BACKGROUND:Allergic rhinitis displays a relevant impact on quality of life. Medications used in the treatment of rhinitis have been assessed on their impact on rhinoconjunctivitis-related quality of life, but not on generic health-related quality of life metrics, such as utilities or EQ-5D visual analogue scale (VAS) levels. This study aimed to compare different medication classes and individual medications on utilities and EQ-5D VAS levels using data from a mobile app. METHODS:We conducted an observational study using direct patient data from the MASK-air mobile application, collected between May 2015 and December 2024. We compared rhinitis medication classes and individual medications on health utilities (computed from the EQ-5D-5L questionnaire) and the EQ-5D VAS. To account for confounding, we employed inverse probability treatment weighting based on propensity scores, adjusting for demographics, baseline symptom control, and asthma status. RESULTS:The study analysed 69,973 observations with EQ-5D VAS data and 842 observations with utility data. At the medication class level, fixed combinations of intranasal antihistamines and corticosteroids were associated with improvements in EQ-5D VAS (mean difference = 1.900; 95% CI = 1.316-2.484) and utilities (mean difference = 0.022; 95% CI = -0.015 to 0.059) compared with oral antihistamines (OAH). Intranasal antihistamines were associated with lower EQ-5D VAS and utility scores than other intranasal treatments. For individual medications, mometasone was associated with a lower EQ-5D VAS than budesonide and fluticasone furoate, while fexofenadine and levocetirizine tended to be associated with lower VAS values than other OAH. CONCLUSION:Fixed combinations of intranasal antihistamines and corticosteroids were associated with better quality-of-life than oral antihistamines and intranasal antihistamines. These findings could support future cost-effectiveness analyses.

Allergic Rhinitis and its Impact on Asthma (ARIA) was, up until 2017, a guideline using the best evidence (Grading of Recommendations, Assessment, Development and Evaluation, GRADE) and developed as a change management strategy. A second change management strategy-in collaboration with the European Academy of Allergy and Clinical Immunology (ARIA-EAACI)-was developed as a person-centred, digitally enabled, artificial intelligence-assisted care (person-centred care) with strong political involvement. The digital tools of ARIA are mainly based on MASK-air, an Organisation for Economic Co-operation and Development (OECD) Best Practice for integrated care for chronic diseases. Artificial intelligence was used, in particular, to approach the patients' views and expectations. The current paper describes the steps to build and achieve a new change management strategy. The future of the Change Management strategy is (i) a collaboration between ARIA and EAACI, (ii) the development of ARIA 2024-2025 guidelines, (iii) the new ARIA-MeDALL classification of multimorbid airway diseases and (iv) embedding MASK-air in a registry for severe allergic diseases. The ultimate goals of the ARIA-EAACI change management strategy will be (i) the transformation of health and care in rhinitis and asthma multimorbidity and (ii) the development of novel guidelines and policies in a cost-effective manner, improving shared-decision-making.

ABSTRACT Allergic Rhinitis and its Impact on Asthma (ARIA) was, up until 2017, a guideline using the best evidence (Grading of Recommendations, Assessment, Development and Evaluation, GRADE) and developed as a change management strategy. A second change management strategy—in collaboration with the European Academy of Allergy and Clinical Immunology (ARIA‐EAACI)—was developed as a person‐centred, digitally enabled, artificial intelligence‐assisted care (person‐centred care) with strong political involvement. The digital tools of ARIA are mainly based on MASK‐air, an Organisation for Economic Co‐operation and Development (OECD) Best Practice for integrated care for chronic diseases. Artificial intelligence was used, in particular, to approach the patients' views and expectations. The current paper describes the steps to build and achieve a new change management strategy. The future of the Change Management strategy is (i) a collaboration between ARIA and EAACI, (ii) the development of ARIA 2024‐2025 guidelines, (iii) the new ARIA‐MeDALL classification of multimorbid airway diseases and (iv) embedding MASK‐air in a registry for severe allergic diseases. The ultimate goals of the ARIA‐EAACI change management strategy will be (i) the transformation of health and care in rhinitis and asthma multimorbidity and (ii) the development of novel guidelines and policies in a cost‐effective manner, improving shared‐decision‐making.

