Se evaluaron el conocimiento y percepción sobre determinantes sociales de la salud respiratoria (DSSR) entre socios de SEPAR mediante encuesta online anónima. Respondieron 293 profesionales (4,8% de socios). Aunque el 98,6% reconoce que los DSSR afectan resultados clínicos y más del 78% identifica pacientes afectados, el 74,7% nunca recibió formación específica. Los indicadores más usados fueron: condiciones de vivienda (77,1%), nivel educativo (70%) y barreras idiomáticas (62,5%). Solo el 3,4% emplea instrumentos estandarizados y el 12,3% dispone de tiempo suficiente en consulta. Obstáculos: baja prioridad institucional, ausencia de protocolos y falta de tiempo. Entre los socios que respondieron, se observa un alto nivel de concienciación sobre la relevancia de los DSSR. Sin embargo, la baja tasa de respuesta limita la generalización de los resultados al conjunto de SEPAR. Hay una necesidad urgente de desarrollar estrategias formativas y protocolos específicos en DSSR, demanda respaldada por el 74% de los encuestados.

Introduction:Severe asthma (SA) management requires a comprehensive, individualized approach with continuous pharmacological treatment adjustments. In SA patients controlled with biologics, decisions on how to adjust maintenance therapy remain a clinical challenge, as current guidelines provide only general recommendations but lack specific practical guidance on how to implement step-down strategies. Material and methods:A literature review about maintenance therapy step-down in SA patients was conducted, complemented by five regional expert meetings across Spain. A total of 87 allergists and pulmonologists from referral hospitals discussed four clinical questions: whether step-down is a potential therapeutic goal, the minimum clinical conditions required to initiate tapering, the duration of disease control needed, and the preferred sequence of therapy reduction. Quantitative insights were captured through televoting, complemented by structured discussions. Results:Experts agreed that maintenance therapy step-down can be considered a potential therapeutic objective in patients with SA who achieve sustained control with biologics. Key conditions identified to start it included absence of exacerbations, nonuse of oral corticosteroids, adequate symptom control and preserved lung function for at least 6 or 12 months. A stepwise sequence for stepping-down maintenance therapy was established, prioritizing withdrawal of leukotriene receptor antagonists and high-to-low-dose reduction of inhaled corticosteroids, and finally withdrawal of long-acting beta-agonists, while maintaining low-dose inhaled corticosteroids. Conclusions:Expert perspectives, together with clinical trial and real-world evidence, support a gradual, individualized approach guided by objective markers and close monitoring. The algorithm proposed will provide clinicians with a structured, evidence-informed framework to guide the safe and effective reduction of SA maintenance therapy in real-world practice.

Artificial intelligence (AI) offers new opportunities to improve asthma management across the care process. This review synthesizes evidence on AI applications in diagnosis, classification, monitoring, and treatment. We conducted a narrative review based on a PubMed search (1995-2025). Eligible studies included peer-reviewed reports on AI applied to diagnosis, monitoring, prediction, and treatment of asthma. Outcomes of interest included diagnostic accuracy, risk prediction, adherence, and clinical decision support. Of 943 records screened, 32 studies met the inclusion criteria. Diagnostic tools integrating clinical data and data from objective tests performed best: deep neural networks combining spirometry and bronchial challenge tests achieved up to 98% accuracy, and automated pulmonary function test interpretation outperformed specialists in consistency and accuracy. Acoustic analyses of cough and respiratory sounds demonstrated sensitivity and specificity above 90%, supporting remote monitoring. In prediction of exacerbations, the electronic health record combining peak expiratory flow and symptom data achieved areas under the curve of up to 0.85. Unsupervised clustering approaches provided clinically meaningful asthma phenotypes. Evidence on treatment optimization remains scarce. AI has the potential to enhance diagnostic accuracy, phenotyping, and monitoring in asthma. However, most studies remain proof-of-concept, with limited external validation and little evidence of clinical impact. Future research should prioritize pragmatic trials, responder stratification, and real-world implementation to confirm clinical and cost-effectiveness.

