Table 2 In- and exclusion criteria

Inclusion criteria

• Age ≥ 18 years

• Confirmed diagnosis of asthma according to asthma guidelines [1, 25, 26]

• Diagnosis of severe, uncontrolled asthma with eligibility for treatment with specific asthma biologicals (omalizumab, mepolizumab, benralizumab, reslizumab, dupilumab, tezepelumab) as determined at the regional asthma MDC according to asthma guidelines [1, 27]

• Previously prescribed asthma biologicals must have been discontinued ≥ 4 times the elimination half-life of the specific biological

• Relative clinical stability. A minimum of 2 weeks should have passed since the onset of asthma exacerbation and/or lower respiratory tract infection requiring treatment with prednisolone and/or antibiotics

Exclusion criteria

• Primary diagnosis of COPD

• History of cancer, including:

- Current basal cell carcinoma, localised squamous cell carcinoma of the skin, or carcinoma in situ of the cervix. Patients are eligible if curative therapy was completed at least 12 months prior to study entry

- Current other malignancies. Patients are eligible if curative treatment was completed at least 5 years before the start of the trial

• Inability to read and understand the Dutch language adequately

• Inability to participate in a remote monitoring and coaching program using a smartphone

• Inability to participate in physical activity (e.g. physical disability)

• Current pregnancy

• Currently breastfeeding

• A liaison with the coordinating or (principal) investigator, which could likely influence the decision to participate in this study voluntarily (in concordance with the WMO – article 5)

If a participant becomes pregnant or starts breastfeeding during the study, they will discontinue their participation. Nonetheless, data collected before discontinuation will be included in the final analysis, and the selected treatment will be continued despite the participant’s withdrawal