CONCLUSION:
In summary, in this real-world difficult asthma cohort, OMA and MEPO were used for distinct SA phenotypes in which they were both multidimensionally effective. Among these phenotypes, we identified some features independently associated with response, which may assist clinicians. In turn, those findings reiterated the importance of detailed characterisation and addressing treatable traits alongside consideration of biologics use in more severe asthma. To further enhance the personalised and optimal use of biologic therapies, future research should develop a deeper endotypic understanding of asthma biologic need and responsiveness.