Management of Severe Asthma Beyond the Guidelines
Authors:
- 16 June 2020
- journal article
- review article
- Published by Springer Nature in Current Allergy and Asthma Reports
- Vol. 20 (9) , 1-11
Abstract
Purpose of Review Asthma is one of the most common chronic respiratory diseases worldwide, yet only a small percentage of patients are categorized as having severe disease. Severe asthmatics, however, are responsible for the largest burden of healthcare costs and lost productivity. Several recent guidelines have addressed disease pathogenesis and treatment modalities for these complex patients. Herein, we review the severe asthma guidelines, compare the existing guidelines, address key areas that are yet to be addressed in the guidelines, and discuss future directions for severe asthma research. Recent Findings This is a narrative review of the 2019 European Respiratory Society/American Thoracic Society (ERS/ATS) and Global Initiative for Asthma (GINA) guidelines that specifically address the diagnosis and management of severe asthma. The pathophysiological mechanisms that underlie severe asthma are reviewed, and novel therapies that target specific pathophysiological pathways in severe asthma are discussed in detail. Although the guidelines address the use of novel biological therapies for patients with T2-mediated disease, data comparing these agents remain sparse. This review addresses several areas that are topics beyond the guidelines and highlight key areas where future research is warranted. Summary This review provides a comprehensive overview of the current state of severe asthma treatment and discusses potential avenues for future research for this patient population.Keywords
This publication has 90 references indexed in Scilit:
- Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010The Lancet, 2012
- Lebrikizumab Treatment in Adults with AsthmaNew England Journal of Medicine, 2011
- Association between Severity of Asthma and Degree of Chronic RhinosinusitisAmerican Journal of Rhinology & Allergy, 2011
- Transcriptional phenotypes of asthma defined by gene expression profiling of induced sputum samplesJournal of Allergy and Clinical Immunology, 2011
- Effectiveness and Safety of Bronchial Thermoplasty in the Treatment of Severe Asthma: A Multicenter, Randomized, Double-Blind, Sham-Controlled Clinical TrialAmerican Journal of Respiratory and Critical Care Medicine, 2010
- T-helper Type 2–driven Inflammation Defines Major Subphenotypes of AsthmaAmerican Journal of Respiratory and Critical Care Medicine, 2009
- Asthma and Sinusitis: Association and ImplicationInternational Archives of Allergy and Immunology, 2008
- Genome-wide profiling identifies epithelial cell genes associated with asthma and with treatment response to corticosteroidsProceedings of the National Academy of Sciences, 2007
- Treatment of chronic rhinosinusitis and its effects on asthmaEuropean Respiratory Journal, 2006
- Omalizumab, anti-IgE recombinant humanized monoclonal antibody, for the treatment of severe allergic asthmaJournal of Allergy and Clinical Immunology, 2001