Anaphylaxis in older adults remains insufficiently studied despite a rising burden in an aging population. This review examines how comorbidities, polypharmacy, and atypical clinical presentations influence risk, diagnosis, and management in this group, and identifies major gaps in current evidence. Registry data show age-related differences in elicitors, with insect venom and drugs predominating in adults ≥ 65 years. Older patients more frequently present without skin symptoms and exhibit cardiovascular-dominant reactions, contributing to diagnostic delay. Cardiovascular and respiratory disease, beta-blockers, ACE inhibitors, and immunosenescence increase severity and complicate treatment. Real-world data suggest that epinephrine remains underused, and while intranasal adrenaline spray has emerged as an alternative, safety data in older patients are lacking. Long-term management is challenged by frailty, functional limitations, and reduced ability to use autoinjectors. Older adults experience more severe, atypical anaphylaxis driven by multimorbidity, medication effects, and age-related immune changes. Early recognition, prompt epinephrine use, and individualized prevention plans are essential. Targeted research is needed to refine diagnostic criteria, clarify medication-related risks, and guide age-adapted management strategies.

Rhinitis in the elderly represents a unique challenge, due to specific clinical profiles, needs, and expectations. Allergic rhinitis (AR) in the elderly is often intertwined with nonallergic rhinitis. Multimorbidity, frailty, disability, and polypharmacy leading to drug-drug interactions are all important in the elderly. Epidemiological data remain limited. AR in the elderly often follows an earlier onset, but some patients may start AR symptoms later. Rhinitis in the elderly is often underrecognized because the symptoms are those of AR possibly combined with nonallergic rhinitis influenced by age-related structural and functional changes in the nose. These include nasal dryness, congestion without clear trigger, and rhinorrhea alone. Several characteristics of AR in the elderly render AR diagnosis more challenging in this age group. An assessment of control and severity is needed to optimize person-centered treatment. There is no specific guideline for the management of AR in the elderly. However, although AR in the elderly may differ from rhinitis in younger adults, and medication efficacy may be reduced, the main management trend is the same as that in younger patients. The key problem is safety, because some drugs may cause specific severe side effects. First-generation oral antihistamines should be avoided. Intranasal corticosteroids, second-generation oral antihistamines, as well as intranasal H1-antihistamine and intranasal H1-antihistamine-intranasal corticosteroid fixed combination are the first-line therapeutic options. Digital health associated with artificial intelligence has a promising future for AR management.

The recent ARIA-MeDALL hypothesis proposed in 2023 that allergic rhinitis (AR) alone and allergic rhinitis and asthma (A) multimorbidity (AR + A) represent 2 distinct diseases. To improve the knowledge on this topic, we have gathered data from real-world studies using MASK-air®. According to our analyses: (i) An “extreme allergy phenotype” [A + AR + C, Conjunctivitis] was confirmed and found to be more severe (symptoms and work productivity) than single diseases alone. (ii) Patients with AR + A required more rhinitis medications, and had more severe VAS levels for nasal and ocular symptoms than those with AR alone in all countries tested. (iii) In clusters with poorly controlled AR, the frequency of co-medicating with more than 1 rhinitis drug was higher in AR + A than in AR alone. (iv) In the CONSTANCES general population cohort, a co-medication pattern (intranasal corticosteroid and oral H1-antihistamines) was associated with the presence of AR + A (vs AR alone). This co-medication pattern was associated in MASK-air® with a poorer AR control than monotherapy. (v) Patients with AR + A had different EQ-5D patterns than those with AR alone. (vi) Large differences were found between AR alone and AR + A in work impairment, resulting in higher weekly indirect costs in all OECD countries in AR + A by comparison to AR alone. Although mHealth studies are hypothesis-generating, and usually not reliable for testing or confirming hypotheses, our results are strongly in support of the nosologic distinction between A + AR and AR alone.