Knowledge and perceptions of social determinants of respiratory health (SDRH) were assessed among SEPAR members using an anonymous online survey. 293 professionals responded (4.8% of members). Although 98.6% recognized that SDRH affects clinical outcomes and more than 78% identified affected patients, 74.7% had never received specific training. The most frequently used indicators were: housing conditions (77.1%), educational level (70%), and language barriers (62.5%). Only 3.4% used standardized instruments, and 12.3% had sufficient time during consultations. Obstacles included low institutional priority, lack of protocols, and time constraints. Among the responding members, a high level of awareness regarding the relevance of SDRH was observed. However, the low response rate limits the generalizability of the results to the entire SEPAR membership. There is an urgent need to develop training strategies and specific protocols on SDRH, a demand supported by 74% of respondents.

BACKGROUND AND OBJECTIVE:Although mepolizumab has demonstrated efficacy and effectiveness in the treatment of severe asthma, it is unknown whether the characteristics of patients starting this biologic have changed over the years and whether this impacts their response to mepolizumab. METHODS:TYREX was a multicenter, retrospective, observational study conducted in 24 asthma units across Spain to compare baseline clinical and demographic characteristics, and 12-month response to mepolizumab in two cohorts defined by the date of biologic initiation (cohort 1: 2017-2019 vs cohort 2: 2022-2024). RESULTS:Among the 446 patients included in the TYREX study, 191 were classified in cohort 1 and 108 in cohort 2. Cohort 1 had higher baseline exacerbation rates (3.45 vs. 2.40/year; p = 0.0002) and higher blood eosinophils (806 vs. 607 cells/μL; p = 0.0175). Twelve months after mepolizumab initiation, annual exacerbation rate were reduced to 0.46 in cohort 1 and to 0.51 in cohort 2, ACT scores increased from 14.23 to 21.84 vs. from 15.43 to 21.06; daily oral corticosteroid dependent patients dropped from 33.51% to 9.04% vs. from 12.96% to 2.78%; and clinical remission was achieved in 37.5% vs. 38.5% of patients after 12 months with mepolizumab. In multivariable analysis for 4-domain clinical remission (n = 108), higher baseline ppFEV1 increased the odds of remission while maintenance OCS use decreased them (Figure. 3). In the 3-domain remission model (n = 198), CRSwNP and higher baseline blood eosinophil count increased the odds of remission, whereas maintenance OCS use decreased them (Figure. 3). CONCLUSION:The decrease over time in severity and blood eosinophilia in asthma patients starting mepolizumab has not shown any impact on the clinical response to the drug.

Severe uncontrolled asthma (SUA) represents a complex and heterogeneous form of asthma that persists despite treatment. Allergic immunoglobulin E (IgE)-mediated SUA can be treated with tezepelumab or omalizumab. The aim was to estimate the cost-effectiveness of tezepelumab compared to omalizumab in the treatment of patients with allergic SUA, from the perspective of the Spanish National Health System (NHS). A Markov model was developed with a time horizon of 60 years, 28-day cycles, and five health states: controlled asthma; uncontrolled asthma; controlled asthma with exacerbation; uncontrolled asthma with exacerbation; and death. The efficacy parameters of the model were based on the NAVIGATOR and SOURCE clinical trials for tezepelumab and standard therapy, and on a network meta-analysis for omalizumab. Utilities and disutilities were extracted from NAVIGATOR and SOURCE and from the literature. The model considered direct costs (€, 2025): pharmacological, administration, exacerbations, disease management, and adverse events arising from oral corticosteroid use, obtained from Spanish data sources. Incremental costs per quality-adjusted life-year (QALY) gained were estimated for tezepelumab compared to the 106 omalizumab dosing profiles defined by weight and IgE. The results were contextualized to the Spanish setting using weight and IgE data obtained from the Primary Care Clinical Database and the literature. Deterministic sensitivity analysis (DSA) and probabilistic sensitivity analysis (PSA) were performed. Tezepelumab was cost-effective compared with omalizumab (450 mg/4 weeks; incremental cost-effectiveness ratio €17,213.44/QALY), considering a willingness-to-pay threshold of €30,000/QALY, and was dominant (more effective and less costly) at higher doses. This represents 69.81

