"
    }
  ],
  "title": "Predicting clinical remission in biologic-treated severe asthma: development of a practical scoring system from a Japanese multicentre study",
  "uid": "7b40e8f8-3b2a-546f-a8de-e041c3c1bb58"
}