Clinicians need a clear definition of severe asthma for precise management

November 14, 2017, American College of Allergy, Asthma, and Immunology

Those who treat patients suffering with severe asthma know how frustrating it can be to try to get the disease under control - despite the introduction in recent years of both biologics and bronchial thermoplasty. These treatments have proven effective, but require an understanding of all that is involved before being prescribed or recommended.

An article in the Annals of Allergy, Asthma and Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI), guides medical professionals through the principles involved in using these new treatments.

"The first principle is correctly identifying severe asthma, which is confusing among medical professionals," says allergist Michael Blaiss, MD, ACAAI Executive Medical Director and lead author. "The authors looked at definitions in the literature and from our own clinical practices, and came up with a user-friendly definition for the practicing clinician. We define severe asthma as asthma that, despite patient adherence, requires high-dose long-acting B2-agonists and/or additional controller medication, or requires oral corticosteroids to prevent it from becoming uncontrolled or that remains uncontrolled despite this therapy."

The authors emphasize that patient adherence must be verified before a patient is diagnosed as having severe asthma.

The article, "Guiding principles for use of newer biologics and bronchial thermoplasty for patients with severe asthma" examines therapeutic options for severe asthma prior to chronic steroid use. The recommendations were based on clinical data of preferred and alternative treatments depending on biomarkers. The included Venn diagram shows the overlap of allergic (IgE) and eosinophilic asthma, clearly demonstrating patients can fall into both categories.

"We felt strongly that before regular use of oral corticosteroids, because of the numerous complications with their chronic use, that other medical interventions should be considered related to the patient's asthma phenotype," says allergist Bradley Chipps, MD, ACAAI President and article co-author. "In contrast to what is usually seen in the literature on severe asthma, we thought that asthma phenotyping should be carried out at diagnosis and not after the patient is severe. Our hope is to prevent potentially poor outcomes before asthma symptoms worsen."

Explore further: Eczema plus family history can mean a longer hospital stay for kids with asthma

Related Stories

Eczema plus family history can mean a longer hospital stay for kids with asthma

October 27, 2017
Asthma and allergies are related, and many people who suffer from asthma have allergies that trigger their asthma. Research being presented at the American College of Allergy, Asthma and Immunology's (ACAAI) Annual Scientific ...

Maternal uncontrolled asthma ups risk of asthma in offspring

July 17, 2017
(HealthDay)—Children whose mothers have uncontrolled asthma during pregnancy are at increased risk of developing the disease at a young age, according to a study published online July 13 in the Journal of Allergy and Clinical ...

Bronchial thermoplasty helps reduce severe asthma attacks and ER visits

May 24, 2017
In a new study presented at the 2017 American Thoracic Society International Conference, adult asthma patients treated with bronchial thermoplasty (BT) had fewer severe exacerbations and were able to reduce their ER visits ...

Biologics for asthma: Attacking the source of the disease, not the symptoms

November 5, 2015
Imagine you suffer from severe asthma, and you've tried every treatment available, but nothing has worked. You still can't breathe. Then a new therapy comes along that attacks the source of the asthma, as opposed to the symptoms, ...

Study shows oral food challenges are safe for diagnosing food allergies

September 7, 2017
The best way to find out if someone has a food allergy is through an oral food challenge (OFC) where the person is given a very small dose of the food by mouth under the supervision of a board-certified allergist to test ...

Teens with asthma almost twice as likely to smoke as their healthy counterparts

November 11, 2016
Curiosity is a driving factor in why most kids start smoking, and the same is true for kids with asthma. A study presented at the American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting found ...

Recommended for you

A code for reprogramming immune sentinels

December 10, 2018
For the first time, a research team at Lund University in Sweden has successfully reprogrammed mouse and human skin cells into immune cells called dendritic cells. The process is quick and effective, representing a pioneering ...

Major breakthrough in quest for cancer vaccine

December 6, 2018
The idea of a cancer vaccine is something researchers have been working on for over 50 years, but until recently they were never able to prove exactly how such a vaccine would work.

Newly identified T cells could play a role in cancer and other diseases

December 6, 2018
Researchers from the UCLA Jonsson Comprehensive Cancer Center and the La Jolla Institute for Immunology have identified a new type of T cell called a phospholipid-reactive T cell that is able to recognize phospholipids, the ...

Classifying brain microglia: Which are good and which are bad?

December 6, 2018
Microglia are known to be important to brain function. The immune cells have been found to protect the brain from injury and infection and are critical during brain development, helping circuits wire properly. They also seem ...

Memory B cells in the lung may be important for more effective influenza vaccinations

December 5, 2018
Seasonal influenza vaccines are typically less than 50 percent effective, according to Centers for Disease Control and Prevention studies. Research at the University of Alabama at Birmingham, published this week in Nature ...

Tuberculosis survives by using host system against itself, study finds

December 5, 2018
In a new study published in the Journal of Experimental Medicine, scientists at the University of Notre Dame have discovered that the pathogen Mycobacterium tuberculosis (MTB) releases RNA into infected cells. This RNA stimulates ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.