Mirror, mirror on the wall: is CompEx the fairest endpoint of all?

Extract Preventing exacerbations is a key goal in asthma management [1]. Over the decades, novel asthma biologics have been approved to reduce the risk of exacerbation in patients with severe or uncontrolled asthma [1, 2]. Clinical trials have traditionally relied on severe exacerbation (SevEx) as the primary endpoint [3]. SevEx is typically defined as events that require systemic corticosteroids, asthma-related hospitalisations, or emergency department visits due to asthma requiring systemic corticosteroids [1, 3]. However, using SevEx as the sole endpoint may overlook subtler but impactful worsening events that patients experience daily [3]. Therefore, extending beyond SevEx as a single endpoint is important to facilitate the development of new therapies.