BACKGROUND:Oral and ocular medications are frequently used in the treatment of allergic rhinitis (AR). As part of the update of the Allergic Rhinitis and its Impact on Asthma (ARIA)-EAACI guidelines, this manuscript presents the ARIA-EAACI 2024-2025 recommendations for oral and ocular treatments. METHODS:The ARIA-EAACI 2024-2025 guideline panel issued recommendations following the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) evidence-to-decision framework. Several sources of evidence were used to inform panel judgements and recommendations, including systematic reviews, mHealth and pharmacovigilance data as well as a survey on costs. RESULTS:Eight guideline questions concerning oral treatments for AR and three questions concerning ocular treatments were addressed. These questions led to the recommendations. Overall, these questions concern the choice between different classes of medication. They also discuss the role of oral antihistamines (OAH), leukotriene receptor antagonists (LTRA), ocular antihistamines (OcAH) and ocular mast cell stabilisers. Four questions had not been previously evaluated in ARIA guidelines, while, for the other four, there was a change in the strength or directionality of the recommendations. Overall, these guidelines recommend using intranasal corticosteroids over OAH and using OAH over LTRA. Moreover, they suggest using OAH over OcAH and suggest being against adding LTRA to OAH. Finally, considerations for choosing between different individual OAHs are presented. CONCLUSION:This ARIA-EAACI 2024-2025 article supports patients, their caregivers and healthcare professionals in choosing oral and ocular treatments for AR. Decisions on treatment should consider the clinical variability of the disease, patients' values and the affordability of medications.

INTRODUCTION:Medication availability and costs can be highly variable across countries and in different time periods. We aimed to conduct a survey among local experts to obtain information on the availability and costs of allergic rhinitis medications in different countries. METHODS:We sent a survey to members of the Allergic Rhinitis and its Impact on Asthma (ARIA) group, asking for the availability and the lowest cost of specific allergic rhinitis medications in their respective countries. Data in local currencies were converted to 2024 US Dollars adjusted for Purchasing Power Parity (PPP). We compared the costs of different medication classes, assuming, for each class, the least expensive drug in each country, as well as full treatment adherence. RESULTS:We received responses from ARIA experts in 51 different countries. Intranasal corticosteroids (INCS) and oral antihistamines (OAH) were available in all countries, but this was not observed for intranasal antihistamines (INAH) or for INAH+INCS. In most countries, OAH was the least costly drug class, while INAH+INCS was the most expensive. Among INCS, beclomethasone was the medication most frequently identified as the cheapest, while cetirizine and loratadine were the OAH most frequently reported as the least expensive. Among INAH+INCS, azelastine-fluticasone was more frequently identified as less costly than olopatadine-mometasone. CONCLUSION:There is an important across-country and across-class variability in terms of costs of allergic rhinitis medications. The results of this study will inform the ARIA-EAACI 2024-2025 guidelines.

BACKGROUND/OBJECTIVES:The ongoing Ukrainian conflict constitutes a grave humanitarian emergency, with refugees facing significant language and cultural barriers hindering access to health care. The UCRAID (Ukrainian Citizen and refugee electronic support in Respiratory diseases, Allergy, Immunology and Dermatology) initiative was launched to support Ukrainian refugees through the MASK-air® and CRUSE® apps. The UCRAID@Apulia study aimed to assess the feasibility of UCRAID via a joint medical and socio-linguistic approach. METHODS:A multidisciplinary, cross-sectional study was conducted from July 2023 to June 2024 involving adult Ukrainian refugees with asthma, allergic rhinitis, atopic dermatitis or chronic urticaria recruited via a network of Ukrainian associations and institutional partners. Participants were introduced to MASK-air® and CRUSE® and administered a 20-item questionnaire assessing sociocultural and healthcare needs, linguistic barriers, comorbidities (Charlson Comorbidity Index) and health-related quality of life (EQ-5D-5L). RESULTS:Among the 381 eligible patients being offered participation, 53 (13.91%) accepted enrolment. While literacy and occupation levels were high, issues with accommodation and bureaucracy were often cited. Mistrust and fear of reprisals emerged as key deterrents to participation. Chronic urticaria and atopic dermatitis were the prevalent allergic conditions. EQ-5D-5L showed good overall health but was characterized by anxiety/depression (32.1%) and pain (17%). Despite significant language barriers in both Italian and English, all participants successfully used both applications. At a 30-day follow-up, 71% reported at least 5 days of consecutive usage with high satisfaction. CONCLUSIONS:Despite low enrolment driven by fear and distrust, mHealth tools like MASK-air® and CRUSE® proved feasible and well-received, with trust building and long-term support being key elements for wider future adoption.