Objectives: Chronic kidney disease (CKD) among lung transplant (LTx) recipients has increased in recent decades. However, there is insufficient evidence regarding clinical outcomes, and current guidelines lack specific recommendations for its management. Methods: This single-center retrospective study included all patients who underwent LTx and were subsequently referred to a dedicated nephrology outpatient clinic. Major adverse renal events were defined as a composite event. Results: Eighty LTx recipients with underlying lung disease etiology such as cystic fibrosis, chronic obstructive pulmonary disease, or interstitial lung disease were included. The mean time from LTx to first nephrologist evaluation was 4.7 years with an eGFR of 31.7 mL/min/1.73 m2. LTx recipients experienced a 48% reduction in eGFR within the first few months after LTx. Rapid progressors require renal replacement therapy earlier than the slow progressors. Patients requiring dialysis had higher all-cause mortality compared to those who did not require dialysis. Conclusions: Early post-LTx functional impairment appears to be the most significant predictor for CKD progression and the eventual need for RRT. Although CNI toxicity is the most common cause of CKD, early nephrology evaluation can uncover other causes and promote early renoprotective measures. For this patient population, specific guidelines addressing CKD after LTx and a multidisciplinary approach are essential.

BACKGROUND:Some patients with severe asthma have overlapping allergic and eosinophilic phenotypes and may be eligible for anti-eosinophilic or anti-immunoglobin E (IgE) biologics. OBJECTIVE:This post hoc sub-analysis assessed real-world mepolizumab effectiveness in patients with overlapping allergic and eosinophilic phenotypes, using 1-year data from the international, prospective REALITI-A (REAL world effectiveness of mepolizumab In paTIent care - Asthma) study. METHODS:The clinically significant asthma exacerbations (CSE) rate was assessed 1 year before (pretreatment) and after (follow-up) mepolizumab treatment, stratified by baseline total IgE (tIgE) levels (<60, 60 to <190, 190 to <550, and ≥550 kilounits per litre [kU/L]), atopic status (yes/no/unknown), previous omalizumab use (yes/no), geographic baseline omalizumab eligibility (eligible/non-eligible), and baseline tIgE level and blood eosinophil count threshold combinations (<81 or ≥81 kU/L and <300 or ≥300 cells per microliter [cells/μL]). RESULTS:Overall, 822 patients were included. CSEs occurred in 760 patients (93%) pretreatment and 398 patients (49%) during follow-up. CSE rate (rate ratio [95% CI]) was reduced in follow-up across all tIgE subgroups (<60 [n = 173]: 0.31 [0.25-0.37]; 60 to <190 [n = 176]: 0.30 [0.25-0.36]; 190 to <550 [n = 170]: 0.26 [0.20-0.33]; ≥550 kU/L [n = 155]: 0.28 [0.23-0.35]) and irrespective of atopic status (yes [n = 422]: 0.29 [0.26-0.33]; no [n = 52]: 0.33 [0.23-0.47]; unknown [n = 348]: 0.28 [0.24-0.32]), previous omalizumab use (yes [n = 151]: 0.37 [0.30-0.45]; no [n = 671]: 0.27 [0.24-0.30]), or eligibility (eligible [n = 349]: 0.29 [0.25-0.34]; non-eligible [n = 191]: 0.32 [0.27-0.38]). Furthermore, the CSE rate was reduced across all tIgE (kU/L) and blood eosinophil count (cells/μL) combinations (<81/<300 [n = 53]: 0.34 [0.24-0.47]; <81/≥300 [n = 103]: 0.33 [0.26-0.41]; ≥81/<300 [n = 98]: 0.36 [0.28-0.47]; ≥81/≥300 [n = 249]: 0.26 [0.22-0.31]). CONCLUSION:Mepolizumab demonstrates real-world effectiveness in reducing exacerbations in patients with severe asthma and an eosinophilic phenotype, regardless of any overlapping allergic phenotype.

