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
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...finition of Severe Asthma for Patients Aged ≥6...
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Diagnosis (Tab...
...mputed tomography of chestIn children and adults...
...eosinophil counts...
...ults with severe asthma, the ATS and E...
...severe asthma, the ATS and ERS suggest tr...
...itric oxide (FeNO)The ATS and ERS sug...
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...morbidities and Contributory FactorsHaving tro...
Treatment
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Table 6. Recommended...
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...ateThe ATS and ERS suggest that clinicians do N...
...bioticsThe ATS and ERS suggest that clinic...
...ifungal agents...
...RS suggest antifungal agents in adults with severe...
...ERS suggest that clinicians do NOT use ant...
...ermoplastyThe ATS recommends that bronchial thermo...
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...d Long-Acting Beta Agonist Plus Inhaled Corticost...
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