INTRODUCTION:Satisfaction with treatments may affect medication adherence and use patterns, including the use of co-medication. We aimed to compare different medications for allergic rhinitis (AR) on (i) patients' satisfaction and (ii) co-medication use frequency. METHODS:We assessed data from the mHealth app MASK-air. We evaluated days on which users with self-reported AR had used-alone or in co-medication-intranasal corticosteroids (INCS), intranasal antihistamines (INAH), fixed combinations of INAH+INCS, or oral antihistamines (OAH). We built multivariable regression models to compare these different AR medication classes (as well as individual medications) on their (i) treatment satisfaction levels (measured using a specific daily visual analogue scale ['VAS satisfaction']) and (ii) odds of being used in co-medication. RESULTS:We assessed 28,177 days reported by 1691 MASK-air users. For all medication classes, co-medication usage was associated with lower treatment satisfaction. When used in monotherapy, OAH were associated with lower VAS satisfaction than INCS (-1.7 points; 95% CI = -2.7; -0.7) or INAH+INCS (-2.1 points; 95% CI = -3.5; -0.7). INCS displayed higher odds of being used in co-medication than OAH (OR = 1.3; 95% CI = 1.0; 1.6) or INAH+INCS (OR = 1.3; 95% CI = 0.8; 1.8). When comparing individual intranasal medications, fluticasone furoate and fluticasone propionate tended to be more frequently used in co-medication. Among individual OAH, desloratadine and rupatadine were associated with higher satisfaction, while fexofenadine was more frequently used in co-medication. CONCLUSION:Using patient-reported data, we evaluated different medication classes and treatments in terms of satisfaction and co-medication frequency. These results provide key insights into the acceptability of AR treatments and will contribute to future treatment guidelines.

Allergic rhinitis (AR) and asthma are common respiratory disorders that often occur together, affecting quality of life and increasing healthcare expenses of patients.These chronic illnesses are often managed without medical supervision, creating distinct challenges. A lack of resources can limit regular follow-up, which in turn promotes disease mismanagement and an increased reliance on self-medication, including the inappropriate use of corticosteroids and nasal decongestants. Community pharmacies could serve as critical primary healthcare providers, facilitating AR and asthma management by promoting therapy adherence, minimizing drug misuse, and improving symptom monitoring using digital tools.The evolving role of pharmacists as vital healthcare team members is highlighted by their involvement in screening, prevention, and patient education, particularly in underserved communities. Strengthening the partnerships between pharmacists, physicians, and patients may lead to more tailored and effective management strategies. This collaborative approach has demonstrated promise in enhancing disease outcomes and reducing healthcare costs.

BACKGROUND AND OBJECTIVES:The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines classify rhinitis as "intermittent" or "persistent" and "mild" or "moderate-severe". Objectives: To assess ARIA classes in a real-world study in terms of phenotypic differences and their association with asthma. METHODS:We performed a cross-sectional real-world study based on users of the MASK-air® app who reported data for at least 3 different months. We assessed the frequency of users according to the ARIA classes and compared these classes in terms of rhinitis symptoms, use of comedication, frequency of comorbid asthma, and the association between comorbid asthma and rhinitis control. RESULTS:A total of 2273 users (180 796 days) were assessed. Most users had moderate-severe rhinitis (n=2003; 88.1%) and persistent rhinitis (n=1144; 50.3%). The frequency of patients with probable asthma was 35.7% (95%CI, 34.5%-37.0%) for intermittent rhinitis and 48.5% (95%CI, 47.1%-49.9%) for persistent rhinitis. The maximum values on the visual analog scale (VAS) for rhinitis symptoms and the combined symptom-medication score were lower in patients with mild rhinitis than in those with moderate-severe rhinitis (irrespective of whether they had persistent or intermittent rhinitis). In most ARIA classes, VAS nose and VAS eye and rhinitis comedication were more frequent in patients with rhinitis+asthma than in those with rhinitis alone. CONCLUSIONS:This study suggests that the presence of asthma is more closely related to persistence of rhinitis than to severity and that the presence of comorbid asthma may be associated with poorer control of rhinitis across the different ARIA classes.