Severe asthma is a heterogeneous syndrome with several clinical variants and often represents a complex disease requiring a specialized and multidisciplinary approach, as well as the use of multiple drugs. The prevalence of severe asthma varies from one country to another, and it is estimated that 50% of these patients present a poor control of their disease. For the best management of the patient, it is necessary to have a correct diagnosis, an adequate follow-up and undoubtedly to offer the best available treatment, including biologic treatments with monoclonal antibodies. With this objective, this consensus process was born, which began in its first version in 2018, whose goal is to offer the patient the best possible management of their disease to minimize their symptomatology. For this 2025 consensus update, a literature review was conducted by the authors, and new sections of how to treat asthma comorbidities or pediatric asthma were added, as a paragraph about monoclonal antibody switch. Subsequently, through a two-round interactive Delphi process, a broad panel of asthma experts from SEPAR and the regional pulmonology societies proposed the recommendations and conclusions contained in this document.

Clinical trials (CT) are the framework upon which novel treatments' safety and efficacy are assessed. The CARABELA-CT initiative aims to optimise Spanish CT procedures by improving efficiency, quality, and subject well-being. To this, it characterised CT healthcare models, identified improvement areas, proposed solutions, and gathered important insights from CT subjects. CARABELA-CT took a three-phase approach. Phase I involved CT healthcare models’ characterisation, including all clinical investigation processes in Spain, across six pilot hospitals, identifying improvement areas and solutions. Phase II validated these findings, defining key healthcare quality indicators. Phase III focused on dissemination and implementation. Additionally, seven randomly invited CT subjects participated in a focus group to share their experiences regarding communication, coordination, and CT impact on quality of life. Three CT healthcare models were identified, distinguished according to access, infrastructure, and resources. Twelve improvement areas were defined, leading to 38 solutions addressing subject education, professional training, organisation, protocols, resources, and technology. Twenty-four healthcare quality indicators were established to monitor CT processes. Subject experiences highlighted the need for clearer communication, digitalised information, and improved subject support, and revealed the emotional and psychological benefits of CT participation, despite the challenges. CARABELA-CT provides a comprehensive framework to enhance Spanish CT processes. This initiative integrates potential solutions in improvement areas in CT development and the corresponding healthcare quality indicators, and prioritises subject experiences to foster efficiency, participant engagement, and a sustainable, patient-centric clinical research model. These findings contribute to the continuous improvement of CT management, ultimately optimising research execution and healthcare outcomes.

Chronic respiratory diseases are a major public health burden, affecting over 7 million people in Spain and representing the third leading cause of death. Conditions such as chronic obstructive pulmonary disease, asthma, and lung cancer are heavily influenced by social and environmental determinants, including socioeconomic status, air quality, and smoking. Moreover, the increasingly aging Spanish population and persistent urban pollution levels further expand the burden of these diseases. This article underscores the urgent need to address inequities in respiratory healthcare through comprehensive policy action. To this end, we herein propose measures such as strengthening primary care to ensure early diagnosis, enhancing coordination between community pharmacy, primary and hospital care, incorporating specialised roles such as continuity-of-care nurses, prioritising access to cost-effective innovative treatments, promoting healthy environments, and reinforcing anti-smoking initiatives. We also advocate for inclusion of social determinants of health indicators in electronic health records and for development of patient education programmes. Tackling respiratory health disparities requires targeted strategies that involve all healthcare and social stakeholders to optimise resource use and improve the quality of life of patients with respiratory diseases in Spain.

