Allergic rhinitis as a potentially modifiable contributor to small airway dysfunction and incomplete clinical remission in severe asthma

We read with great interest the article by Al-Ahmad et al, which demonstrated that small airway dysfunction (SAD) is a functional barrier to spirometry-defined clinical remission (CR) in severe asthma treated with biologic therapies.1 We congratulate the authors on this important work, which highlights the complementary value of impulse oscillometry (IOS) and spirometry in assessing distal airway impairment.