Objective:

To evaluate the prognostic utility of type 2 biomarkers (such as blood eosinophil count and fractional exhaled nitric oxide) in predicting asthma attacks across sexes.

Key Findings:

• Female patients had a higher annualized severe attack rate (0.90) compared to male patients (0.74), indicating a need for targeted management.
• Prior asthma attack history was a stronger predictor of future attacks in males than females, suggesting different risk profiles.
• No meaningful sex-based differences in the predictive value of type 2 biomarkers for asthma attacks, indicating uniform applicability.
• Higher body mass index and poorer asthma control were observed in female patients, highlighting the need for tailored interventions.

Interpretation:

While female patients experience higher asthma attack rates, the predictive utility of biomarkers does not differ by sex, suggesting that risk stratification can be applied uniformly across both sexes.

Limitations:

• Analysis limited to control arms of randomized trials, potentially introducing placebo effects that may skew results.
• Data on gender identity not available; only sex at birth analyzed, which may overlook important demographic factors.
• Small subgroup of patients with severe obesity and exclusion of active treatment arms limit the generalizability of findings.

Conclusion:

Biomarker-guided risk stratification is applicable to both sexes, but female patients without recent attacks may still be at elevated risk and should be monitored closely.