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Despite excellent therapies and evidence-based guidelines, severe asthma is frequently uncontrolled. The most relevant clinical characteristics to manage severe asthma in adult patients and guide treatment choice were reviewed by a group of worldwide specialists in asthma and biologic drugs from nine countries. Biomarker levels (blood eosinophil count and fractional concentration of exhaled nitric oxide [FeNO]), clinical features Oral Corticosteroid [OCS] dependence, specific comorbid disease entities associated with severe type 2 asthma), and safety considerations are all addressed in the recommendations. Biomarkers, such as blood or sputum eosinophil counts, as well as FeNO, appear to have prognostic and predictive value, and should be assessed in all patients with severe asthma, according to current research.