This document is a detailed proposal addressing the management of spirometry and other pulmonary function tests in the post-COVID-19 pandemic context in Spain. The introduction discusses how the pandemic has affected the performance of these essential tests and underscores the need for a pragmatic assessment of risks and benefits, given that the absence of pulmonary function studies may lead to significant diagnostic and therapeutic errors.The section on the epidemiological situation in Spain highlights that the WHO no longer considers COVID-19 a public health emergency of international concern, reflecting the reduced severity of the disease due to high vaccination coverage and the characteristics of circulating variants.The regulatory framework states that the Health Institute Carlos III has defined a new epidemiological surveillance strategy aimed at restoring social and healthcare normality. A ministerial order issued by the Ministry of Health is mentioned, which lifts the mandatory use of facemasks in certain settings, in alignment with the strategy to return to normalcy.The proposal provides an in-depth analysis of the infectious risk to healthcare workers and patients in pulmonary function laboratories, concluding that current practices -along with the use of surgical masks and viral filters- minimize the generation and transmission of infectious aerosols.Detailed recommendations are provided for risk management, including architectural controls, administrative measures, hygiene practices, and personal protective protocols, with the goal of safeguarding both healthcare professionals and patients.The cited bibliography reinforces the scientific evidence base underlying the proposed recommendations and demonstrates a careful and deliberate approach to the safe and efficient reintroduction of spirometry and other pulmonary function tests into routine healthcare.

Resumen: El asma grave (AG) constituye un síndrome heterogéneo con diversas variantes clínicas y representa en muchas ocasiones, una enfermedad compleja con necesidad de un abordaje especializado y multidisciplinar, así como la utilización de múltiples fármacos. La prevalencia del AG varía de un país a otro, y se estima que el 50% de estos pacientes graves tienen un mal control de su enfermedad. Para el mejor manejo del paciente es necesario un correcto diagnóstico, un seguimiento adecuado y sin duda ofrecerle el mejor tratamiento disponible, incluyendo los tratamientos biológicos con anticuerpos monoclonales (mAb). Con este afán nació este proceso de consenso que se inició en su primera versión en el año 2018, cuya finalidad última es ofrecer al paciente el mejor manejo posible de su enfermedad para así minimizar su sintomatología. Para esta actualización del consenso 2025, se realizó por parte de los autores una revisión de la literatura, añadiéndose secciones sobre el tratamiento del asma en las comorbilidades y en pediatría, además de un apartado sobre el manejo del cambio de mAb. Posteriormente a través de un proceso interactivo tipo Delphi a dos rondas un panel amplio de expertos en asma de la Sociedad de Neumología y Cirugía Torácica (SEPAR) y las sociedades autonómicas de neumología propusieron las recomendaciones y conclusiones que se recogen en el documento. Abstract: Severe asthma is a heterogeneous syndrome with several clinical variants and often represents a complex disease requiring a specialized and multidisciplinary approach, as well as the use of multiple drugs. The prevalence of severe asthma varies from one country to another, and it is estimated that 50% of these patients present a poor control of their disease. For the best management of the patient, it is necessary to have a correct diagnosis, an adequate follow-up and undoubtedly to offer the best available treatment, including biologic treatments with monoclonal antibodies. With this objective, this consensus process was born, which began in its first version in 2018, whose goal is to offer the patient the best possible management of their disease to minimize their symptomatology. For this 2025 consensus update, a literature review was conducted by the authors, and new sections of how to treat asthma comorbidities or pediatric asthma were added, as a paragraph about monoclonal antibody switch. Subsequently, through a two-round interactive Delphi process, a broad panel of asthma experts from SEPAR and the regional pulmonology societies proposed the recommendations and conclusions contained in this document.

