Title

Definition, Evaluation and Treatment of Severe Asthma

Authoring Organizations

American Thoracic Society

European Respiratory Society

Publication Month/Year

February 3, 2014

Last Updated Month/Year

October 4, 2024

Supplemental Implementation Tools

Document Type

Guideline

External Publication Status

Published

Country of Publication

Global

Document Objectives

The purpose of this document is to revise the definition of severe asthma, discuss the possible phenotypes and provide guidance about the management of patients with severe asthma. The target audience of these guidelines is specialists in respiratory medicine and allergy managing adults and children with severe asthma. General internists, paediatricians, primary care physicians, other healthcare professionals and policy makers may also benefit from these guidelines. This document may also serve as the basis for development and implementation of locally adapted guidelines.

Target Patient Population

Patients with asthma

Target Provider Population

General internists, pediatricians, primary care physicians

PICO Questions

  1. Should chest HRCT scans be routinely ordered in patients with symptoms of severe asthma without known specific indications for performing this test (based on history, symptoms and/or results of other investigations)?

  2. Should treatment guided by sputum eosinophil count, rather than treatment guided by clinical criteria alone, be used in patients with severe asthma?

  3. Should treatment guided by FeNO in addition to clinical criteria, rather than treatment guided by clinical criteria alone, be used in patients with severe asthma?

  4. Should a monoclonal anti-IgE antibody be used in patients with severe allergic asthma?

  5. Should methotrexate be used in the treatment of severe asthma?

  6. Should macrolide antibiotics be used in patients with severe asthma?

  7. Should antifungal agents be used in patients with severe asthma?

  8. Should bronchial thermoplasty be used in patients with severe asthma?

Inclusion Criteria

Male, Female, Adolescent, Adult, Child, Older adult

Health Care Settings

Ambulatory, Childcare center, School

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Diagnosis, Assessment and screening, Treatment, Management

Keywords

asthma, severe asthma, eosinophils

Supplemental Methodology Resources

Data Supplement, Data Supplement, Data Supplement