Clinical management of severe therapy-resistant asthma

ABSTRACT

Introduction: Severe therapy-resistant asthma is an area where there has been recent advances in understanding that is percolating into improvements in management.

Areas covered: This review covers the recent definition and approach to the diagnosis of severe asthma and its differentiation from difficult-to-treat asthma. The recent advances in phenotyping severe asthma and in ensuing changes in management approaches together with the introduction of new therapies are covered from a review of the recent literature.

Expert commentary: After ascertaining the diagnosis of severe asthma, patients need to be treated adequately with existing therapies. The management approach to severe asthma now comprises of a phenotyping step for the definition of either an allergic or eosinophilic severe asthma for which targeted therapies are currently available. This will lead to a precision medicine approach to the management of severe asthma.

KEYWORDS:

• Severe asthma
• difficult-to-treat asthma
• asthma guidelines
• phenotyping
• management of asthma
• eosinophilic asthma
• exhaled nitric oxide

Declaration of Interest

KF. Chung reports personal fees from Advisory Board membership with GSK, Boehringer Ingelheim, Novartis, Astra-Zeneca and Teva, personal fees from payments for lectures from Astra-Zeneca, Novartis and Merck, and grants for research to his institution from Merck and GSK, all in relation to asthma, COPD and cough. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

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Funding

This paper was not funded.