BACKGROUND:There is need for better understanding of the impact of demographic and clinical characteristics on outcomes with mepolizumab in patients with severe asthma. OBJECTIVE:To assess mepolizumab outcomes in severe asthma by demographic and clinical characteristics. METHODS:REALITI-A (GSK ID: 204710) was an international, prospective, observational study of adults with severe asthma (eosinophilic phenotype) initiating mepolizumab (100 mg subcutaneously). This 1-year post hoc subanalysis assessed outcomes stratified by sex, age at asthma onset, body mass index, smoking status, disease duration, and FeNO in parts per billion. Outcomes included clinically significant asthma exacerbations (CSEs), maintenance oral corticosteroids use, Asthma Control Questionnaire-5 scores, and pre-bronchodilator FEV1 between pretreatment or baseline and 12-month follow-up. RESULTS:Among 822 enrolled patients, 63% were female; of those with available data, 79% were aged 18 years or older at asthma onset, 60% had never smoked, and 37% were former smokers. Across all subgroups after mepolizumab treatment, CSEs were significantly reduced by 53% to 79%. Except for the current smoker subgroup, maintenance oral corticosteroid doses were numerically reduced by 50% to 100% and least-squares mean Asthma Control Questionnaire-5 scores were significantly improved by -1.02 to -1.57; least-squares mean pre-bronchodilator FEV1 significantly improved by 3.1% to 8.4% (except for the current smoker, BMI ≥30, and FeNO <25 and 25 to <50 subgroups). There were trends toward a greater reduction in CSE rates with older age at onset, body mass index less than 25 kg/m2, and nonsmoker or former smoker subgroups. CONCLUSION:Mepolizumab improved outcomes in patients with severe asthma over a varied demographic spectrum in this large real-world study.

Este documento es una propuesta detallada que aborda la gestión de la espirometría y otras pruebas de función pulmonar en el contexto pospandémico de COVID-19 en España. La introducción discute cómo la pandemia ha afectado la realización de estas pruebas esenciales y subraya la necesidad de una valoración pragmática de los riesgos y beneficios, dado que la falta de estudios de función pulmonar puede conllevar errores diagnósticos y terapéuticos significativos.La sección sobre la situación epidemiológica en España destaca que la OMS ya no considera a la COVID-19 una emergencia de salud pública de importancia internacional, reflejando una menor severidad de la enfermedad gracias a la alta cobertura de vacunación y a las características de las cepas circulantes.El marco normativo establece que el Instituto Carlos III ha definido una nueva estrategia de vigilancia epidemiológica que busca el restablecimiento de la normalidad social y sanitaria. Se menciona una orden emitida por el Ministerio de Sanidad que termina la obligatoriedad del uso de mascarillas en ciertos contextos, en línea con la estrategia de volver a la normalidad.La propuesta analiza en profundidad el riesgo infeccioso para los trabajadores y los pacientes en los laboratorios de función pulmonar, concluyendo que las prácticas actuales, junto con el uso de mascarillas quirúrgicas y filtros virales, minimizan la generación y transmisión de aerosoles infecciosos.Se proporcionan recomendaciones detalladas para la gestión de riesgos, incluyendo controles arquitectónicos, medidas administrativas, prácticas de higiene, y protocolos de protección personal, con el fin de proteger tanto a los profesionales sanitarios como a los pacientes.La bibliografía citada refuerza la base de evidencia científica detrás de las recomendaciones propuestas y demuestra un enfoque cuidadoso y considerado hacia la reintroducción segura y eficiente de la espirometría y otras pruebas de función pulmonar en la atención sanitaria habitual.

