Definition, Evaluation and Treatment of Severe Asthma
Key Points
Key Points
- Severe asthma is defined as asthma that requires treatment with high dose inhaled corticosteroids plus a second controller and/or systemic corticosteroids to prevent it from becoming ‘‘uncontrolled’’ or that remains ‘‘uncontrolled’’ despite this therapy. (See Tables 1 & 2)
- Severe asthma is a heterogeneous condition consisting of phenotypes such as severe allergic asthma, eosinophilic asthma, neutrophilic asthma, chronic airflow obstruction, recurrent exacerbations and corticosteroid insensitivity.
- The prevalence of severe asthma in adults and children is estimated to be 5–10% of the total asthma population.
- The ATS/ERS Severe Asthma guidelines make recommendations addressing the roles of computed tomography, sputum eosinophils, and exhaled nitric oxide in the diagnosis of severe asthma.
(see Table 3) - The ATS/ERS Severe Asthma guidelines make recommendations addressing the roles of anti-IgE antibody, methotrexate, macrolide antibiotics, anti-fungal agents, and bronchial thermoplasty in the treatment of severe asthma. (see Table 6)
Diagnosis
...agnosis...
...Definition of Severe Asthma for Patie...
...2. Definition of High Daily Dose of...
...ble 3. DiagnosisHaving trouble viewing table? Expa...
...iagnosis (Table 3)...
...d tomography of chestIn children and adults w...
...um eosinophil count...
...ults with severe asthma, the ATS and...
...with severe asthma, the ATS and ERS suggest tr...
...c oxide (FeNO)The ATS and ERS suggest that clin...
...s Which Can Masquerade as Severe Asthm...
...bidities and Contributory FactorsHav...
Treatment
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...le 6. Recommended Therapies...
...i-IgE antibody (omaliz...
In patients with severe allergic asth...
...dren. (C, VL)620...
MethotrexateThe ATS and ERS suggest tha...
...antibioticsThe ATS and ERS suggest that clin...
...ntifungal agents...
...e ATS and ERS suggest antifungal agents in adul...
...ERS suggest that clinicians do NOT use anti...
...ial ThermoplastyThe ATS recommends that bronchia...
.... Quick Relief MedicationsHaving tro...
.... Inhaled CorticosteroidsHaving trouble viewing...
...ned Long-Acting Beta Agonist Plus Inhaled Corti...
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