Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2015 Oct;15(5):452-6.
doi: 10.7861/clinmedicine.15-5-452.

Drug therapies in severe asthma - the era of stratified medicine

Kathy J Hetherington  1 , Liam G Heaney  2
Affiliations
Review

Drug therapies in severe asthma - the era of stratified medicine

Kathy J Hetherington et al. Clin Med (Lond). 2015 Oct.

Abstract

Difficult-to-treat asthma affects up to 20% of patients with asthma and is associated with significant healthcare cost. It is an umbrella term that defines a heterogeneous clinical problem including incorrect diagnosis, comorbid conditions and treatment non-adherence; when these are effectively addressed, good symptom control is frequently achieved. However, in 3-5% of adults with difficult-to-treat asthma, the problem is severe disease that is unresponsive to currently available treatments. Current treatment guidelines advise the 'stepwise' increase of corticosteroids, but it is now recognised that many aspects of asthma are not corticosteroid responsive, and that this 'one size fits all' approach does not deliver clinical benefit in many patients and can also lead to side effects. The future of management of severe asthma will involve optimisation with currently available treatments, particularly corticosteroids, including addressing non-adherence and defining an 'optimised' corticosteroid dose, allied with the use of 'add-on' target-specific novel treatments. This review examines the current status of novel treatments and research efforts to identify novel targets in the era of stratified medicines in severe asthma.

Keywords: Severe asthma; personalised medicine; stratified medicine.

PubMed Disclaimer

References

    1. Global Initiative for Asthma Global strategy for asthma management and prevention. Available online at www.ginasthma.org/local/uploads/files/GINA_Report_2014_Aug12.pdf [Accessed 19 March 2015].
    1. Hekking PP, Wener RR, Amelink M. The prevalence of severe refractory asthma. J Allergy Clin Immunol 2015;135:896–902. - PubMed
    1. Heaney LG, Robinson DS. Severe asthma treatment: need for characterising patients. Lancet 2005;365:974–6. - PubMed
    1. Chung KF, Wenzel SE, Brozek JL. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J 2014;43:343–73. - PubMed
    1. NHS England A14/S/1b – 2013/14 NHS standard contract for respiratory: severe asthma (adult). Available online at www.england.nhs.uk/wp-content/uploads/2013/06/a14-respiratory-sev-asthma... [Accessed 19 March 2015. ].

Substances