The Spanish Asthma Guideline (GEMA) 5.5 marks a significant conceptual and clinical advance in asthma management across Spanish-speaking healthcare systems. This updated edition incorporates the latest scientific insights into the pathophysiology, diagnosis, phenotyping, and treatment of asthma, while maintaining its practical, evidence-based orientation. A key innovation is the redefinition of therapeutic objectives: treatment is no longer limited to symptom control but is directed toward achieving and sustaining clinical remission, following the principles established by the Spanish REMAS consensus. The guideline also integrates recent evidence supporting the role of biologic therapies in specific inflammatory phenotypes, the implementation of maintenance and reliever therapy (MART) in adolescents, and a more rational approach to bronchodilator use in pediatric exacerbations. Further updates include refined recommendations on stepwise pharmacological strategies, expanded indications for advanced therapies in both adults and children, and updated management of associated conditions such as allergic bronchopulmonary aspergillosis and eosinophilic granulomatosis with polyangiitis. Organizationally, GEMA 5.5 strengthens the role of multidisciplinary asthma units, digital monitoring tools, and adherence-promoting interventions. Overall, GEMA 5.5 represents a paradigm shift toward personalized, remission-oriented asthma care, reinforcing its position as the leading Spanish-language reference for evidence-based clinical practice in respiratory medicine.

La inteligencia artificial (IA) y el aprendizaje automático (ML) puede llegar a transformar el diagnóstico y manejo de las enfermedades respiratorias como el asma. Estas herramientas permiten analizar grandes volúmenes de datos clínicos, genéticos y ambientales para mejorar la detección temprana, predecir exacerbaciones y personalizar tratamientos. Los algoritmos como redes neuronales, máquinas de soporte vectorial y árboles de decisión destacan por su capacidad para identificar patrones complejos, superando las técnicas tradicionales. Sin embargo, la implementación de la IA en la práctica clínica enfrenta retos. La falta de validación en grandes cohortes y la brecha de conocimiento entre científicos de datos y médicos limitan su adopción. Además, la interpretabilidad de algunos modelos avanzados, como las redes neuronales profundas, plantea dificultades en su aplicación práctica, ya que es crucial que los médicos comprendan los resultados para tomar decisiones informadas. A pesar de estos desafíos, la IA ha demostrado su potencial en la clasificación de pacientes según la gravedad del asma y la identificación de diferentes fenotipos, lo que facilita una atención más personalizada. Además, las herramientas de IA generativa, como ChatGPT, han mostrado utilidad en la educación sobre asma, aunque aún requieren mejoras en precisión y accesibilidad. Podemos concluir que, aunque la IA ofrece grandes promesas para mejorar el manejo del asma, su implementación clínica efectiva depende de superar obstáculos técnicos y éticos, y de la colaboración interdisciplinaria.

Purpose:To generate an evaluation checklist for the multidisciplinary approach to patients with asthma or suspected asthma. Patients and Methods:This was a qualitative study based on a literature review and expert opinions. A multidisciplinary steering committee with knowledge and experience in asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) was established and comprised two pneumologists, two allergologists, and two otorhinolaryngologists. They designed a preliminary evaluation checklist based on the best evidence available and their experience. An extra panel of 21 experts (five pneumologists, five allergologists, and 11 otorhinolaryngologists) analyzed and discussed the checklist, leading to the final version. Results:The checklist for the multidisciplinary approach to patients with asthma or suspected asthma includes the first and the follow-up visits. It is organized into several sections covering 1) current asthma and past history (diagnosis, symptoms, severity, control, etc.); 2) comorbidities (CRSwNP, atopic dermatitis, etc.); 3) physical examination and diagnostic tests (spirometry, bronchodilator reversibility test, fractional exhaled nitric oxide, etc.); 4) complementary tests (imaging, laboratory, allergy tests, etc.); 5) red flags (near-fatal asthma, CRSwNP complications); and 6) biological treatment (indication, response to treatment, decision making, etc.). Each section is divided into sub-sections detailing the recommended evaluation items. These items contain explanations, definitions, or variable lists that can be measured using direct questions, validated questionnaires, or other procedures such as imaging techniques or biomarkers. The checklist also proposes clinical actions. Conclusion:This evaluation checklist might help improve and standardize the clinical management of patients with asthma or suspected asthma.