Background Allergic rhinitis (AR) impacts quality of life, work and school productivity. Over the last years, an important body of evidence resulting from mHealth data has led to a better understanding of AR. Such advances have motivated an EAACI-endorsed update of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines (ARIA 2024-2025). This manuscript presents the ARIA 2024-2025 recommendations for intranasal treatments, one of the mainstays for AR management.Methods The ARIA 2024-2025 guideline panel issued recommendations following the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) evidence-to-decision framework. Several sources of evidence were used to inform panel judgments and recommendations, including systematic reviews, evaluation of mHealth and pharmacovigilance data, as well as a survey of experts on costs.Results Eleven guideline questions concerning intranasal treatments for AR were prioritized, leading to recommendations. Overall, these questions concern the choice between different classes of intranasal medications-most notably, intranasal corticosteroids (INCS), antihistamines (INAH), fixed combinations of INAH+INCS and decongestants-or between different individual medications within each class. Four questions had not been evaluated in previous ARIA guidelines, while for the other three there was a change in the strength or directionality of recommendations. Overall, recommendations point to the suggested use of INAH+INCS over INAH or INCS and INCS over INAH.Conclusion This ARIA 2024-2025 article supports patients, their caregivers, and healthcare professionals in choosing an intranasal treatment. However, decisions on AR treatment should consider the clinical variability of the disease, patients' values, and the affordability of medications.

BACKGROUND:Adherence to rhinitis treatment has been insufficiently assessed. We aimed to use data from the MASK-air mHealth app to assess adherence to oral antihistamines (OAH), intra-nasal corticosteroids (INCS) or azelastine-fluticasone in patients with allergic rhinitis. METHODS:We included regular European MASK-air users with self-reported allergic rhinitis and reporting at least 1 day of OAH, INCS or azelastine-fluticasone. We assessed weeks during which patients answered the MASK-air questionnaire on all days. We restricted our analyses to data provided between January and June, to encompass the pollen seasons across the different assessed countries. We analysed symptoms using visual analogue scales (VASs) and the combined symptom-medication score (CSMS), performing stratified analyses by weekly adherence levels. Medication adherence was computed as the proportion of days in which patients reported rhinitis medication use. Sensitivity analyses were performed considering all weeks with at most 1 day of missing data and all months with at most 4 days of missing data. RESULTS:We assessed 8212 complete weeks (1361 users). Adherence (use of medication > 80% days) to specific drug classes ranged from 31.7% weeks for azelastine-fluticasone to 38.5% weeks for OAH. Similar adherence to rhinitis medication was found in users with or without self-reported asthma, except for INCS (better adherence in asthma patients). VAS and CSMS levels increased from no adherence to full adherence, except for INCS. A higher proportion of days with uncontrolled symptoms was observed in weeks with higher adherence. In full adherence weeks, 41.2% days reported rhinitis co-medication. The sensitivity analyses displayed similar results. CONCLUSIONS:A high adherence was found in patients reporting regular use of MASK-air. Different adherence patterns were found for INCS compared to OAH or azelastine-fluticasone that are likely to impact guidelines.

Allergic rhinitis (AR), traditionally considered as a childhood condition, is increasingly recognized among older adults, driven by rising life expectancy and environmental factors. Although allergic sensitization declines with age, AR prevalence in the elderly is underestimated, with 3–12% of geriatric patients affected. Diagnosis is challenging due to nonspecific symptoms and overlapping conditions, leading to underdiagnosis and inadequate treatment. AR significantly impacts the quality of life (QoL), often exacerbating respiratory comorbidities like asthma and COPD. Presbynasalis, encompassing age-related sinonasal changes, includes reduced allergic responses, increased chronic rhinosinusitis, altered nasal structure, and impaired mucociliary clearance. Non-allergic rhinitis, atrophic rhinitis, and overlapping rhinitis further complicate AR diagnosis in the elderly. Effective management involves personalized pharmacotherapy, allergen-specific immunotherapy (AIT), and addressing comorbidities and polypharmacy risks. Despite safety concerns, recent studies demonstrate AIT efficacy in elderly patients, reducing symptoms and medication use. Given AR’s impact on cognitive and respiratory health, accurate diagnosis and treatment can enhance QoL and mitigate health decline. Greater awareness and further research are essential to understand AR prevalence and improve outcomes for geriatric patients.

