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New severe asthma guidelines issued

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A redefinition of severe asthma and recommendations on how to treat it will be published in new guidelines this week.

The condition is thought to strike under one in 10 of all asthmatics.

But these sufferers shoulder the largest burden and need a disproportionate amount of healthcare costs to be spent on treating their illness, which is more difficult to control.

A joint task force of the European Respiratory Society and the American Thoracic Society is publishing the guidelines in the European Respiratory Journal.

The guidelines explain severe asthma as “asthma which requires treatment with high dose inhaled corticosteroids (ICS) plus a second controller (LABA or long-acting β2 agonists, leukotriene modifier, theophylline or systemic corticosteroids) to prevent it from becoming uncontrolled or which remains uncontrolled despite this therapy.”

This definition is aimed at helping the medical profession to confirm a diagnosis of severe asthma and address linked factors that could be making asthma hard to treat.

The guidelines give a detailed discussion of the classification (phenotyping) of patients with severe asthma because evidence indicates that the conditions affects people in varying ways.

Recent studies have started to cluster severe asthma into different kinds (or phenotypes) based on clinical and certain biological features of the condition.

Such results can assist scientists in creating targeted treatments for this group of people whose asthma remains hard to treat, despite taking the recommended therapies.

The guidelines also urge ongoing study into phenotyping severe asthma and discovering more successful treatments especially targeted at specific phenotypes of severe asthma.

Recommendations were made on five treatments that have been implemented or suggested for use in severe asthma.

These were anti-IgE treatment, methotrexate, anti-fungal treatment, macrolide antibiotics and bronchial thermoplasty.

Co-lead author Professor Fan Chung, of the Imperial College London and the Royal Brompton Hospital, said: “This new guideline provides a platform to help us understand severe asthma and how to treat it.”

The guideline is published online on December 12.


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