Severe and Difficult‐to‐Treat Asthma in Adults

@article{Israel2017SevereAD,
  title={Severe and Difficult‐to‐Treat Asthma in Adults},
  author={E. Israel and H. Reddel},
  journal={The New England Journal of Medicine},
  year={2017},
  volume={377},
  pages={965–976}
}
Adults with severe asthma consume substantial human and financial resources. This review examines the biology, current diagnosis, and treatment of this multifaceted condition. 

Paper Mentions

Interventional Clinical Trial
The primary objective of this study is to evaluate several interventions given to participants with severe asthma. Interventions are administered in a crossover manner with 16… Expand
ConditionsAsthma
InterventionDrug, Other
Escalating Inhaled Glucocorticoids to Prevent Asthma Exacerbations.
  • P. Bardin
  • Medicine
  • The New England journal of medicine
  • 2018
Inhaled glucocorticoids are pivotal to achieve asthma control and disease stability in both children and adults; despite their use, with or without other treatments, many patients with asthma have ...
Variability of blood eosinophils in patients in a clinic for severe asthma
  • Ewa Rakowski, Sibo Zhao, +6 authors J. Reibman
  • Medicine
  • Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
  • 2019
Blood eosinophils are used to determine eligibility for agents targeting IL‐5 in patients with uncontrolled asthma. However, little is known about the variability of blood eosinophil measures inExpand
Severe asthma in Australia Diagnosis of severe asthma
Patients are considered to have difficult-to-treat (difficult) asthma if their asthma remains uncontrolled despite high intensity asthma therapy (ie, high dose inhaled corticosteroids plus secondExpand
Severe asthma in Australia Managing comorbid conditions in severe asthma
• Personalised diagnosis and management of comorbid conditions are essential to achieving effective and improved outcomes for patients with severe asthma. Comorbidity is the presence of one or moreExpand
Involvement of the epidermal growth factor receptor in IL‐13–mediated corticosteroid‐resistant airway inflammation
TLDR
Effective treatment for severe asthma is a significant unmet need because many severe asthmatics exhibit corticosteroid‐unresponsive mixed granulocytic inflammation. Expand
Asthma: newer Tx options mean more targeted therapy.
It's an exciting era of asthma management, with the introduction of several novel modalities, including biological therapy and bronchial thermoplasty.
Addressing Comorbidities in Difficult Asthma
TLDR
The conditions discussed in this chapter will be allergic rhinitis, chronic rhinosinusitis with or without nasal polyps, aspirin-exacerbated respiratory disease, obstructive sleep apnea, gastroesophageal reflux disease/laryngopharyngealReflux disease, and vocal cord dysfunction. Expand
Update on Diagnosis and Management of Severe Asthma
TLDR
Patients with severe asthma comprise 5% to 10% of the patient population with asthma, but they use 60% of treatment costs, and nurse practitioners can facilitate timely and comprehensive treatment that can improve patient outcomes. Expand
Integrating Type 2 Biologics in the Management of Uncontrolled Severe Asthma: The Importance of Lung Function in Disease Control
A1267. ATS, San Diego, California, USA, May 17–22, 2019. 80. Regeneron Sanofi Genzyme. Dupixent (dupilumab) prescribing information. 2019. Available at: https://www.Expand
Biological treatments for severe asthma: where do we stand?
  • W. Busse
  • Medicine
  • Current opinion in allergy and clinical immunology
  • 2018
TLDR
For patients with severe asthma and biomarkers indicating a type 2 inflammatory pathway, the addition of biologics has proven to be an effective approach to achieve disease control and is an appropriate next step treatment. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 55 REFERENCES
Three phenotypes of adult‐onset asthma
TLDR
To identify underlying mechanisms of adult‐onset asthma and to capture predictors of disease progression, detailed characterization and phenotyping is necessary. Expand
The Asthma-COPD Overlap Syndrome.
TLDR
The asthma-COPD overlap syndrome is reviewed, showing an increasing awareness that many patients have features of both disorders. Expand
Safety and efficacy of a CXCR2 antagonist in patients with severe asthma and sputum neutrophils: a randomized, placebo‐controlled clinical trial
  • P. Nair, M. Gaga, +7 authors P. Chanez
  • Medicine
  • Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
  • 2012
Increased numbers of neutrophils are reported in the airways of patients with severe asthma. It is not clear if they contribute to the lack of control and severity. There are currently no strategiesExpand
Therapeutic interventions in severe asthma
TLDR
AIT, Allergen Immunotherapy, a prototype of Precision Medicine, is considered, also in light of the recent evidences of Sublingual Immunotherapy (SLIT) tablet efficacy and safety in mite allergic asthma patients. Expand
Mepolizumab for Severe Eosinophilic Asthma (DREAM): A Multicentre, Double-Blind, Placebo-Controlled Trial
TLDR
To elucidate the efficacy, safety, and patient characteristics of responsiveness to mepolizumab (a humanized monoclonal antibody against interleukin 5), a large number of patients with severe, eosinophilic asthma were enrolled in 81 multinational centers. Expand
The cost of treating severe refractory asthma in the UK: an economic analysis from the British Thoracic Society Difficult Asthma Registry
TLDR
This study uses data from the British Thoracic Society Difficult Asthma Registry to estimate direct healthcare treatment costs from an National Health Service perspective and examines factors that explain variations in costs. Expand
Noneosinophilic asthma: a distinct clinical and pathologic phenotype.
TLDR
Evidence is presented suggesting that noneosinophilic asthma represents a stable phenotype associated with a distinct lower airway pathology and structure and that elements of this immune response contribute to airway dysfunction. Expand
Lung imaging in asthmatic patients: the picture is clearer.
TLDR
New insights into current and future modalities for imaging in asthmatic patients and their application are discussed to potentially shed a clearer picture of the underlying pathophysiology of asthma, especially severe asthma, and the proposed clinical utility of imaging in patients with this common disease. Expand
Refractory asthma: mechanisms, targets, and therapy
TLDR
Investigation into the mechanisms behind glucocorticoid resistance will lead to novel treatments that improve control of severe refractory asthma and help patients with more severe disease who may be less responsive to steroids. Expand
International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma
TLDR
Recommendations and guidelines on the evaluation and treatment of severe asthma in children and adults and coordinated research efforts for improved phenotyping will provide safe and effective biomarker-driven approaches to severe asthma therapy are provided. Expand
...
1
2
3
4
5
...