BACKGROUND:Allergic rhinitis may impair work productivity. This study aimed to assess (i) the differential impact of allergic rhinitis symptoms on work performance, assessed by means of Visual Analogue Scale (VAS) work; and (ii) the effect of asthma comorbidity on work productivity. METHODS:We assessed data from the MASK-air mHealth app of patients with allergic rhinitis. We identified factors associated with the impact of allergic symptoms on work productivity through multivariable linear mixed effects models. RESULTS:We studied 260,378 days from 20,724 patients. In multivariable regression models, nasal symptoms showed the strongest association with VAS work (regression coefficient = 0.38 [95%CI = 0.38; 0.38]). Poor rhinitis control, measured by the combined symptom-medication score, was associated with worse VAS work (regression coefficient = 0.96 [95%CI = 0.96; 0.97]). The median VAS work in patients with probable or possible asthma (median = 9, interquartile range = 22 for probable and 23 for possible asthma) was greater than for patients with no evidence of asthma (median = 3, interquartile range = 12) (Cohen's d = 0.60). In patients with probable asthma, nasal and asthma symptoms showed a similar impact on work productivity (regression coefficient for VAS nose = 0.32 [95%CI = 0.31; 0.32]; regression coefficient for VAS asthma = 0.30 [95%CI = 0.29; 0.31]). CONCLUSIONS:Allergy symptoms, especially nasal symptoms, are associated with worse work productivity. In addition, patients with allergic rhinitis and asthma display more impairment in work productivity than patients with allergic rhinitis alone.

Sex and gender play a critical role in allergic diseases, influencing immune response, clinical phenotypes, treatment strategies, outcomes, and health-related quality of life. Despite mounting evidence across multiple studies examining sex/gender differences in a multitude of allergic diseases, most address isolated conditions, not taking into consideration the vast interplay of hormonal, genetic, immunological, and sociocultural factors and their unique consequences for clinicians and researchers. With this position paper, we aim to assess currently available evidence on the sex- and gender-specific characteristics of the most common allergic diseases, providing an overview of present knowledge and future areas of improvement for clinicians and researchers. This position paper was developed by the Società Italiana di Allergologia, Asma ed Immunologia Clinica (SIAAIC): a panel of experts who conducted a literature review focusing on sex and gender differences across major allergic diseases. A consensus-based approach was employed to assess the immunological, clinical, and therapeutic implications of available evidence, offering a recommendation for researchers and clinicians alike. Data highlights marked differences driven by sex and gender in disease prevalence, immune pathways, clinical phenotype and severity, as well as therapeutic outcomes. Female patients appear to show a higher prevalence of Th2-driven ailments, autoimmune overlap, and allergic drug reactions, whereas males are more likely to experience fatal anaphylaxis and severe mastocytosis. Sex hormones can modulate multiple immune pathways leading to mast cell activation, antibody production, and cytokine expression, thus contributing to divergent disease trajectories. In conclusion, sex and gender are a key determinant in allergic diseases, and their integration in future research is essential to develop a tailored approach to treatment. Efforts should prioritise the identification of sex- and gender-specific biomarkers, therapeutic strategies, and equitable access to healthcare services. A sex- and gender-aware approach could potentially improve outcomes, optimise treatment strategies, and address current gaps in allergy practice.

BACKGROUND AND RESEARCH QUESTION:We aimed to assess whether levels of digital biomarkers can reflect monthly patterns of asthma control. STUDY DESIGN AND METHODS:We performed a longitudinal study on patients with asthma and comorbid rhinitis who filled ≥26 days of data in a month in the MASK-air® app and who reported at least 1 day of treatment with an inhaled corticosteroid with or without a long-acting β2-agonist (ICS ± LABA). We applied k-means cluster analysis to define clusters of months according to daily asthma control and medication use. Clusters were compared using digital biomarkers (visual analogue scale [VAS] on asthma symptoms and electronic daily asthma control score [e-DASTHMA]). We compared patients who did not switch with patients who switched their ICS ± LABA. RESULTS:We assessed 243 patients and 1358 months. We identified three clusters of poor asthma control despite high ICS ± LABA adherence, one cluster of poor asthma control and poor ICS ± LABA adherence, one cluster of good asthma control and high ICS ± LABA adherence and one cluster of good asthma control despite poor ICS ± LABA adherence. These clusters displayed relevant differences in VAS asthma and e-DASTHMA levels. Similar clusters were found in 'non-switchers' versus 'switchers'. CONCLUSION:Levels of digital biomarkers reflect asthma control patterns and might be used to monitor patients with asthma.