Human and animal rights statement

All reported human data collection, performed by the authors, was in accordance with the ethical standards of the institutional and/or national research committees of the countries participating in ISAR and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Financing

The data of this study was provided by the Observational and Pragmatic Research Institute (OPRI) Pte Ltd. This study was funded by Optimum Patient Care Global Ltd (OPCG). The International Severe Asthma Registry (ISAR) is operated by OPCG and co-funded by OPCG and AstraZeneca Ltd.

Competing interests

Désirée Larenas-Linnemann reports personal fees from ALK-Abelló, AstraZeneca national and global, Bayer, Bioderma, Chiesi, Grunenthal, Grin, GlaxoSmithKline national and global, Viatris, Novartis, Pfizer, Sanofi, Siegfried, Syneos Health, Carnot, grants for guideline development from Abbvie, Bayer, Chiesi, Lilly, Sanofi, AstraZeneca, Pfizer, Novartis, Circassia, UCB, GlaxoSmithKline, outside the submitted work. Saraid Cerda Reyes declares receiving conference fees from Novartis S.A de C.V, GlaxoSmithKline Mexico, AstraZeneca Mexico and, Sanofi Mexico. Nidia K. Castillon Benavides declares no relevant conflict of interest. Elvia Angelica Contreras Contreras declares no relevant conflict of Interest. Ulises N. García-Ramírez received fees as speaker and advisory board from: AstraZeneca, GlaxoSmithKline, Sanofi Genzyme, Chiesi and Novartis. Lilia M. Borboa Olivares received congress support from AstraZeneca, and Octapharma. Nadia Aguilar-Hinojosa received speaker’s fees and congress support from AstraZeneca Mexico. Karen L. Rivera Alvarado declares no relevant conflict of interest. Itzel V. Ochoa-García was a speaker for AstraZeneca. Maria de la luz Garcia participated in advisory boards by Carnot and received speaker’s fees by Armstrong, Siegfried, and Chiesi. Ricardo Campos Cerda declares no relevant conflict of interest. Claudine I. Nava Ramírez declares receiving conference fees from Novartis S.A. de C.V. Yair H González Tuyub received fees as a speaker and advisory board member from: AstraZeneca, GlaxoSmithKline, and IPI-Asacpharma. Víctor González-Uribe reports receiving honoraria for lectures, consultancy fees, advisory boards, and research grants from the following companies: GlaxoSmithKline, Sanofi, AstraZeneca, FAES Farma, ALK, and AbbVie. Hugo A. Azuara-Trujillo has received speaker and consultant fees for Astra Zeneca, GlaxoSmithKline, Takeda, and Novartis. Claudia E. Jimenez declares no relevant conflict of interest. Elsy M. Navarrete- Rodríguez reports receiving honoraria for lectures, consultancy fees, advisory boards, from the following companies: GlaxoSmithKline, Sanofi, AstraZeneca, AbbVie, Lilly, and Armstrong. Blanca E. del-Rio-Navarro reports receiving honoraria for lectures, consultancy fees, advisory boards, and research grants from the following companies: OPELLA, Sanofi, and AstraZeneca. Laura Mendoza-Reyna has received speaker and consultant fees from GlaxoSmithKline, Pfizer, and Sanofi. Dominic (A) Friston is an employee of Optimum Patient Care (OPC). OPC is a co-founder of the International Severe Asthma Registry. Ghislaine Scelo is a consultant for Observational and Pragmatic Research Institute (OPRI). OPRI conducted this study in collaboration with Optimum Patient Care, a co-founder of the International Severe Asthma Registry. David (B) Price has advisory board membership with AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis, Viatris, Teva Pharmaceuticals; consultancy agreements with AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis, Viatris, Teva Pharmaceuticals; grants and unrestricted funding for investigator-initiated studies (conducted through Observational and Pragmatic Research Institute Pte Ltd) from AstraZeneca, Chiesi, Viatris, Novartis, Regeneron Pharmaceuticals, Sanofi Genzyme, and UK National Health Service; payment for lectures/speaking engagements from AstraZeneca, Boehringer Ingelheim, Chiesi, Cipla, Inside Practice, GlaxoSmithKline, Medscape, Viatris, Novartis, Regeneron Pharmaceuticals and Sanofi Genzyme, Teva Pharmaceuticals; payment for travel/accommodation/meeting expenses from AstraZeneca, Boehringer Ingelheim, Novartis, Medscape, Teva Pharmaceuticals.; owns 74% of the social enterprise Optimum Patient Care Ltd (Australia and UK) and 92.61% of Observational and Pragmatic Research Institute Pte Ltd (Singapore); is peer reviewer for grant committees of the UK Efficacy and Mechanism Evaluation Programme, and Health Technology Assessment; and he was an expert witness for GlaxoSmithKline.